Changes in alcohol consumption after treatment for depression: a secondary analysis of the Swedish randomised controlled study REGASSA

Strid, Catharina; Hallgren, Mats; Forsell, Yvonne; Kraepelien, Martin; Öjehagen, Agneta

doi:10.1136/bmjopen-2018-028236

Cited by 8 publications

(7 citation statements)

References 41 publications

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“…Lastly, since we did not assess alcohol or drug use after treatment or at follow-up, we are unable to comment on whether drug or alcohol use changed over the course of treatment, perhaps due to the treatment itself. A recent study on ICBT for depression found that alcohol consumption had not changed markedly at the 12-month follow-up, despite positive changes in relation to depression ( Strid et al, 2019 ). Future studies could further investigate to what extent ICBT for depression and anxiety affects alcohol and drug use, even when it's not addressed.…”

Section: Discussionmentioning

confidence: 99%

Alcohol and drug use among clients receiving internet-delivered cognitive behavior therapy for anxiety and depression in a routine care clinic – Demographics, use patterns, and prediction of treatment completion and outcomes

Sundström

Edmonds

Soucy

et al. 2022

Internet Interventions

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Background Research shows that alcohol and drug use among mental health clients is common and has the potential to negatively impact treatment outcomes. Internet-delivered cognitive behavior therapy (ICBT) as a treatment for anxiety and depression is on the rise, but little is known about the prevalence of alcohol and drug use among clients and how this use affects treatment completion and outcomes. Objective The objective of the current study was to explore the prevalence of alcohol and drug use among clients in ICBT for depression and anxiety, and to investigate the impact of alcohol and drug use on treatment completion and symptom outcomes. Material and methods Data was collected from 1155 clients who participated in two randomized ICBT trials for depression and anxiety, conducted in a routine care clinic. Thirty-five individuals reporting severe substance use when applying to the trials were excluded. Demographic variables, and alcohol and drug use were measured at screening, and measures of depression and anxiety were administered at pre- and post-treatment. Results Four out of five clients reported having used alcohol in the past year, while one in five reported having used drugs in the past year. Around a third of clients had reported either problematic alcohol use, drug problems, or both. The analyses showed that drug problems, and combined alcohol and drug problems were negatively associated with treatment completion, but neither alcohol nor drug use had an impact on depression and anxiety outcomes. Conclusions Alcohol and drug problems are likely to be present among a large proportion of patients using ICBT for anxiety and depression. This may not be a barrier to treatment benefit, at least when those with severe alcohol and drug problems have been excluded.

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Section: Discussionmentioning

confidence: 99%

Alcohol and drug use among clients receiving internet-delivered cognitive behavior therapy for anxiety and depression in a routine care clinic – Demographics, use patterns, and prediction of treatment completion and outcomes

Sundström

Edmonds

Soucy

et al. 2022

Internet Interventions

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“…Second, depression treatment alone is not always effective in reducing problematic alcohol use. A recent study showed that despite clinically relevant effects of both digital and regular depression treatment, alcohol use among depressed hazardous drinkers remained unchanged ( Strid et al. , 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Digital Interventions for People With Co-Occurring Depression and Problematic Alcohol Use: A Systematic Review and Meta-Analysis

Schouten

Christ

Dekker

et al. 2021

Alcohol and Alcoholism

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Aims This systematic review and meta-analysis assessed the effectiveness of digital interventions addressing depressive symptoms and alcohol use simultaneously among people with co-occurring depression and problematic alcohol use. Methods Seven databases were searched for trials evaluating digital interventions aimed at depression and alcohol use. Random-effects meta-analyses were conducted to pool effects on depressive symptoms and alcohol use up to 3-month and 6-month follow-up. Overall quality for every outcome was assessed with GRADE (Grading of Recommendations Assessment, Development and Evaluation). Results The pooled effect of digital interventions compared to their comparators was in favour of digital interventions. Small but significant effects on depressive symptoms at 3-month follow-up were found (g = 0.34, 95% confidence interval (CI): 0.06–0.62, P = 0.02, k = 6) and non-significant effects at 6-month follow-up (g = 0.29, 95% CI: −0.16 to 0.73, P = 0.15, k = 5). For alcohol use, the pooled effect of digital interventions was small and non-significant at 3-month follow-up (g = 0.14, 95% CI: −0.02 to 0.30, P = 0.07, k = 6) and significant at 6-month follow-up (g = 0.14, 95% CI: 0.07–0.20, P = 0.005, k = 5). Sensitivity analysis indicated the latter finding to be sensitive to statistical estimator choice. Quality of evidence was moderate, except for depressive symptoms at 6-month follow-up for which it was low. Conclusion Based on the literature, digital interventions are effective in reducing depressive symptoms at 3-month follow-up and alcohol use at 6-month follow-up among people with comorbid depression and problematic alcohol use. More high-quality trials are needed to confirm the current findings.

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“…After randomly assigning 31 smokers to continue smoking and 33 smokers to quit, anxiety and depressive symptoms decreased (more) in the latter group during 3 months follow-up (Dawkins, Powell, Pickering, Powell, & West, 2009). Among 540 participants randomly assigned to receive different types of treatment for depression there were significant treatment effects on depressive symptoms, but no changes in alcohol consumption (Strid, Hallgren, Forsell, Kraepelien, & Öjehagen, 2019). A considerable amount of work has focussed on cognitive behavioral therapy (CBT) to reduce alcohol consumption.…”

Section: Experimental Evidence From Human Studiesmentioning

confidence: 99%

“…Among 540 participants randomly assigned to receive different types of treatment for depression there were significant treatment effects on depressive symptoms, but no changes in alcohol consumption (Strid, Hallgren, Forsell, Kraepelien, & Öjehagen, 2019 ). A considerable amount of work has focussed on cognitive behavioral therapy (CBT) to reduce alcohol consumption.…”

Section: Introductionmentioning

confidence: 99%

Using Mendelian randomization analysis to better understand the relationship between mental health and substance use: a systematic review

et al. 2021

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Background Poor mental health has consistently been associated with substance use (smoking, alcohol drinking, cannabis use, and consumption of caffeinated drinks). To properly inform public health policy it is crucial to understand the mechanisms underlying these associations, and most importantly, whether or not they are causal. Methods In this pre-registered systematic review, we assessed the evidence for causal relationships between mental health and substance use from Mendelian randomization (MR) studies, following PRISMA. We rated the quality of included studies using a scoring system that incorporates important indices of quality, such as the quality of phenotype measurement, instrument strength, and use of sensitivity methods. Results Sixty-three studies were included for qualitative synthesis. The final quality rating was ‘−’ for 16 studies, ‘– +’ for 37 studies, and ‘+’for 10 studies. There was robust evidence that higher educational attainment decreases smoking and that there is a bi-directional, increasing relationship between smoking and (symptoms of) mental disorders. Another robust finding was that higher educational attainment increases alcohol use frequency, but decreases binge-drinking and alcohol use problems, and that mental disorders causally lead to more alcohol drinking without evidence for the reverse. Conclusions The current MR literature increases our understanding of the relationship between mental health and substance use. Bi-directional causal relationships are indicated, especially for smoking, providing further incentive to strengthen public health efforts to decrease substance use. Future MR studies should make use of large(r) samples in combination with detailed phenotypes, a wide range of sensitivity methods, and triangulate with other research methods.

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Changes in alcohol consumption after treatment for depression: a secondary analysis of the Swedish randomised controlled study REGASSA

Cited by 8 publications

References 41 publications

Alcohol and drug use among clients receiving internet-delivered cognitive behavior therapy for anxiety and depression in a routine care clinic – Demographics, use patterns, and prediction of treatment completion and outcomes

Alcohol and drug use among clients receiving internet-delivered cognitive behavior therapy for anxiety and depression in a routine care clinic – Demographics, use patterns, and prediction of treatment completion and outcomes

Digital Interventions for People With Co-Occurring Depression and Problematic Alcohol Use: A Systematic Review and Meta-Analysis

Using Mendelian randomization analysis to better understand the relationship between mental health and substance use: a systematic review

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