Abstract
AimsTo determine the prevalence of comorbid probable post-traumatic stress disorder and alcohol misuse in a UK military cohort study and to determine the level of co-occurrence between these disorders; further aims were to investigate the association between alcohol misuse and the different PTSD symptom clusters, and to assess what factors are associated with probable PTSD in participants with alcohol misuse.MethodsData from 9984 participants of Phase 2 of the health and well-being survey of serving and ex-serving members of the UK Armed Forces were assessed for probable PTSD and alcohol misuse using the PTSD checklist (PCL-C) and the alcohol use disorders identification test (AUDIT), respectively.Results1.8 % [95 % confidence interval (CI) 1.5–2.1] of the sample met the criteria for both PTSD and alcohol misuse. All three symptom clusters of PTSD were significantly associated with alcohol misuse, with similar odds ranging from 2.46 to 2.85. Factors associated with probable PTSD in individuals reporting alcohol misuse were age [ages 30–34 (years): OR 2.51, 95 % CI 1.15–5.49; ages 40–44 years: OR 2.77, 95 % CI 1.18–6.47], officer rank (OR 0.36, 95 % CI 0.16–0.85), being in a combat role in parent unit (OR 1.99, 95 % CI 1.20–3.31) and common mental disorder (CMD) (OR 21.56, 95 % CI 12.00–38.74).ConclusionsThis study provides strong evidence that PTSD and alcohol misuse are often co-occurring. CMD was highly associated with probable PTSD in individuals with alcohol misuse.
Highlights
Posttraumatic stress disorder (PTSD) and alcohol misuse are both potentially debilitating disorders, and the association between the two is well established [1,2,3]
Aims To determine the prevalence of comorbid probable post-traumatic stress disorder and alcohol misuse in a UK military cohort study and to determine the level of cooccurrence between these disorders; further aims were to investigate the association between alcohol misuse and the different PTSD symptom clusters, and to assess what factors are associated with probable PTSD in participants with alcohol misuse
We have looked at the prevalence of PTSD in those scoring positively for alcohol misuse, the low overall prevalence of participants scoring positive for probable PTSD prevented us from having the statistical power to investigate what factors were associated with alcohol misuse in the PTSD group
Summary
Posttraumatic stress disorder (PTSD) and alcohol misuse are both potentially debilitating disorders, and the association between the two is well established [1,2,3]. Hazardous alcohol use or dependence is the most common comorbidity in males with PTSD [2], and the estimated prevalence of alcohol use disorders in individuals with PTSD is higher than that of the general population [4]. Results from the US National Comorbidity Survey (NCS) report a prevalence of PTSD of 10.3 % in men and 26.2 % in women who have alcohol dependence/misuse in the US general population, while the risk of developing alcohol dependence in those with previous PTSD was 2.67 and 3.37 times greater in men and women, respectively [10]. In the more recent NCS-replication, PTSD was associated with a higher risk (approximately four times the odds) of both alcohol dependence and alcohol abuse [11]. Alcohol misuse and PTSD share common risk factors, for example combat exposure [14, 15], childhood adversity [16, 17] and common mental disorder [18, 19]
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