Sally Hunt

Randomized controlled trial of cognitive-behavioural therapy for coexisting depression and alcohol problems: short-term outcome

AIMS Alcohol use disorders and depression co-occur frequently and are associated with poorer outcomes than when either condition occurs alone. The present study (Depression and Alcohol Integrated and Single-focused Interventions; DAISI) aimed to compare the effectiveness of brief intervention, single-focused and integrated psychological interventions for treatment of coexisting depression and alcohol use problems. METHODS Participants (n = 284) with current depressive symptoms and hazardous alcohol use were assessed and randomly allocated to one of four individually delivered interventions: (i) a brief intervention only (single 90-minute session) with an integrated focus on depression and alcohol, or followed by a further nine 1-hour sessions with (ii) an alcohol focus; (iii) a depression focus; or (iv) an integrated focus. Follow-up assessments occurred 18 weeks after baseline. RESULTS Compared with the brief intervention, 10 sessions were associated with greater reductions in average drinks per week, average drinking days per week and maximum consumption on 1 day. No difference in duration of treatment was found for depression outcomes. Compared with single-focused interventions, integrated treatment was associated with a greater reduction in drinking days and level of depression. For men, the alcohol-focused rather than depression-focused intervention was associated with a greater reduction in average drinks per day and drinks per week and an increased level of general functioning. Women showed greater improvements on each of these variables when they received depression-focused rather than alcohol-focused treatment. CONCLUSIONS Integrated treatment may be superior to single-focused treatment for coexisting depression and alcohol problems, at least in the short term. Gender differences between single-focused depression and alcohol treatments warrant further study.

Recruiting for health, medical or psychosocial research using Facebook: systematic review

Recruiting participants is a challenge for many health, medical and psychosocial research projects. One tool more frequently being used to improve recruitment is the social networking website Facebook. A systematic review was conducted to identify studies that have used Facebook to recruit participants of all ages, to any psychosocial, health or medical research. 110 unique studies that used Facebook as a recruitment source were included in the review. The majority of studies used a cross-sectional design (80%) and addressed a physical health or disease issue (57%). Half (49%) of the included studies reported specific details of the Facebook recruitment process. Researchers paid between

Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: Outcomes to 36-months

1.36 and

A randomized controlled trial of vocational intervention for young people with first-episode psychosis: method

110 per completing participants (Mean =

Neurocognitive profiles of people with comorbid depression and alcohol use: Implications for psychological interventions

17.48, SD =

Systematic review of neurocognition in people with co-occurring alcohol misuse and depression

23.06). Among studies that examined the representativeness of their sample, the majority concluded (86%) their Facebook-recruited samples were similarly representative of samples recruited via traditional methods. These results indicate that Facebook is an effective and cost-efficient recruitment method. Researchers should consider their target group, advertisement wording, offering incentives and no-cost methods of recruitment when considering Facebook as a recruitment source. It is hoped this review will assist researchers to make decisions regarding the use of Facebook as a recruitment tool in future research.

Individual placement and support for vocational recovery in first-episode psychosis: randomised controlled trial

Integrated psychological treatment addressing co-existing alcohol misuse and depression has not been compared with single-focused treatment. This trial evaluates changes over 36 months following randomization of 284 outpatients to one of four motivational interviewing and cognitive-behavior therapy (MICBT) based interventions: (1) brief integrated intervention (BI); or BI plus 9 further sessions with (2) an integrated-, (3) alcohol-, or (4) depression-focus. Outcome measures included changes in alcohol consumption, depression (BDI-II: Beck Depression Inventory) and functioning (GAF: Global Assessment of Functioning), with average improvements from baseline of 21.8 drinks per week, 12.6 BDI-II units and 8.2 GAF units. Longer interventions tended to be more effective in reducing depression and improving functioning in the long-term, and in improving alcohol consumption in the short-term. Integrated treatment was at least as good as single-focused MICBT. Alcohol-focused treatment was as effective as depression-focused treatment at reducing depression and more effective in reducing alcohol misuse. The best approach seems to be an initial focus on both conditions followed by additional integrated- or alcohol-focused sessions.

Change in Neurocognition in People with Co-occurring Alcohol Misuse and Depression: 12-Month Follow-up

Young people who are experiencing first‐episode psychosis (FEP) are at increased risk of being unemployed compared to either their same age peers in the general population, or those with other mental illnesses. Significant research has been conducted examining employment interventions for those with chronic psychotic illness. This has yielded strong results in favour of an intervention called individual placement and support (IPS). However, significantly less work has examined the benefit of this approach to those in FEP when the potential for vocational rehabilitation is perhaps greater. This study adds to the knowledge of vocational intervention in first‐episode psychotic illness. Additionally, it expands this work into the areas of cognition, social cognition, social inclusion and economics.

The iTreAD project: a study protocol for a randomised controlled clinical trial of online treatment and social networking for binge drinking and depression in young people

Depression and alcohol use disorders frequently co-occur and are highly prevalent. Both conditions are known to impair cognitive functioning, yet research into the role of these impairments in response to Cognitive Behaviour Therapy (CBT) is limited. The purpose of the present study was to examine the relationship between baseline neuropsychological performance, severity of depressive symptoms and alcohol use disorders. Participants with current depression and hazardous alcohol use were functioning in the average range on all neuropsychological measures prior to treatment entry. Baseline measures of drinking severity and a range of cognitive functions were inversely correlated. After controlling for other baseline variables, superior baseline cognitive functioning predicted greater reductions in depression severity after 17 weeks. These predictive effects occurred across both brief and extended interventions. Findings suggest that improvement in depression following psychological treatment is enhanced by greater fluid reasoning ability and is predicted by executive functioning, regardless of the treatment length or problem focus.

Neurocognitive profiles of young people at high-risk versus first episode psychosis: A follow-up study

BACKGROUND Alcohol misuse and depression represent two major social and health problems globally. These conditions commonly co-occur and both are associated with significant cognitive impairment. Despite this, few studies have examined the impact on cognitive functioning of co-occurring alcohol misuse and depression. This study aims to critically review findings from peer-reviewed published articles examining neuropsychological test performance among samples of people with co-occurring alcohol misuse and depression. METHOD A comprehensive literature search was conducted, yielding six studies reporting neuropsychological profiles of people with co-occurring alcohol misuse and depression. Results comparing cognitive functioning of people with this comorbidity to those with alcohol misuse alone, depression alone, healthy controls and published norms were examined as well as those describing the correlation between depressive symptoms and cognitive functioning in people with alcohol use disorders. RESULTS In the majority of instances, the comorbid groups did not differ significantly from those with depression only or alcohol misuse only, nor from healthy controls or published norms. In the cases where a difference in neuropsychological test scores between groups was found, it was not consistently identified across studies. However, visual memory was identified in two studies as being impaired in comorbid samples and is worthy of inclusion in future studies. LIMITATIONS Due to the small number of included studies and the large variation in inclusion criteria as well as differing assessment tools and methodologies between studies, the review did not include a quantitative synthesis. CONCLUSIONS Research into cognitive deficits among people with singly occurring versus co-occurring alcohol misuse and depression is accumulating. Evidence suggests that the neuropsychological performance among samples with this comorbidity is generally not severely impaired and is unlikely to preclude benefit from treatment.