title: Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: outcomes to 36-months.
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.
authors.affiliation: Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Callaghan NSW 2308, Australia. Electronic address: Amanda.Baker@newcastle.edu.au.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Baker
authors.affiliation: Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology, Queensland 4001, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Kavanagh
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Australia.
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Kay-Lambkin
authors.affiliation: Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Callaghan NSW 2308, Australia.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Hunt
authors.affiliation: Hunter New England Mental Health, Newcastle NSW 2300, Australia.
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Lewin
authors.affiliation: Schizophrenia Research Institute and School of Psychiatry, University of New South Wales, NSW 2052, Australia.
authors.forename: Vaughan J
authors.initials: VJ
authors.lastname: Carr
authors.affiliation: School of Medicine and Public Health, The University of Newcastle, Callaghan NSW 2308, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McElduff
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing
keywords: Alcohol dependence; Cognitive behavior therapy; Comorbidity; Depression; Long-term outcomes; Motivational interviewing; Randomized controlled trial