Christian Baumgartner1, Michael P Schaub2, Andreas Wenger2, Doris Malischnig3, Mareike Augsburger2, Dirk Lehr4, Matthijs Blankers5, David D Ebert6, Severin Haug2. 1. Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland. Electronic address: christian.baumgartner@isgf.uzh.ch. 2. Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland. 3. Institute for Addiction Prevention, Addiction and Drug Coordination Vienna, Vienna, Austria. 4. Division of Online Health Training, Leuphana University Lueneburg, Germany. 5. Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands. 6. Department for Sport and Health Sciences, Chair for Psychology and Digital Mental Health Care, Technical University Munich, Munich, Germany.
Abstract
BACKGROUND: Depression and harmful alcohol use are two of the top five leading causes of years of life lost to disability in high-income countries. Integrated treatment targeting both at the same time is often considered more complicated and difficult and, therefore, more expensive. Consequently, integrated internet-based interventions could be a valuable addition to traditional care. METHODS: A three-arm randomized controlled trial was conducted comparing the effectiveness of (1) an integrated, minimal-guidance, adherence-focused self-help intervention designed to reduce both alcohol use and depression symptoms (AFGE-AD); (2) a similar intervention designed to reduce alcohol use only (AFGE-AO), and (3) internet access as usual (IAU) as a control condition, in at least moderately depressed alcohol misusers from February 2016-March 2020. We recruited 689 alcohol misusers (51.6 % males, mean age = 42.8 years) with at least moderate depression symptoms not otherwise in treatment from the general population. Six months after baseline, 288 subjects (41.8 %) were reachable for the final assessment. RESULTS: All interventions yielded reduced alcohol-use after six months (AFGE-AD: -16.6; AFGE-AO: -19.8; IAU: -13.2). Those who undertook active-interventions reported significantly fewer standard drinks than controls (AFGE-AD: p = .048, d=0.10; AFGE-AO: p = .004, d=0.20). The two active-intervention groups also reported significantly less severe depression symptoms than controls (AFGE-AD: p = .006, d=0.41; AFGE-AO: p = .008, d=0.43). Testing revealed noninferiority between the two interventions. CONCLUSIONS: This study documented sustained effectiveness of the first integrated, fully internet-based self-help intervention developed for the reduction of both alcohol use and depression symptoms in at least moderately depressed adult alcohol misusers recruited from the general population.
RCT Entities:
BACKGROUND:Depression and harmful alcohol use are two of the top five leading causes of years of life lost to disability in high-income countries. Integrated treatment targeting both at the same time is often considered more complicated and difficult and, therefore, more expensive. Consequently, integrated internet-based interventions could be a valuable addition to traditional care. METHODS: A three-arm randomized controlled trial was conducted comparing the effectiveness of (1) an integrated, minimal-guidance, adherence-focused self-help intervention designed to reduce both alcohol use and depression symptoms (AFGE-AD); (2) a similar intervention designed to reduce alcohol use only (AFGE-AO), and (3) internet access as usual (IAU) as a control condition, in at least moderately depressed alcohol misusers from February 2016-March 2020. We recruited 689 alcohol misusers (51.6 % males, mean age = 42.8 years) with at least moderate depression symptoms not otherwise in treatment from the general population. Six months after baseline, 288 subjects (41.8 %) were reachable for the final assessment. RESULTS: All interventions yielded reduced alcohol-use after six months (AFGE-AD: -16.6; AFGE-AO: -19.8; IAU: -13.2). Those who undertook active-interventions reported significantly fewer standard drinks than controls (AFGE-AD: p = .048, d=0.10; AFGE-AO: p = .004, d=0.20). The two active-intervention groups also reported significantly less severe depression symptoms than controls (AFGE-AD: p = .006, d=0.41; AFGE-AO: p = .008, d=0.43). Testing revealed noninferiority between the two interventions. CONCLUSIONS: This study documented sustained effectiveness of the first integrated, fully internet-based self-help intervention developed for the reduction of both alcohol use and depression symptoms in at least moderately depressed adult alcohol misusers recruited from the general population.
Authors: Jona R Frohlich; Karli K Rapinda; Michael P Schaub; Andreas Wenger; Christian Baumgartner; Edward A Johnson; Matthijs Blankers; David D Ebert; Heather D Hadjistavropoulos; Corey S Mackenzie; Jeffrey D Wardell; Jason D Edgerton; Matthew T Keough Journal: Addict Behav Rep Date: 2022-06-03
Authors: Christopher Sundström; Vanessa Peynenburg; Carly Chadwick; David Thiessen; Andrew Wilhems; Marcie Nugent; Matthew T Keough; Michael P Schaub; Heather D Hadjistavropoulos Journal: Addict Sci Clin Pract Date: 2022-07-23