title: The influence of depression on treatment for methamphetamine use.
abstract: OBJECTIVE
  To determine whether the presence of comorbid depression influences response to psychological treatment for methamphetamine use.
  
  
  METHODS
  Randomised controlled clinical trial.
  
  
  METHODS
  Our study was conducted between 2001 and 2005 at two sites in Australia: the Hunter Region of New South Wales and the city of Brisbane, Queensland. The 214 participants, who were all using methamphetamine at least once a week in the month prior to the study, were self-referred or referred from health services or drug and alcohol clinical services. Participants were divided into two groups based on whether or not they had depressive symptoms at baseline.
  
  
  METHODS
  The control group received only a self-help booklet; the two treatment groups received either two or four counselling sessions involving cognitive behaviour therapy and motivational interviewing techniques to manage methamphetamine use.
  
  
  METHODS
  Changes in methamphetamine use and depression at 5 weeks and 6 months after baseline.
  
  
  RESULTS
  Over 70% of participants met criteria for depression at baseline, and depression was associated with significantly greater severity of methamphetamine use and related issues. Benzodiazepine use was significantly higher among depressed than non-depressed participants. Reductions in methamphetamine use between baseline and 5 weeks were independently predicted by comorbid depression, in favour of increased change among those with baseline depression. Depressed participants who received three or four counselling sessions showed a significant reduction in depression at 5 weeks. However, reductions in methamphetamine use and depression compared with baseline were no longer evident at 6 months.
  
  
  CONCLUSIONS
  Over the short term, comorbid depression did not negatively affect response to treatment, with some evidence of a dose-response treatment effect for reduction in depression. This was not maintained at 6 months, indicating that methamphetamine-focused treatment may not enable people with comorbid depression to make sustained improvement at the level of their counterparts without depression.
  
  
  BACKGROUND
  ACTRN12611000355976.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. f.kaylambkin@unsw.edu.au
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Kay-Lambkin
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Baker
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Lee
authors.forename: Linda
authors.initials: L
authors.lastname: Jenner
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Lewin
mesh_terms: D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D000704:Analysis of Variance; D001315:Australia / Q000453:epidemiology; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003376:Counseling; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult