Randomized controlled trial of cognitive-behavioural therapy for coexisting depression and alcohol problems: short-term outcome.
OBJECTIVE
Alcohol use disorders and depression co-occur frequently and are associated with poorer outcomes than when either condition occurs alone. The present study (Depression and Alcohol Integrated and Single-focused Interventions; DAISI) aimed to compare the effectiveness of brief intervention, single-focused and integrated psychological interventions for treatment of coexisting depression and alcohol use problems.


METHODS
Participants (n = 284) with current depressive symptoms and hazardous alcohol use were assessed and randomly allocated to one of four individually delivered interventions: (i) a brief intervention only (single 90-minute session) with an integrated focus on depression and alcohol, or followed by a further nine 1-hour sessions with (ii) an alcohol focus; (iii) a depression focus; or (iv) an integrated focus. Follow-up assessments occurred 18 weeks after baseline.


RESULTS
Compared with the brief intervention, 10 sessions were associated with greater reductions in average drinks per week, average drinking days per week and maximum consumption on 1 day. No difference in duration of treatment was found for depression outcomes. Compared with single-focused interventions, integrated treatment was associated with a greater reduction in drinking days and level of depression. For men, the alcohol-focused rather than depression-focused intervention was associated with a greater reduction in average drinks per day and drinks per week and an increased level of general functioning. Women showed greater improvements on each of these variables when they received depression-focused rather than alcohol-focused treatment.


CONCLUSIONS
Integrated treatment may be superior to single-focused treatment for coexisting depression and alcohol problems, at least in the short term. Gender differences between single-focused depression and alcohol treatments warrant further study.
Baker
Amanda L
AL
Centre for Brain and Mental Health Research, The University of Newcastle, University Drive, Callaghan, NSW, Australia. amanda.baker@newcastle.edu.au
Kavanagh
David J
DJ
Kay-Lambkin
Frances J
FJ
Hunt
Sally A
SA
Lewin
Terry J
TJ
Carr
Vaughan J
VJ
Connolly
Jennifer
J
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology / Q000628:therapy*; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D000434:Alcoholic Beverages / Q000706:statistics & numerical data; D000704:Analysis of Variance; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome; D055815:Young Adult