Related Experiment Videos
Posttraumatic stress disorder and drug disorders: testing causal pathways
1Department of Psychiatry, Henry Ford Health Sciences Center, Detroit, Mich 48202-3450, USA. hchilco1@hfhs.org
Archives of General Psychiatry
|October 23, 1998
Summary
Posttraumatic stress disorder (PTSD) significantly increases the risk of developing drug use disorders, particularly with prescribed psychoactive drugs. However, drug use does not appear to increase the risk of developing PTSD after trauma exposure.
Area of Science:
- Psychiatry
- Psychology
- Epidemiology
Background:
- High comorbidity exists between posttraumatic stress disorder (PTSD) and drug use disorders.
- Causal relationships between PTSD, trauma exposure, and drug use disorders remain unclear.
Purpose of the Study:
- To investigate the causal links between posttraumatic stress disorder (PTSD), exposure to traumatic events, and the development of drug use disorders.
- To determine if PTSD precedes or follows drug use disorders.
Main Methods:
- Longitudinal study of 1007 adults aged 21-30 in southeast Michigan, followed for 5 years.
- Psychiatric disorders assessed using the National Institute of Mental Health Diagnostic Interview Schedule.
- Cox proportional hazards models with time-dependent covariates analyzed temporal sequencing.
Main Results:
- PTSD diagnosis significantly increased the risk of drug abuse or dependence (HR=4.5).
- Exposure to trauma without PTSD did not elevate drug abuse risk.
- Risk was highest for prescribed psychoactive drug abuse/dependence (HR=13.0).
- No evidence found that pre-existing drug use increased trauma exposure or PTSD risk.
Conclusions:
- Findings suggest drug use disorders in individuals with PTSD may be an attempt to self-medicate symptoms.
- Shared vulnerability to both PTSD and drug use disorders cannot be excluded as a potential factor.