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Am J Psychiatry 1997; 154:752-757
Copyright © 1997 by American Psychiatric Association
Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents
EY Deykin and SL Buka
Department of Psychiatry, Harvard Medical School, Boston, USA. Deykin.Eva_Y@Boston.VA.-Gov or Dandeykin@aol.com
OBJECTIVE: This study ascertained the prevalence of posttraumatic stress
disorder (PTSD) among chemically dependent adolescents and identified
factors that influence the risk of PTSD after a qualifying trauma. METHOD:
The study group consisted of 297 adolescents aged 15-19 years who met the
DSM-III-R criteria for dependence on alcohol or other drugs and who were
receiving treatment in seven publicly funded Massachusetts facilities. PTSD
and other axis I diagnoses were assessed by the Diagnostic Interview
Schedule. Data on risk factors were collected by a specially constructed
interview schedule. RESULTS: The lifetime prevalence of PTSD was 29.6%
(24.3% for males and 45.3% for females), and the current prevalence was
19.2% (12.2% for males and 40.0% for females). These prevalences reflect a
high occurrence of traumatic exposures and a high case rate among those who
experienced trauma. The risk of PTSD varied with the nature of the trauma,
the number of traumas experienced, psychiatric comorbidity, and familial
characteristics. The higher rate of PTSD among females was due to a greater
frequency of rape, which carries a high risk of PTSD development, and to a
high rate of comorbid conditions. CONCLUSIONS: The lifetime prevalence of
PTSD among these chemically dependent adolescents is five times that
reported for a community sample of adolescents. This extremely high rate
provides new understanding of the etiologic connection between PTSD and
chemical dependence and has implications for their treatment.
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