Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers
Background Questions regarding the extent to which post-traumatic stress disorder (PTSD) is comorbid with alcohol and drug use are particularly germane in an era when the American College of Surgeons Committee on Trauma (ACS-COT) is considering policy requiring screening, intervention and/or referra...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-10-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/7/1/e000913.full |
| _version_ | 1826956401390387200 |
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| author | Eileen M Bulger Jin Wang Lauren K Whiteside Deepika Nehra Kathleen Moloney Douglas F Zatzick Joan Russo Jefferson Nguyen Laura Veach |
| author_facet | Eileen M Bulger Jin Wang Lauren K Whiteside Deepika Nehra Kathleen Moloney Douglas F Zatzick Joan Russo Jefferson Nguyen Laura Veach |
| author_sort | Eileen M Bulger |
| collection | DOAJ |
| description | Background Questions regarding the extent to which post-traumatic stress disorder (PTSD) is comorbid with alcohol and drug use are particularly germane in an era when the American College of Surgeons Committee on Trauma (ACS-COT) is considering policy requiring screening, intervention and/or referral services for patients presenting with psychological sequalae of traumatic injury. Literature review revealed few multisite trauma-center-based investigations that have assessed the association between PTSD symptoms and alcohol and drug use comorbidities in injured patients.Methods This investigation was a secondary analysis of baseline data collected prior to randomization in a 25-site trauma center pragmatic clinical trial. All 635 patients included in the investigation had elevated PTSD symptom levels at the time of trauma center admission. Self-report questionnaire screening, laboratory toxicology results, and electronic health record data were combined to assess the frequencies of alcohol, stimulant (i.e., amphetamine and cocaine), opioid and marijuana use comorbidities for injured patients. Logistic regression was used to assess the associations between demographic and injury characteristics and alcohol and drug use comorbidity.Results The frequency of patients with one or more alcohol or substance use comorbidity was between 62% and 79%. Over 50% of patients were positive for one or more alcohol or cannabis comorbidity. Approximately 26% of patients were positive for stimulants and 10% for opioid comorbidity.Discussion This multisite investigation suggests that between 62% and 79% of hospitalized injury survivors with elevated PTSD symptoms have one or more alcohol or drug use comorbidity. Orchestrated ACS-COT policy and trauma center service delivery development should incorporate the key finding that a substantial majority of patients with high levels of psychological distress (eg, elevated PTSD symptoms) may have alcohol and drug use comorbidities.Level of evidence Level II (epidemiological investigation of untreated controls from a multisite randomized clinical trial)Trial registration number NCT02655354. |
| first_indexed | 2024-03-13T00:09:53Z |
| format | Article |
| id | doaj.art-abccf4e1c3404e7082547c1f65529667 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2025-02-18T00:06:55Z |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-abccf4e1c3404e7082547c1f655296672024-11-30T08:35:10ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762022-10-017110.1136/tsaco-2022-000913Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centersEileen M Bulger0Jin Wang1Lauren K Whiteside2Deepika Nehra3Kathleen Moloney4Douglas F Zatzick5Joan Russo6Jefferson Nguyen7Laura Veach8Department of Surgery, University of Washington, Seattle, Washington, USA1 Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USADepartment of Surgery, University of Washington, Seattle, Washington, USADepartment of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USAPsychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USAPsychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USADepartment of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USADepartment of Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USABackground Questions regarding the extent to which post-traumatic stress disorder (PTSD) is comorbid with alcohol and drug use are particularly germane in an era when the American College of Surgeons Committee on Trauma (ACS-COT) is considering policy requiring screening, intervention and/or referral services for patients presenting with psychological sequalae of traumatic injury. Literature review revealed few multisite trauma-center-based investigations that have assessed the association between PTSD symptoms and alcohol and drug use comorbidities in injured patients.Methods This investigation was a secondary analysis of baseline data collected prior to randomization in a 25-site trauma center pragmatic clinical trial. All 635 patients included in the investigation had elevated PTSD symptom levels at the time of trauma center admission. Self-report questionnaire screening, laboratory toxicology results, and electronic health record data were combined to assess the frequencies of alcohol, stimulant (i.e., amphetamine and cocaine), opioid and marijuana use comorbidities for injured patients. Logistic regression was used to assess the associations between demographic and injury characteristics and alcohol and drug use comorbidity.Results The frequency of patients with one or more alcohol or substance use comorbidity was between 62% and 79%. Over 50% of patients were positive for one or more alcohol or cannabis comorbidity. Approximately 26% of patients were positive for stimulants and 10% for opioid comorbidity.Discussion This multisite investigation suggests that between 62% and 79% of hospitalized injury survivors with elevated PTSD symptoms have one or more alcohol or drug use comorbidity. Orchestrated ACS-COT policy and trauma center service delivery development should incorporate the key finding that a substantial majority of patients with high levels of psychological distress (eg, elevated PTSD symptoms) may have alcohol and drug use comorbidities.Level of evidence Level II (epidemiological investigation of untreated controls from a multisite randomized clinical trial)Trial registration number NCT02655354.https://tsaco.bmj.com/content/7/1/e000913.full |
| spellingShingle | Eileen M Bulger Jin Wang Lauren K Whiteside Deepika Nehra Kathleen Moloney Douglas F Zatzick Joan Russo Jefferson Nguyen Laura Veach Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers Trauma Surgery & Acute Care Open |
| title | Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers |
| title_full | Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers |
| title_fullStr | Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers |
| title_full_unstemmed | Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers |
| title_short | Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers |
| title_sort | post traumatic stress disorder ptsd symptoms and alcohol and drug use comorbidity at 25 us level i trauma centers |
| url | https://tsaco.bmj.com/content/7/1/e000913.full |
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