Characteristics and drinking patterns of veterans with alcohol dependence with and without post-traumatic stress disorder

• Veterans with AD were compared to those with AD + PTSD.
• Baseline demographic and clinical characteristics of the 2 groups were compared.
• Veterans with comorbidity had worse clinical outcomes across all domains.
• Veterans with AD+PTSD experienced more consequences from drinking than the AD group.

Alcohol use disorders and post-traumatic stress disorder (PTSD) are highly prevalent and commonly co-occur, notably in veterans. We explored differences in the pre-treatment characteristics of veterans with alcohol dependence (AD) alone compared to those with co-occurring AD and PTSD. Veterans were recruited to participate in two different treatment studies and baseline characteristics were compared. Those with co-occurring illnesses demonstrated significantly higher pre-treatment pathology across all psychopathological domains. While those with AD alone averaged more days of drinking and had more heavy drinking days, those with co-occurring illnesses reported more drinking-related symptoms. The presence of a major depressive episode had no effect on drinking. Within the PTSD group, combat exposure was associated with increased drinking independent of the severity of PTSD symptoms. This study underscores the importance of screening for comorbidity in clinical treatment settings, and for collecting detailed drinking histories and assessing psychiatric symptoms across all domains of psychopathology.