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Neuropsychological functioning and outcomes of treatment for co-occurring depression and substance use disorders.

AbstractBACKGROUND:
We previously published findings from our clinical trial comparing treatment outcomes for substance-dependent veterans with co-occurring depression who received Integrated Cognitive Behavioral Therapy (ICBT) or Twelve-Step Facilitation (TSF) Therapy.
OBJECTIVES:
This study is a secondary analysis that examined whether neuropsychological functioning at baseline moderated substance use and depression outcomes in ICBT relative to TSF.
METHODS:
This study was a randomized clinical trial in which 164 veterans with major depressive disorder and comorbid alcohol, cannabinol, and/or stimulant dependence were randomly assigned to either ICBT or TSF group therapy. A comprehensive neuropsychological test battery was administered at baseline.
RESULTS:
Contrary to our hypothesis, participants with poor neuropsychological functioning had better substance use outcome in ICBT than in TSF, whereas participants with good neuropsychological functioning had comparable substance use outcomes in TSF and ICBT by 18-month follow-up. Depression outcomes, in contrast, were not moderated by neuropsychological functioning by 18-month follow-up.
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE:
The substance use outcomes may suggest that substance-dependent depressed adults with poorer neuropsychological functioning should be offered ICBT over TSF. These individuals may be less able to develop and use novel coping skills for managing substance use and depressive symptoms on their own without formal structured training in cognitive and behavioral skills provided in ICBT.
AuthorsEric Granholm, Susan R Tate, Peter C Link, Katherine P Lydecker, Kevin M Cummins, John McQuaid, Chris Shriver, Sandra A Brown
JournalThe American journal of drug and alcohol abuse (Am J Drug Alcohol Abuse) Vol. 37 Issue 4 Pg. 240-9 (Jul 2011) ISSN: 1097-9891 [Electronic] England
PMID21517712 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)
Topics
  • Cognitive Therapy (methods)
  • Depressive Disorder, Major (psychology, therapy)
  • Diagnosis, Dual (Psychiatry) (psychology)
  • Female
  • Humans
  • Male
  • Mental Processes
  • Middle Aged
  • Neuropsychological Tests (statistics & numerical data)
  • Psychotherapy, Group (methods)
  • Substance-Related Disorders (psychology, therapy)
  • Veterans (psychology)

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