title: Treatment of comorbid alcohol use disorders and depression with cognitive-behavioural therapy and motivational interviewing: a meta-analysis.
abstract: OBJECTIVE
  To review published studies on the effectiveness of combining cognitive-behavioural therapy (CBT) and motivational interviewing (MI) to treat comorbid clinical and subclinical alcohol use disorder (AUD) and major depression (MDD) and estimate the effect of this compared with usual care.
  
  
  METHODS
  We conducted systematic literature searches in PubMed, PsycINFO and Embase up to June 2013 and identified additional studies through cross-references in included studies and systematic reviews. Twelve studies comprising 1721 patients met our inclusion criteria. The studies had sufficient statistical power to detect small effect sizes.
  
  
  RESULTS
  CBT/MI proved effective for treating subclinical and clinical AUD and MDD compared with controls, with small overall effect sizes at post-treatment [g=0.17, confidence interval (CI)=0.07-0.28, P<0.001 for decrease of alcohol consumption and g=0.27, CI: 0.13-0.41, P<0.001 for decrease of symptoms of depression, respectively]. Subgroup analyses revealed no significant differences for both AUD and MDD. However, digital interventions showed a higher effect size for depression than face-to-face interventions (g= 0.73 and g=0.23, respectively, P=0.030).
  
  
  CONCLUSIONS
  Combined cognitive-behavioural therapy and motivational interviewing for clinical or subclinical depressive and alcohol use disorders has a small but clinically significant effect in treatment outcomes compared with treatment as usual.
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, Amsterdam, the Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, the Netherlands; Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany.
authors.forename: Heleen
authors.initials: H
authors.lastname: Riper
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Hunter
authors.forename: Jessica
authors.initials: J
authors.lastname: de Wit
authors.forename: Matthias
authors.initials: M
authors.lastname: Berking
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
mesh_terms: D019973:Alcohol-Related Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D006801:Humans; D062405:Motivational Interviewing / Q000379:methods*; D016896:Treatment Outcome
keywords: Alcohol use disorders; cognitive-behavioural therapy; comorbidity; major depression; meta-analysis; motivational interviewing; randomized controlled trials; treatment effect