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

• Published in: Journal of substance abuse treatment 2014-03, Vol.46 (3), p.281-290
• Main Authors: Baker, Amanda L., Ph.D, Kavanagh, David J., Ph.D, Kay-Lambkin, Frances J., Ph.D, Hunt, Sally A., M.Psych. (Clin.), Lewin, Terry J., B.Com. (Psych)Hons, Carr, Vaughan J., M.D, McElduff, Patrick, Ph.D
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol Drinking - psychology; Alcoholism; Alcoholism - therapy; Behavior modification; Biological and medical sciences; Brief interventions; Clinical outcomes; Clinical trials; Cognitive behavior therapy; Cognitive Therapy; Comorbidity; Depression; Depression - therapy; Desintoxication. Drug withdrawal; Drug addiction; Female; Humans; Long-term outcomes; Male; Medical sciences; Mental depression; Middle Aged; Miscellaneous; Motivational Interviewing; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Randomization; Randomized controlled trial; Short term; Substance abuse treatment; Treatments
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2013.10.001

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.