PROGNOSTIC VALUE OF ALCOHOL USE DISORDERS IN COMBATANTS WITH POST-TRAUMATIC STRESS DISORDER FOR THE SEVERITY OF COGNITIVE DYSFUNCTION

Abstract

Introduction. Literature data on the impact of alcohol use disorders (AUD) on cognitive function in combatants with post-traumatic stress disorder (PTSD) remain inconclusive, which underscores the rationale and relevance of the present study. Aim. To assess the prognostic value of alcohol use disorders in combatants with post-traumatic stress disorder in relation to the severity of cognitive dysfunction. Materials and methods. The study analyzed the results of examinations of 274 inpatients with PTSD, all of whom were male combatants aged 20-56 years. Depending on the presence of AUD, the patients were divided into two groups: those with isolated PTSD and those with PTSD comorbid with AUD. PTSD was diagnosed according to Order No. 121 of the Ministry of Health of Ukraine dated February 23, 2016. AUD was assessed using the CAGE, AUDIT, and CIWA-Ar tests, while cognitive function was evaluated using the MMSE, MoCA, SAGE, Clock Drawing Test, and 10-Word Recall Test. The results were statistically analyzed and presented as (M±m). Prognostic value was determined using multivariable logistic regression analysis. Results. Alcohol use disorders in combatants were associated with an increased frequency of difficulties with concentration and feelings of loneliness, fluctuations in blood pressure, episodes of dizziness, and flashbacks. In combatants with PTSD, AUD was a prognostic marker of difficulty concentrating, increasing its likelihood by 9.76-fold (p<0.0001), and of feelings of loneliness, increasing the likelihood by 1.69-fold (p=0.057). The comorbidity of PTSD and AUD increased the likelihood of dementia according to the MMSE by 7.24-fold (p=0.001), cognitive dysfunction according to the SAGE by 3.30-fold (p=0.0002), and impairment on the Clock Drawing Test by 2.04-fold (p=0.015), as well as increasing the likelihood of medium and low memory performance by 33.45-fold (p<0.0001). Conclusions. Alcohol use disorders in combatants with post-traumatic stress disorder are a marker of cognitive dysfunction and are associated with an increased likelihood and severity of cognitive impairment.