Objectives

Opioid use disorder (OUD) is a public health emergency. Evidence suggests that posttraumatic stress disorder (PTSD) is common among individuals with OUD; however, few studies evaluate whether concurrent diagnoses affect treatment outcomes. This review examines the impact of concurrent diagnoses of OUD and PTSD on treatment outcomes.

Methods

A search was performed using articles identified through June 30, 2020 in PubMed, PsycINFO, and EMBASE. Included peer-reviewed articles evaluated individuals with OUD and a PTSD diagnosis via standardized assessment and/or medical record diagnoses, and reported relationships between diagnosis and treatment outcomes and/or other psychiatric conditions.

Results

Out of 412 articles, 17 studies met inclusion criteria for this review (from 13 databases). Articles included had a total of n = 2190 with OUD, with n = 79 non-OUD comparison participants. Studies examining individuals with OUD revealed comorbid PTSD was associated with more severe addiction, higher rates of depression, attempted suicide, and psychosocial problems.

Conclusions

Among individuals with OUD, presence of PTSD is associated with multiple mental health problems. The impact of PTSD on drug use is inconclusive. Although only 5 studies examined psychosocial PTSD treatment, all found PTSD-focused treatment to be effective for those with comorbid OUD. Overall, results suggest the need to better identify PTSD among those with OUD, and to develop and evaluate interventions that are brief, integrative, and easy to implement in clinical settings.

中文翻译：

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被诊断患有共病阿片类药物使用障碍和创伤后应激障碍的个体的治疗结果：综述

目标

阿片类药物使用障碍 (OUD) 是一种突发公共卫生事件。有证据表明，创伤后应激障碍 (PTSD) 在 OUD 患者中很常见；然而，很少有研究评估并发诊断是否会影响治疗结果。本综述探讨了同时诊断 OUD 和 PTSD 对治疗结果的影响。

方法

使用截至 2020 年 6 月 30 日在 PubMed、PsycINFO 和 EMBASE 中确定的文章进行搜索。纳入的同行评审文章通过标准化评估和/或病历诊断评估了患有 OUD 和 PTSD 诊断的个体，并报告了诊断与治疗结果和/或其他精神疾病之间的关系。

结果

在 412 篇文章中，17 项研究符合本综述的纳入标准（来自 13 个数据库）。包含的文章共有n  = 2190 篇带有 OUD 的文章，其中n  = 79 名非 OUD 比较参与者。对 OUD 患者进行的研究显示，合并的 PTSD 与更严重的成瘾、更高的抑郁率、自杀未遂和心理社会问题有关。

结论

在 OUD 患者中，PTSD 的存在与多种心理健康问题有关。创伤后应激障碍对吸毒的影响尚无定论。虽然只有 5 项研究检查了社会心理 PTSD 治疗，但所有研究都发现以 PTSD 为重点的治疗对合并 OUD 的人有效。总体而言，结果表明需要更好地识别 OUD 患者中的 PTSD，并开发和评估简短、综合且易于在临床环境中实施的干预措施。