Clinical challenges in the treatment of patients with posttraumatic stress disorder and substance abuse

Curr Opin Psychiatry. 2007 Nov;20(6):614-8. doi: 10.1097/YCO.0b013e3282f0ffd9.


Purpose of review: The aim of this article is to review the current literature on co-occuring posttraumatic stress disorder and substance-use disorder, with an emphasis on clinical aspects and emerging treatments.

Recent findings: In clinical populations (focusing on either disorder), about 25-50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures. In recent years, several promising treatment programs have been developed specifically for co-occuring posttraumatic stress disorder and substance-use disorder, with one model having been established as effective thus far.

Summary: Comorbid posttraumatic stress disorder/substance-use disorder is a frequent diagnosis in clinical populations that severely affects course and outcome. Treatment approaches appropriate for this vulnerable population need to be evaluated further and implemented in routine practice.

Publication types

  • Review

MeSH terms

  • Comorbidity
  • Diagnosis, Dual (Psychiatry)
  • Humans
  • Psychotherapy / methods
  • Stress Disorders, Post-Traumatic / drug therapy
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / therapy*
  • Substance-Related Disorders / drug therapy
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / therapy*
  • Treatment Outcome