Citation

Mansfield AJ, Greenbaum MA, Schaper KM, Banducci AN, Rosen CS. Psychiatr. Serv. 2017; 68(6): 632-635.

Affiliation

Dr. Mansfield and Ms. Schaper are with the National Center for PTSD-Pacific Islands Division, U.S. Department of Veterans Affairs (VA) Pacific Islands Health Care System, Honolulu, and Dr. Mansfield is also with the Department of Health Policy and Management, University of North Carolina at Chapel Hill (e-mail: damon@unc.edu ). Mr. Greenbaum, Dr. Banducci, and Dr. Rosen are with the National Center for PTSD-Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California. Mr. Greenbaum is also with the VA Sierra Pacific Network Mental Illness Research, Education and Clinical Center, Palo Alto, California. Dr. Banducci and Dr. Rosen are also with the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.

Copyright

(Copyright © 2017, American Psychiatric Association)

DOI

10.1176/appi.ps.201600128

PMID

28245698

Abstract

OBJECTIVE: This study examined whether a co-occurring substance use disorder contributed to disparities in receipt of Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) specialty care or psychotherapy.

METHODS: Logistic regression, controlling for sociodemographic characteristics, was used to examine predictors of PTSD care among 424,211 veterans with confirmed PTSD (two or more PTSD diagnosis encounters) who accessed care in a VHA facility between fiscal years 2009 and 2010.

RESULTS: Overall, 16% of veterans had PTSD and a co-occurring substance use disorder diagnosis. In adjusted analyses, veterans with a co-occurring substance use disorder were more likely than veterans with PTSD alone to receive any outpatient PTSD specialty care and complete eight or more sessions of outpatient psychotherapy within 14 weeks, but they were less likely to be treated in inpatient PTSD specialty units.

CONCLUSIONS: Co-occurring substance use disorders did not appear to hinder receipt of outpatient specialty PTSD treatment or of sufficient psychotherapy among VHA-enrolled veterans.

Language: en

Keywords

Posttraumatic stress disorder (PTSD), Dual diagnosis, Alcohol abuse; drug abuse, Outpatient treatment, Inpatient treatment