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Posttraumatic Stress Disorders and Addiction

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Co-occurring Addictive and Psychiatric Disorders

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Abstract

Disorders related to stress or trauma are common among patients with substance use disorders (SUD). In clinical samples of patients with SUD, the prevalence of lifetime Posttraumatic Stress Disorder (PTSD) ranges from 26 % to 52 %, and from 15 % to 41 % for current PTSD. A substantial number of these patients suffer from the consequences of severe and prolonged interpersonal trauma usually referred to as “Complex PTSD”. Another common consequence of repeated interpersonal trauma in childhood are dissociative symptoms that may or may not co-occur with PTSD in SUD patients. While several hypotheses can explain the relationships between SUD and PTSD, the self-medication hypothesis has the strongest empirical support. Patients with both disorders have a more severe clinical profile than SUD patients without PTSD, poorer adherence to treatment, a shorter duration of abstinence, and worse outcomes across a variety of measures. Their clinical needs often make a treatment approach necessary that integrates SUD specific and trauma specific interventions. Several trauma treatments focusing on the present (i.e. providing skills training and psycho-education) and, more recently, also past-focused (i.e. exposure-based) treatments have been evaluated in SUD patients with co-occurring PTSD. Some of them outperformed SUD treatment-as-usual on PTSD and/or substance use outcomes. Findings on the effects of medication in patients with SUD and co-occurring PTSD are scarce and remain inconclusive.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Ingo Schäfer

  2. Quartier Mounicat, Bascous, France

    Willemien Langeland

Authors
  1. Ingo Schäfer
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  2. Willemien Langeland
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Correspondence to Ingo Schäfer .

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Editors and Affiliations

  1. Collaborative Psychiatric Research Institute, Antwerp University PC Alexian Brothers Boechout, Boechout, Belgium

    Geert Dom

  2. Clinical Psychological Service and Department, University Hospital of Psychiatry & University of Bern, Bern, Switzerland

    Franz Moggi

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Schäfer, I., Langeland, W. (2015). Posttraumatic Stress Disorders and Addiction. In: Dom, G., Moggi, F. (eds) Co-occurring Addictive and Psychiatric Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45375-5_12

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  • DOI: https://doi.org/10.1007/978-3-642-45375-5_12

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