Pregled bibliografske jedinice broj: 506547
Alcoholism and posttraumatic stress disorder
Alcoholism and posttraumatic stress disorder // Psychiatria Danubina 10 (2) - Proceedings from 18th Danube Symposion of Psychiatry / Jakovljević, Miro (ur.).
Zagreb: Medicinska naklada, 1998. str. 96-97 (poster, međunarodna recenzija, cjeloviti rad (in extenso), znanstveni)
Alcoholism and posttraumatic stress disorder
Uzun, Suzana ; Bajs, Maja ; Mimica, Ninoslav ; Folnegović-Šmalc, Vera ; Ljubin, Tajana
Vrsta, podvrsta i kategorija rada
Radovi u zbornicima skupova, cjeloviti rad (in extenso), znanstveni
Psychiatria Danubina 10 (2) - Proceedings from 18th Danube Symposion of Psychiatry / Jakovljević, Miro - Zagreb : Medicinska naklada, 1998, 96-97
18th Danube Symposion of Psychiatry
Mjesto i datum
Zagreb, Hrvatska, 04-06.06.1998
Alcoholism ; PTSD
All kinds of mental disorders can occur as the reaction to trauma, and the most frequent is posttraumatic stress disorder. Investigations show that the posttraumatic stress disorder occurs in 0.5% of men and in 1.3 % of women in general population. It has been found, as could be expected, that incidence grows with the severity of stress. After the war in Vietman 18-54% of veterans suffered from posttraumatic stress disorder. One investigation of the Vietnam veterans showed that from posttraumatic stress disorder suffered 26% participants in severe combats, 17% participants of less severe combats and 7% of those not directly involved in battles. Another study proved that 36% of Vietman veterans who participated in severe combats fulfilled the criteria for posttraumatic stress disorder, 24% of those in moderate battles, and 17% of soldiers not directly involved in battles. The investigations of war prisoners of the World War II showed that 67% of them suffered from PTSD after liberation from prison. Numerous investigations show taht patients fulfilling the diagnostic criteria for PTSD also fulfil diagnostic criteria (according to DSM IV) for other disorders. Most often are mentioned symptoms of depression and alcoholism. It seems that depression is in close correlation with PTSD. Besides the possibility of etiological connection of PTSD and depression (Foy 1994), it has been concluded that depression can be the consequence of despair connected with emotional burden of untreated chronic PTSD. Psychotic disorder can occur together with a postrtraumatic one, although such cases are rare. Among veterans of the Vietnam war very common are various personality disorders (paranoid, narcissistic, schizoid). The investigation also reveal that alcoholism often accompanies PTSD, as well as abuse of other psychoactive substances, as an additional diagnosis. Several authors state that past and present dependence accompany almost 100% of cases with PTSD symptoms. The results of Stewart et al. Point to the strong correlation among exposure to trauma, PTSD and acohol abuse, i.e. alcoholism. Taylor and Abrams in their investigation obtained the result that 64% of patients treated as PTSD fulfilled the diagnostic criteria for alcoholism. Furthermore, Sierls et al. speak about 76% of patients with the established diagnoses of PTSD and alcoholism, while Robins got the data of 65% of alcoholics in the group of patients with PTSD, and Spitzer of 64% of such patients. Seventy percent performed in 2490 Vietnams veterans showed the combination of diagnosis of PTSD and alcoholism in 73% of the cases. In his research Davidson shows that alcoholism and depression are the most frequent diagnostic categories in patients treated due to PTSD symptomatology. In the investigation of Jonathan et al. alcoholism is present in 97.3% of patients treated due to disturbances belonging to PTSD. The author finds the reasons for the occurence of alcoholism in the group of war veterans in the fact that they try to cope with the help of alcohol with symptomatology which characterizes PTSD after their return to civilian life (the examinees developed clinical features of alcoholism within 7 years after returning from war). The results of Bondewys point to the presence of alcoholism in the group of patients with PTSD symptoms in 91.1% of cases in the population of war veterans. According to the same author, alcoholism is the most frequent diagnosis connected with the diagnosis of PTSD. Barnett finds a stronger correlation between alcohol dependence and symptomatology of PTSD than it stated in clinical literature or in the program for Vietnam veterans. The investigation shows that Vietnam veterans who were exposed to war trauma for a longer time have a higher risk of developing problems connected with alcohol. The results of many other investigations show taht the group of patients with PTSD and comorbidity, particularly with alcoholism as the additional diagnosis, was more exposed to traumatic experience than the group with PTSD only. In our investigation were included 164 patients treated at the Department of General and Forensic Psychiatry and Clinical Psychophysiology, Psychiatric Hospital Vrapče, in the period from 1992 to 1997, under the diagnosis of PTSD. All the patients were male and diagnosed according to DSM IV criteria. The results show that patients also fulfilled, along with the basic diagnosis of PTSD, the diagnostic criteria for alcoholism (23.8%), depression (22.6%), permanent personality disorders (3%), psychotic disorder (1.8%), depression and alcoholism (1.2%). In 34.7% of the examinees were fulfilled only criteria for establishing the diagnosis of PTSD. In the group of patients fulfilling the diagnostic criteria for PTSD and alcoholism (23.8%), 82.1% of them did not consume alcoholic drinks before the start of war events, 12.8% used alcohol now and then, and only 1.5% of the examined belonged to the group of alcoholics before war, and were treated due to the problems connected with the excessive abuse of alcohol. Regarding the number of hospital treatments in the period 1992- 1997, in the group of examinees with the diagnoses of PTSD and alcoholism, 75.9% of them were hospitalized once, 12.8% twice, 5.1% three times, while 2.6% were treated four or more times. The mean age of this group was 37+/- 8.11 years. 46.2% did not finish primary school, 48.7% completed primary school, while 5.1% had secondary school qualifications. In the group with the diagnoses of PTSD and alcoholism 61.5% were married, 28.2% unmarried and 10.2% divorced. The results of our investigation point to a high correlation between posttraumatic stress disorder and alcohol dependence. The reason for this could be the attempt of patients to cope with PTSD symptomatology by means of alcohol. On the other hand there is great tolerance regarding the use of alcoholic drinks and disorders caused by excessive drinking. To consumate alcoholic drinks is considered as normal in our enviroment. It is certain that alcoholic dependence is one of the greatest and most untoward problems appearing in patients with PTSD. Namely, addiction complicates the course of the disease, and has negative effects upon treatment and rehabilitation.
Kliničke medicinske znanosti, Psihologija
Cited/abstracted in Excerpta Medica (EMBASE), Psychological abstracts/PsycINFO