TY - JOUR
T1 - Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment
AU - Delgadillo, Jaime
AU - Gore, Stuart
AU - Ali, Shehzad
AU - Ekers, David
AU - Gilbody, Simon
AU - Gilchrist, Gail
AU - McMillan, Dean
AU - Hughes, Elizabeth
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Depressed mood often co-exists with frequent drug and alcohol use. This trial examined the feasibility of screening, recruitment, randomization and engagement of drug and alcohol users in psychological interventions for depression symptoms. A total of 50 patients involved in community drugs and alcohol treatment (CDAT) were randomly allocated to behavioral activation delivered by psychological therapists (n= 23) or to cognitive behavioral therapy based self-help introduced by CDAT workers (n= 27). We examined recruitment and engagement rates, as well as changes in depression (PHQ-9) symptoms and changes in percent days abstinent (PDA within last month) at 24. weeks follow-up. The ratio of screened to recruited participants was 4 to 1, and the randomization schedule successfully generated 2 groups with comparable characteristics. Follow-up was possible with 78% of participants post-treatment. Overall engagement in psychological interventions was low; only 42% of randomized participants attended at least 1 therapy session. Patients offered therapy appointments co-located in CDAT clinics were more likely to engage with treatment (odds ratio. = 7.14, p=.04) compared to those offered appointments in community psychological care clinics. Intention-to-treat analyses indicated no significant between-group differences at follow-up in mean PHQ-9 change scores (p=.59) or in PDA (p=.08). Overall, it was feasible to conduct a pragmatic trial within busy CDAT services, maximizing external validity of study results. Moderate and comparable improvements in depression symptoms over time were observed for participants in both treatment groups.
AB - Depressed mood often co-exists with frequent drug and alcohol use. This trial examined the feasibility of screening, recruitment, randomization and engagement of drug and alcohol users in psychological interventions for depression symptoms. A total of 50 patients involved in community drugs and alcohol treatment (CDAT) were randomly allocated to behavioral activation delivered by psychological therapists (n= 23) or to cognitive behavioral therapy based self-help introduced by CDAT workers (n= 27). We examined recruitment and engagement rates, as well as changes in depression (PHQ-9) symptoms and changes in percent days abstinent (PDA within last month) at 24. weeks follow-up. The ratio of screened to recruited participants was 4 to 1, and the randomization schedule successfully generated 2 groups with comparable characteristics. Follow-up was possible with 78% of participants post-treatment. Overall engagement in psychological interventions was low; only 42% of randomized participants attended at least 1 therapy session. Patients offered therapy appointments co-located in CDAT clinics were more likely to engage with treatment (odds ratio. = 7.14, p=.04) compared to those offered appointments in community psychological care clinics. Intention-to-treat analyses indicated no significant between-group differences at follow-up in mean PHQ-9 change scores (p=.59) or in PDA (p=.08). Overall, it was feasible to conduct a pragmatic trial within busy CDAT services, maximizing external validity of study results. Moderate and comparable improvements in depression symptoms over time were observed for participants in both treatment groups.
KW - Alcohol
KW - Cognitive behavioral therapy
KW - Comorbidity
KW - Depression
KW - Drugs
UR - http://www.scopus.com/inward/record.url?scp=84930415925&partnerID=8YFLogxK
U2 - 10.1016/j.jsat.2015.02.008
DO - 10.1016/j.jsat.2015.02.008
M3 - Article
C2 - 25819701
AN - SCOPUS:84930415925
SN - 0740-5472
VL - 55
SP - 6
EP - 14
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
ER -