Cognitive-behavioural therapy for substance use disorders in people with psychotic disorders

Background Few randomised controlled trials have been aimed specifically at substance use reduction among people with psychotic disorders. Aims To investigate whether a 10-session intervention consisting of motivational interviewing and cognitive-behavioural therapy (CBT) was more efficacious than routine treatment in reducing substance use and improving symptomatology and general functioning. Method A community sample of people with a psychotic disorder and who reported hazardous alcohol, cannabis and/or amphetamine use during the preceding month was recruited. Participants were randomly allocated to motivational interviewing/CBT (n=65) or treatment as usual (n=65), and were assessed on multiple outcomes at baseline, 15 weeks, 6 months and 12 months. Results There was a short-term improvement in depression and a similar trend with regard to cannabis use among participants who received the motivational interviewing/CBT intervention, together with effects on general functioning at 12 months. There was no differential benefit of the intervention on substance use at 12 months, except for a potentially clinically important effect on amphetamine use. Conclusions The motivational interviewing/CBT intervention was associated with modest improvements.

[1]  A. Baker,et al.  Amphetamine use and co-occurring psychological problems: Review of the literature and implications for treatment , 2005 .

[2]  A. Baker,et al.  Comparisons between psychosis samples with different patterns of substance use recruited for clinical and epidemiological studies , 2005, Psychiatry Research.

[3]  F. Kay-Lambkin,et al.  Brief cognitive behavioural interventions for regular amphetamine users: a step in the right direction. , 2005, Addiction.

[4]  F. Kay-Lambkin,et al.  The 'co-morbidity roundabout': a framework to guide assessment and intervention strategies and engineer change among people with co-morbid problems. , 2004, Drug and alcohol review.

[5]  A. J. Donnell,et al.  Factor Structure and Differential Validity of the Expanded Brief Psychiatric Rating Scale , 2004, Assessment.

[6]  John Jamieson,et al.  Analysis of covariance (ANCOVA) with difference scores. , 2004, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[7]  R. Rapee,et al.  Predicting who benefits from psychoeducation and self help for panic attacks. , 2004, Behaviour research and therapy.

[8]  D. Kavanagh,et al.  Demographic and clinical correlates of comorbid substance use disorders in psychosis: multivariate analyses from an epidemiological sample , 2004, Schizophrenia Research.

[9]  N. Tarrier,et al.  Cognitive–behavioural therapy and motivational intervention for schizophrenia and substance misuse , 2003, British Journal of Psychiatry.

[10]  J. Sim,et al.  Intention-to-treat approach to data from randomized controlled trials: a sensitivity analysis. , 2003, Journal of clinical epidemiology.

[11]  G. Hulse,et al.  Five-year outcomes of a brief alcohol intervention for adult in-patients with psychiatric disorders. , 2003, Addiction.

[12]  F. Scogin,et al.  Self-administered treatment in stepped-care models of depression treatment. , 2003, Journal of clinical psychology.

[13]  G. Schippers,et al.  Reforming Dutch substance abuse treatment services. , 2002, Addictive behaviors.

[14]  Mike C. Jackson,et al.  The concurrent validity of the Global Assessment of Functioning (GAF). , 2002, The British journal of clinical psychology.

[15]  A. Baker,et al.  Evaluation of a motivational interview for substance use within psychiatric in-patient services. , 2002, Addiction.

[16]  D. Altman,et al.  Statistics notes: Analysing controlled trials with baseline and follow up measurements. , 2001, BMJ.

[17]  C. Barrowclough,et al.  Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. , 2001, The American journal of psychiatry.

[18]  V. Carr,et al.  The NISAD Schizophrenia Research Register: why do we need a database of schizophrenia volunteers? , 2001, The Australian and New Zealand journal of psychiatry.

[19]  Robert C. Smith,et al.  Effects of Cigarette Smoking on Psychopathology Scores in Patients With Schizophrenia: An Experimental Study , 2001, Substance abuse.

[20]  R. Stephens,et al.  A randomized controlled trial of brief cognitive-behavioral interventions for cannabis use disorder. , 2001, Journal of substance abuse treatment.

[21]  K. Nuechterlein,et al.  Symptom dimensions in recent-onset schizophrenia and mania: a principal components analysis of the 24-item Brief Psychiatric Rating Scale , 2000, Psychiatry Research.

[22]  L. Sobell,et al.  Stepped care as a heuristic approach to the treatment of alcohol problems. , 2000, Journal of consulting and clinical psychology.

[23]  D Castle,et al.  Psychotic Disorders in Urban Areas: An Overview of the Study on Low Prevalence Disorders , 2000, The Australian and New Zealand journal of psychiatry.

[24]  G. Kirov,et al.  Randomised controlled trial of compliance therapy , 1998, British Journal of Psychiatry.

[25]  Judi Clements.  Drugs and mental health , 1995, The Lancet.

[26]  R. Mattick,et al.  Treatment Approaches for Alcohol and Drug Dependence: An Introductory Guide , 1995 .

[27]  N. Heather,et al.  Development and validation of a multi-dimensional instrument for assessing outcome of treatment among opiate users: the Opiate Treatment Index. , 1992, British journal of addiction.

[28]  A. Farmer,et al.  A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. , 1991, Archives of general psychiatry.

[29]  F. Kay-Lambkin,et al.  Intervention for alcohol, cannabis and amphetamine use among people with a psychotic illness. , 2004 .

[30]  R. Brooner,et al.  A multicenter randomized evaluation of methadone medical maintenance. , 2002, Drug and alcohol dependence.

[31]  W. Miller,et al.  Motivational interviewing: preparing people for change. , 2002 .

[32]  J. Jamieson,et al.  Dealing with baseline differences: two principles and two dilemmas. , 1999, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[33]  R. Liberman,et al.  Brief Psychiatric Rating Scale (BPRS) Expanded Version (4.0): Scales, Anchor Points, and Administration Manual , 1993 .

[34]  C. Schuster.  Reports from research centres--16. The National Institute on Drug Abuse (NIDA). , 1989, British journal of addiction.

[35]  C. Schuster.  The National Institute on Drug Abuse (NIDA) , 1989 .

[36]  D. Abrams,et al.  Treating alcohol dependence , 1989 .

[37]  A. Beck,et al.  Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation , 1988 .

[38]  J. Prochaska,et al.  Toward a Comprehensive Model of Change , 1986 .

[39]  W. Miller,et al.  Treating addictive behaviors : processes of change , 1986 .