Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment

Jaime Delgadillo, Stuart Gore, Shehzad Ali, David Ekers, Simon Gilbody, Gail Gilchrist, Dean McMillan, Elizabeth Hughes

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

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.

LanguageEnglish
Pages6-14
Number of pages9
JournalJournal of Substance Abuse Treatment
Volume55
DOIs
Publication statusPublished - 1 Aug 2015

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Randomized Controlled Trials
Alcohols
Depression
Pharmaceutical Preparations
Psychology
Appointments and Schedules
Therapeutics
Random Allocation
Pragmatic Clinical Trials
Intention to Treat Analysis
Cognitive Therapy
Drug Users
Reproducibility of Results
Odds Ratio

Cite this

Delgadillo, Jaime ; Gore, Stuart ; Ali, Shehzad ; Ekers, David ; Gilbody, Simon ; Gilchrist, Gail ; McMillan, Dean ; Hughes, Elizabeth. / Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment. In: Journal of Substance Abuse Treatment. 2015 ; Vol. 55. pp. 6-14.
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Feasibility Randomized Controlled Trial of Cognitive and Behavioral Interventions for Depression Symptoms in Patients Accessing Drug and Alcohol Treatment. / Delgadillo, Jaime; Gore, Stuart; Ali, Shehzad; Ekers, David; Gilbody, Simon; Gilchrist, Gail; McMillan, Dean; Hughes, Elizabeth.

In: Journal of Substance Abuse Treatment, Vol. 55, 01.08.2015, p. 6-14.

Research output: Contribution to journalArticle

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