This study is the first to examine dissociation and childhood traumatization among hospitalized alcohol-dependent (AD) patients in Hungary. We aimed to identify a subgroup of AD patients characterized by childhood trauma and dissociative symptoms, and investigated potential differences in childhood traumatization, prior treatments, perceived effectiveness of these treatments and clinical severity.

Eighty-nine AD inpatients completed the Dissociative Experiences Scale, Multidimensional Inventory of Dissociation (MID), selected sections of the SR-DDIS, and four subscales of the Traumatic Antecedents Questionnaire (neglect, emotional, physical, and sexual abuse). Additional items assessed prior treatments, perceived effectiveness, and suicide attempts. Based on trauma history and dissociation level, three groups were formed: (1) AD without trauma or dissociation, (2) traumatized AD without dissociation, and (3) dissociative–traumatized AD.

Childhood trauma was reported by 76.9% of participants. The dissociative–traumatized group showed higher prevalence and longer duration of childhood sexual abuse than the traumatized group. Based on MID results, dissociative symptoms were observed exclusively in the dissociative–traumatized group, including voice hearing, identity confusion, flashbacks, derealization, and self-alteration. The dissociative–traumatized group initiated substance use earlier and had the youngest age at first psychiatric admission, indicating greater clinical severity. Longest remission duration and prevalence of suicide attempts also differed significantly across groups, with the dissociative–traumatized group showing the shortest abstinence duration and the highest prevalence of suicide attempts, further supporting a more severe clinical profile. Although perceived effectiveness of previous addiction treatments did not differ across groups, the dissociative–traumatized group sought psychotherapy more frequently and reported more ineffective prior treatments.

We identified a subgroup of AD patients with traumatization and dissociative symptoms, with more severe clinical profile and poorer treatment outcomes (perceived). Systematic assessment of childhood trauma and dissociative symptoms in AD patients is warranted, as these factors are associated with greater clinical severity and may be linked to poorer prognosis in the absence of trauma- and dissociation-informed treatment.