Psychological Interventions on Abstinence in Patients with Alcohol Use Disorder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Peiming Zhang; Jie Zhan; Shuting Wang; Yuyuan Tang; Huishan Chen; Yiqiao Wang; Xiaojing Wei; Hao Wen; Ting Pan; Ze Chen; Chunzhi Tang; Nenggui Xu; Liming Lu

doi:10.2147/NDT.S372300

Psychological Interventions on Abstinence in Patients with Alcohol Use Disorder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Neuropsychiatr Dis Treat. 2022 Aug 23:18:1815-1830. doi: 10.2147/NDT.S372300. eCollection 2022.

Authors

Peiming Zhang¹, Jie Zhan², Shuting Wang¹, Yuyuan Tang¹, Huishan Chen¹, Yiqiao Wang¹, Xiaojing Wei¹, Hao Wen³, Ting Pan⁴, Ze Chen¹, Chunzhi Tang¹, Nenggui Xu¹, Liming Lu¹

Affiliations

¹ Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, People's Republic of China.
² Postdoctoral Research Station, Department of Rehabilitation, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, People's Republic of China.
³ Department of Neurology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou City, Guangdong Province, People's Republic of China.
⁴ TCM Department, Foshan Fosun Chancheng Hospital, Foshan City, Guangdong Province, People's Republic of China.

Abstract

Purpose: Accumulating research suggests that psychotherapy helps improve abstinence but the difference in the efficacy of multiple psychotherapies in alcohol use disorder (AUD) remains to be explored.

Patients and methods: A systematic search of databases (Pubmed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and EBSCO) for studies (published from inception to April 10th.) of adults diagnosed with AUD accepting psychotherapies was conducted. Studies covering 9 countries and regions. The qualitative analysis pooled 2646 individuals from 34 randomized controlled trials (RCTs) and the networks included 1928 participants (23 RCTs). The outcomes included percentage of days abstinent (PDA), change in drinks per drinking day (change in DDD), and change in craving compared among individuals accepting various psychotherapies. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered on the International Prospective Register of Systematic Reviews (PROSPERO).

Results: For the network of PDA, motivational enhancement treatment (MET) (35.44, 11.78 to 59.09, high-certainty) and couple therapy (CT) (28.89, 13.42 to 44.36, moderate-certainty) were significantly different from treatment as usual (TAU) with the surface under the cumulative ranking curve (SUCRA) mean rank 1.9 and 1.9 respectively. TAU+supportive psychotherapy (SP) was better than TAU for the change in DDD in the high-quality direct comparison.

Conclusion: The motivational enhancement and the couple therapy show potential amelioration for alcohol abstinence. Additionally, the preferred interventions are different for improving PDA and change in DDD. The evidence network remains to be strengthened.

Keywords: alcohol use disorder; network meta-analysis; psychotherapy; randomized controlled trial; systematic review.

Publication types

Review

Grants and funding

This work was funded by:1. National Natural Science Foundation of China (Grant No. 82174527). (Liming Lu) URL: https://www.nsfc.gov.cn/2. The special project of “Lingnan modernization of traditional Chinese medicine” in 2019 Guangdong Provincial R & D Program (NO:2020B1111100008). (Nenggui Xu) URL: https://www.gdzwfw.gov.cn/portal/v2/guide/11440000006939801C2442003003007103. The Chinese Medicine Innovation Team Project of the State Administration of Traditional Chinese Medicine. (Nenggui Xu) URL: http://rjs.satcm.gov.cn/zhengcewenjian/2021-10-26/23006.html4. China Postdoctoral Science Foundation (No.2021M700906). (Jie Zhan) URL: https://jj.chinapostdoctor.org.cn/website/zhengshuchayan.html.The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.