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Randomized Controlled Trial
. 2010 Sep;24(3):453-65.
doi: 10.1037/a0019943.

Clinical outcomes of an integrated treatment for depression and substance use disorders

Katherine P Lydecker  1 , Susan R Tate, Kevin M Cummins, John McQuaid, Eric Granholm, Sandra A Brown
Affiliations
Randomized Controlled Trial

Clinical outcomes of an integrated treatment for depression and substance use disorders

Katherine P Lydecker et al. Psychol Addict Behav. 2010 Sep.

Abstract

The authors compared longitudinal treatment outcomes for depressed substance-dependent veterans (N = 206) assigned to integrated cognitive-behavioral therapy plus standard pharmacotherapy (ICBT + P) or 12-step facilitation therapy plus standard pharmacotherapy (TSF + P). Drug and alcohol involvement and depressive symptomology were measured at intake and at 3-month intervals during treatment and up to 1 year posttreatment. Participants in both treatment conditions showed decreased depression and substance use from intake. ICBT + P participants maintained improvements in substance involvement over time, whereas TSF + P participants had more rapid increases in use in the months following treatment. Decreases in depressive symptoms were more pronounced for TSF + P than ICBT + P in the 6 months posttreatment. Within both treatment groups, higher attendance was associated with improved substance use and depression outcomes over time. Initial levels of depressive symptomology had a complex predictive relationship with long-term depression outcomes. Early treatment response predicted long-term substance use outcomes for a portion of the sample. Although both treatments were associated with improvements in substance use and depression, ICBT + P may lead to more stable substance use reductions compared with TSF + P.

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Figures

Figure 1
Figure 1
Participant Flow Chart.
Figure 2
Figure 2
Modeled Substance Use Trajectories Based on Group Attendance and Early Treatment Response (The three sets of lines represent predicted PDA when Phase I PDA is at the 90th, 50th, and 10th percentile, respectively).
Figure 3
Figure 3
Modeled Depression Trajectories Based on Group Attendance and Intake Levels of Depression (The three sets of lines represent predicted HDRS when intake HDRS is at the 90th, 50th, and 10th percentile, respectively).
Figure 4
Figure 4
Percent Days Using Alcohol and Drugs for TSF+P and ICBT+P Participants.
See this image and copyright information in PMC

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