Cognitive profiles for comorbid depression and alcohol use disorders: Impact on response to treatment

  • Sally Hunt, Centre for Brain and Mental Health Research, University of Newcastle, Australia
  • A/Prof Amanda Baker, Centre for Brain and Mental Health Research, University of Newcastle, Australia
  • Dr Frances Kay-Lambkin, National Drug and Alcohol Research Centre, University of NSW, Australia
  • Mr Terry Lewin, Centre for Brain and Mental Health Research, University of Newcastle, Australia
  • Prof Patricia Michie, School of Psychology, University of Newcastle, Australia
  • Prof David Kavanagh, Queensland University of Technology, Australia

    • Aims: Clinicians are often asked to predict whether a client with depression and alcohol use co-morbidity will benefit from a psychological intervention such as Cognitive Behaviour Therapy (CBT). Few studies have investigated the impact of cognitive functioning on response to treatment for co-existing depression and alcohol use disorders. The current study aims to clarify these issues by examining the neuropsychological performance of participants with current co-morbid depression and alcohol use at hazardous levels, prior to entry to a CBT treatment trial.
    Study Design: Participants completed a comprehensive assessment of neuropsychological functioning, mental health and substance use history prior to random allocation to one of four CBT treatments (brief intervention, depression focused, alcohol focused, or integrated depression and alcohol treatments). Symptom assessments were repeated at 19-weeks post initial assessment.
    Participants: A sample of 167 people reporting a recent history of hazardous alcohol use and depression were recruited.
    Outcome Measures: Baseline neuropsychological assessment: Matrix Reasoning, Block Design, Vocabulary, Similarities, STROOP, Verbal Fluency, and Digit Span. Baseline and 15-week symptom assessment: BDI-II total score, GAF, OTI (drinks per day), Time Line Follow Back (drinks per week, drinking days per week and maximum drinks consumed).
    Results: Regression analyses demonstrated that Matrix Reasoning is a significant predictor of change in BDI-II total score from baseline to 19-weeks. Measures of cognitive functioning did not significantly predict change in alcohol use.
    Conclusions: This study presents novel findings which will be useful for clinicians and researchers in selecting appropriate treatments for people with depression and alcohol co-morbidity.