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Randomized Controlled Trial
. 2013 Mar 21:13:93.
doi: 10.1186/1471-244X-13-93.

The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit - a randomised controlled trial with two year follow-up

Affiliations
Randomized Controlled Trial

The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit - a randomised controlled trial with two year follow-up

Gunnhild Bagøien et al. BMC Psychiatry. .

Abstract

Background: The prevalence of substance use in people acutely admitted to in-patient psychiatric wards is high and the patients` duration of stay is limited. Motivational interviewing is a method with evidence based effect in short interventions. The aims of the present study were to compare the effects of 2 sessions of motivational interviewing and treatment as usual (intervention group) with treatment as usual only (control group) on adult patients with comorbid substance use admitted to a psychiatric in-patient emergency unit.

Methods: This was an open randomised controlled trial including 135 patients where substance use influenced the admittance. After admission and assessments, the patients were allocated to the intervention group (n = 67) or the control group (n = 68). The primary outcome was self-reported days per month of substance use during the last 3 months at 3, 6, 12 and 24 months after inclusion. Data was analysed with a multilevel linear repeated measures regression model.

Results: Both groups reduced substance use during the first 12 months with no substantial difference between the 2 groups. At 2 year follow-up, the control group had increased their substance use with 2.4 days (95% confidence interval (CI) -1.5 to 6.3), whereas the intervention group had reduced their monthly substance use with 4.9 days (95% CI 1.2 to 8.6) compared to baseline. The 2 year net difference was 7.3 days of substance use per month (95% CI 1.9 to 12.6, p < 0.01) in favour of the intervention group.

Conclusions: The present study suggests that 2 sessions of motivational interviewing to patients with comorbid substance use admitted to a psychiatric emergency unit reduce substance use frequency substantially at 2 year follow-up.

Trial registration: ClinicalTrials.gov Identifier: NCT00184223.

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Figures

Figure 1
Figure 1
Recruitment and attrition according to CONSORT guidelines.
Figure 2
Figure 2
Estimated days per month of substance use the last 3 months. With 95% confidence intervals (vertical lines) as a function of months from baseline. Estimates based on a linear mixed model.

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