Psychiatry Research EG

Numerous studies have documented a strong correlation between trauma exposure and substance abuse in young people. A recent survey of adolescents revealed that teens who had experienced physical or sexual abuse/ assault were three times more likely to report past or current substance abuse than those without a history of trauma [1]. Surveys of adolescents receiving treatment for substance abuse have shown that more than 70% had a history of trauma exposure [2,3]. The link between trauma and substance abuse is even more striking among adolescents with posttraumatic stress disorder (PTSD). Studies indicated that up to 59% of young people with PTSD subsequently develop problems related to substance abuse [3–6]. Many researchers and providers point to the selfmedication hypothesis to explain the connection between trauma exposure and substance abuse, suggesting that youth resort to psychoactive drugs and alcohol in an attempt to cope with traumatic stress or reminders of loss. Although there is a lot of evidence to support this pathway, studies evaluating the frequency of substance abuse after trauma exposure have reported rates as high as 76% [6–9]. It is also true that substance abuse can increase an adolescent’s risk of trauma exposure and of experiencing traumatic stress symptoms. Successful treatment of adolescents with co-occurring traumatic stress and substance abuse therefore requires interventions that address the challenges of both disorders. Failure to provide such comprehensive treatments may significantly impair these teenagers’ likelihood of long-term recovery. In the absence of coping strategies to manage distress associated with trauma, adolescents with co-occurring disorders are more likely to relapse and revert to maladaptive coping strategies than are teenagers with substance abuse alone [10]. There are very few studies in Egypt that have investigated the characteristics of substance dependence in adolescents with a history of trauma [11]. The aim of this study was to address the characteristics of substance dependence and comorbid psychiatric disorders in adolescents with and without a history of trauma (physical or sexual) and in a subgroup that had PTSD.