Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: Outcomes to 36-months |
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| Authors: | Amanda L. Baker David J. Kavanagh Frances J. Kay-Lambkin Sally A. Hunt Terry J. Lewin Vaughan J. Carr Patrick McElduff |
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| Affiliation: | 1. Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Callaghan NSW 2308, Australia;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. Hunter New England Mental Health, Newcastle NSW 2300, Australia;5. Schizophrenia Research Institute and School of Psychiatry, University of New South Wales, NSW 2052, Australia;6. School of Medicine and Public Health, The University of Newcastle, Callaghan NSW 2308, Australia |
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| 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. |
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| Keywords: | Depression Alcohol dependence Comorbidity Cognitive behavior therapy Motivational interviewing Long-term outcomes Randomized controlled trial |
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