Effectiveness of a digital alcohol intervention as an add-on to depression treatment for young adults: results of a pragmatic randomized controlled trial
release_5lw7vauxmvadngpor6i63z37ni
by
Maria Schouten,
Anna E. Goudriaan,
Michael P. Schaub,
Jack J. M. Dekker,
Matthijs Blankers
Abstract
<jats:title>Abstract</jats:title>
<jats:sec id="S0033291724000953_sec_a1">
<jats:title>Background</jats:title>
Problematic drinking frequently co-occurs with depression among young adults, but often remains unaddressed in depression treatment. Evidence is insufficient on whether digital alcohol interventions can be effective in this young comorbid population. In a randomized controlled trial, we examined the effectiveness of Beating the Booze (BtB), an add-on digital alcohol intervention to complement depression treatment for young adults.
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<jats:sec id="S0033291724000953_sec_a2" sec-type="methods">
<jats:title>Methods</jats:title>
Participants were randomized to BtB + depression treatment as usual (BTB + TAU, <jats:italic>n</jats:italic> = 81) or TAU (<jats:italic>n</jats:italic> = 82). The primary outcome was treatment response, a combined measure for alcohol and depression after 6-month follow-up. Secondary outcomes were number of weekly drinks (Timeline Follow-back) and depressive symptoms (Center for Epidemiologic Studies Depression scale). Treatment response was analyzed using generalized linear modeling and secondary outcomes using robust linear mixed modeling.
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<jats:sec id="S0033291724000953_sec_a3" sec-type="results">
<jats:title>Results</jats:title>
Low treatment response was found due to lower than expected depression remission rates. No statistically significant between-group effect was found for treatment response after 6-month follow-up (odds ratio 2.86, <jats:italic>p</jats:italic> = 0.089, 95% confidence interval [CI] 0.85–9.63). For our secondary outcomes, statistically significant larger reductions in weekly drinks were found in the intervention group after 3-month (<jats:italic>B</jats:italic> = −4.00, <jats:italic>p</jats:italic> = 0.009, 95% CI −6.97 to −1.02, <jats:italic>d</jats:italic> = 0.27) and 6-month follow-up (<jats:italic>B</jats:italic> = −3.20, <jats:italic>p</jats:italic> = 0.032, 95% CI −6.13 to −0.27, <jats:italic>d</jats:italic> = 0.23). We found no statistically significant between-group differences on depressive symptoms after 3-month (<jats:italic>B</jats:italic> = −0.57, <jats:italic>p</jats:italic> = 0.732, 95% CI −3.83 to 2.69) nor after 6-month follow-up (<jats:italic>B</jats:italic> = −0.44, <jats:italic>p</jats:italic> = 0.793, 95% CI −3.69 to 2.82).
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<jats:sec id="S0033291724000953_sec_a4" sec-type="conclusions">
<jats:title>Conclusions</jats:title>
The add-on digital alcohol intervention was effective in reducing alcohol use, but not in reducing depressive symptoms and treatment response among young adults with co-occurring depressive disorders and problematic alcohol use.
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<jats:sec id="S0033291724000953_sec_a5">
<jats:title>Trial registration:</jats:title>
Pre-registered on October 29, 2019 in the Overview of Medical Research in the Netherlands (OMON), formerly the Dutch Trial Register(<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://onderzoekmetmensen.nl/en/trial/49219">https://onderzoekmetmensen.nl/en/trial/49219</jats:ext-link>).
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