How common is alcohol use disorder in posttraumatic stress disorder? A systematic review, meta-analysis, and moderator analysis.
Maria Olivia Pozzolo Pedro, Manoela Pozzolo Pedro, Gabriella Zimmer Monteiro et al.
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In 30 seconds
This systematic review and meta-analysis examined alcohol use disorder (AUD) prevalence among adults with posttraumatic stress disorder (PTSD), using 20 observational studies with 185,432 participants. Because only three studies reported current AUD and were insufficient for meta-analysis, the pooled estimate concerns lifetime AUD: 35.58% (95% confidence interval [CI]: 24.48%-48.48%). Prevalence varied substantially across studies (I 2 = 99.37%). Clinical samples, inpatient settings, and veteran status were associated with higher prevalence; a greater proportion of female participants was associated with lower prevalence.
Key findings
- Pooled lifetime AUD prevalence among adults with PTSD was 35.58% (95% confidence interval [CI]: 24.48%-48.48%).
- Lifetime prevalence estimates showed high heterogeneity (I 2 = 99.37%).
- Clinical sample source, inpatient care, and veteran status were associated with higher lifetime AUD prevalence.
- A higher proportion of female participants was associated with lower prevalence; current versus lifetime PTSD assessment was associated with higher prevalence.
Why it matters
The substantial estimated lifetime burden and variation across populations indicate that AUD may be an important comorbidity in PTSD care. Differences by setting and participant characteristics can help clinicians interpret prevalence estimates in context and support attention to alcohol-related needs alongside trauma-related symptoms.
What to keep in mind
Current AUD studies were insufficient for meta-analysis, so the pooled estimate applies only to lifetime prevalence. The very high heterogeneity indicates substantial variation across included studies.