Social Psychiatry and Psychiatric Epidemiology

, Volume 49, Issue 9, pp 1401–1425 | Cite as

A systematic review of the comorbidity between PTSD and alcohol misuse

  • Frances Debell
  • Nicola T. Fear
  • Marc Head
  • Samantha Batt-Rawden
  • Neil Greenberg
  • Simon Wessely
  • Laura GoodwinEmail author



This systematic review aimed to assess (1) the level of comorbidity of post-traumatic stress disorder (PTSD) and alcohol misuse reported in research studies since 2007 and (2) any associations found between specific PTSD symptom clusters and alcohol misuse.


A literature search was carried out to capture any papers published from 2007 to the end of July 2012. Six hundred and twenty abstracts were identified and reviewed, and 42 papers were included in the final review after applying inclusion and exclusion criteria.


The prevalence of comorbid alcohol misuse in those with PTSD ranged from 9.8 to 61.3 %. The prevalence of comorbid PTSD in those with alcohol misuse ranged from 2.0 to 63.0 %, and the majority of prevalence rates were over 10.0 %. Almost all of the odds ratios representing the strength of association between the conditions across a variety of populations were significant, and those ranged from 1.1 to 4.87. Of the different PTSD symptom clusters, this review found most evidence for associations between alcohol misuse and both avoidance/numbing symptoms and hyperarousal symptoms.


Given that comorbidity appears to be common, the evidence from this systematic review supports the use of routine screening for comorbidity in populations who are known to have PTSD or alcohol misuse.


Post-traumatic stress disorder Alcohol misuse Alcohol use disorder Comorbidity 



This research received no specific grant from any funding agency, commercial or not-for-profit sectors. Dr Laura Goodwin receives salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London.

Conflict of interest

Professor Simon Wessely is Honorary Civilian Consultant Advisor in Psychiatry to the British Army and a Trustee of Combat Stress, a UK charity that provides services and support for veterans with mental health problems.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Frances Debell
    • 1
  • Nicola T. Fear
    • 2
    • 3
  • Marc Head
    • 1
  • Samantha Batt-Rawden
    • 2
  • Neil Greenberg
    • 3
  • Simon Wessely
    • 2
  • Laura Goodwin
    • 2
    Email author
  1. 1.King’s College London School of MedicineLondonUK
  2. 2.King’s Centre for Military Health Research, Department of Psychological Medicine, Institute of PsychiatryKing’s College LondonLondonUK
  3. 3.Academic Centre for Defence Mental Health, Department of Psychological Medicine, Institute of PsychiatryKing’s College LondonLondonUK

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