Integrated vs single-focussed treatment for depression and alcohol use problems: A randomised controlled trial

  • A/Prof Amanda Baker, Centre for Brain and Mental Health Research, University of Newcastle, Australia
  • Prof David Kavanagh, Queensland University of Technology, Australia
  • Sally Hunt, 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 Vaughan Carr, Schizophrenia Research Institute, Australia

    • Background: Depression and alcohol use problems commonly co-occur and this co-morbidity has been shown to result in poorer treatment outcomes than when the conditions are experienced independently. Despite this, effective evidenced-based treatments have yet to be developed and fully tested for addressing the unique needs of people with co-existing depression and alcohol use problems. The DAISI project is one of the first in the world to do so.
    Aims: To investigate whether an intervention that integrates treatment for depression and alcohol abuse was more efficacious in reducing alcohol use and symptoms of depression, than treatments that focus on alcohol or depression alone.
    Method: A sample of people who reported a recent history of hazardous alcohol use and depression were recruited. Participants were randomly allocated to one of four CBT/motivational interviewing treatments. The first three conditions offered 10 sessions which focused on a) depression (n=71); b) alcohol use (n=68); or c) integrated depression and alcohol focus (n=75). The remaining group received a single case formulation and assessment feedback session (n=70). Assessments took place at baseline, mid therapy and 15 weeks.
    Results: Participants in all treatment conditions demonstrated a significant improvement in depression and a reduction in alcohol use. Additionally, those who received the integrated intervention had lower depression scores than those in either of the single focused treatments.
    Conclusions: These findings should be useful for clinicians and researchers in selecting appropriate treatments for people with depression and alcohol use co-morbidity. Ongoing follow-up will clarify the longevity of these treatment effects.