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

Amanda L Baker; David J Kavanagh; Frances J Kay-Lambkin; Sally A Hunt; Terry J Lewin; Vaughan J Carr; Patrick McElduff

doi:10.1016/j.jsat.2013.10.001

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

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

Authors

Amanda L Baker¹, David J Kavanagh², Frances J Kay-Lambkin³, Sally A Hunt⁴, Terry J Lewin⁵, Vaughan J Carr⁶, Patrick McElduff⁷

Affiliations

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.

PMID: 24210534
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.

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

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alcohol Drinking / psychology
Alcoholism / therapy*
Cognitive Behavioral Therapy*
Depression / therapy*
Female
Humans
Male
Middle Aged
Motivational Interviewing*