Prof. Ingo Schäfer

Ingo Schäfer, MD, MPH, is a Psychiatrist and Psychotherapist at the University of Hamburg, Germany. He is director of the Center for Interdisciplinary Addiction Research (ZIS), head of the trauma and stress research group at the University Department of Psychiatry and Psychotherapy, and director of the coordinating center for traumatised refugees (Centra) in Hamburg. In the last 20 years, he has conducted research on the consequences of psychological trauma in children, adults from the general population, refugee populations, and patients with addiction and other mental disorders. He has coordinated nationwide research networks funded by the German Ministry for Education and Research (BMBF) on trauma and addiction in the general population (CANSAS, 2012-2016) and in refugee populations (PREPARE, 2019-2024). Over the years, he has built up several clinical departments and structures for patients with posttraumatic disorders, including the outpatient department for posttraumatic disorders at the University of Hamburg, an integrated outpatient treatment program for patients with borderline personality disorder, a specialized inpatient unit for traumatized patients with substance use disorders and the coordinating center for traumatised refugees. He is Past President of the German-speaking Society for Psychotraumatolgy (DeGPT) and the European Society for Traumatic Stress Studies (ESTSS). He coordinates the national German guideline for the treatment of posttraumatic stress disorder and the national guideline for opioid use disorders, is a member of the national council on childhood sexual abuse, an advisor of the psychotrauma center of the German armed forces, the EU centre of expertise for victims of terrorism, and various other organisations in the fields of addiction and psychotraumatology.

Background: Substance-related disorders are among the most common comorbidities in post-traumatic stress disorder. A lifetime diagnosis of harmful substance use or dependence is found in 25-50% of people with post-traumatic stress disorder. Conversely, depending on the setting, gender and substances used, up to half of people with substance use disorders also have a post-traumatic stress disorder. The dual diagnosis of post-traumatic stress disorder and addiction is associated with additional clinical challenges. For example, traumatized patients in addiction treatment have an earlier onset of addiction, more pre-treatment and a greater current severity of addiction. Regardless of the setting (trauma therapy or addiction treatment), therapeutic approaches for those affected must generally integrate interventions for both areas of the disorder. Methods: The lecture will present different clinical constellations in relation to the comorbidity of trauma-related disorders and addiction disorders. Adapted clinical concepts for this dual diagnosis will be presented, including the evidence for their effectiveness.

Results: A large number of therapeutic approaches are now available, most of which integrate cognitive-behavioral therapy (CBT) interventions from trauma therapy and addiction treatment. Stronger effects have often been described on the trauma-related disorders than on the substance-related problems.

Conclusion: Both problem areas must be addressed in a comprehensive treatment approach in order to achieve long-term stabilization. All available approaches for the treatment of trauma-related disorders can also be used safely and effectively in patients with additional substance disorders.

• Roberts NP, Lotzin A, Schäfer I. (2022). "A systematic review and meta-analysis of psychological interventions for comorbid post-traumatic stress disorder and substance use disorder". Eur J Psychotraumatol. 2022 May 3;13(1):2041831. doi: 10.1080/20008198.2022.2041831. PMID: 35558682; PMCID: PMC9090345.
• Schäfer I, Lotzin A. (2018). "Psychosocial support to tackle trauma-related symptoms and related substance use disorders". Council of Europe
• Schäfer I, et al (2017). "Understanding the role of childhood abuse and neglect as a cause and consequence of substance abuse: the German CANSAS network". Eur J Psychotraumatol. 2017 Mar 31;8(1):1304114. doi: 10.1080/20008198.2017.1304114. PMID: 28451071; PMCID: PMC5399994.