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J Subst Abuse Treat. 2014 Mar;46(3):281-90. doi: 10.1016/j.jsat.2013.10.001. Epub 2013 Oct 14.

Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: outcomes to 36-months.

Author information

1
Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Callaghan NSW 2308, Australia. Electronic address: Amanda.Baker@newcastle.edu.au.
2
Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology, Queensland 4001, Australia.
3
National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Australia.
4
Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Callaghan NSW 2308, Australia.
5
Hunter New England Mental Health, Newcastle NSW 2300, Australia.
6
Schizophrenia Research Institute and School of Psychiatry, University of New South Wales, NSW 2052, Australia.
7
School of Medicine and Public Health, The University of Newcastle, Callaghan NSW 2308, Australia.

Abstract

Integrated psychological treatment addressing co-existing alcohol misuse and depression has not been compared with single-focused treatment. This trial evaluates changes over 36 months following randomization of 284 outpatients to one of four motivational interviewing and cognitive-behavior therapy (MICBT) based interventions: (1) brief integrated intervention (BI); or BI plus 9 further sessions with (2) an integrated-, (3) alcohol-, or (4) depression-focus. Outcome measures included changes in alcohol consumption, depression (BDI-II: Beck Depression Inventory) and functioning (GAF: Global Assessment of Functioning), with average improvements from baseline of 21.8 drinks per week, 12.6 BDI-II units and 8.2 GAF units. Longer interventions tended to be more effective in reducing depression and improving functioning in the long-term, and in improving alcohol consumption in the short-term. Integrated treatment was at least as good as single-focused MICBT. Alcohol-focused treatment was as effective as depression-focused treatment at reducing depression and more effective in reducing alcohol misuse. The best approach seems to be an initial focus on both conditions followed by additional integrated- or alcohol-focused sessions.

KEYWORDS:

Alcohol dependence; Cognitive behavior therapy; Comorbidity; Depression; Long-term outcomes; Motivational interviewing; Randomized controlled trial

PMID:
24210534
DOI:
10.1016/j.jsat.2013.10.001
[Indexed for MEDLINE]

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