Journal Article

An Online Intervention for Co-Occurring Depression and Problematic Alcohol Use in Young People: Primary Outcomes From a Randomized Controlled Trial

Teesson, Maree, Kay-Lambkin, Frances, Deady, Mark, Mills, Katherine L

2016

Overview

Depression and problematic alcohol use represent two of the major causes of disease burden in young adults. These conditions frequently co-occur and this is associated with increased harm and poorer outcomes than either disorder in isolation. Integrated treatments have been shown to be effective; however, there remains a significant gap between those in need of treatment and those receiving it. The increased availability of eHealth programs presents a unique opportunity to treat these conditions. This study aimed to evaluate the feasibility and preliminary efficacy of an automated Web-based self-help intervention (DEAL Project) in treating co-occurring depressive symptoms and problematic alcohol use in young people. Young people (aged 18 to 25 years) with moderate depression symptoms and drinking at hazardous levels (recruited largely via social media) were randomly allocated to the DEAL Project (n=60) or a Web-based attention-control condition (HealthWatch; n=44). The trial consisted of a 4-week intervention phase with follow-up assessment at posttreatment and at 3 and 6 months postbaseline. The primary outcomes were change in depression severity according to the Patient Health Questionnaire-9 as well as quantity and frequency of alcohol use (TOT-AL). The DEAL Project was associated with statistically significant improvement in depression symptom severity (d=0.71) and reductions in alcohol use quantity (d=0.99) and frequency (d=0.76) in the short term compared to the control group. At 6-month follow-up, the improvements in the intervention group were maintained; however, the differences between the intervention and control groups were no longer statistically significant, such that between-group effects were in the small to moderate range at 6 months (depression symptoms: d=0.39; alcohol quantity: d=-0.09; alcohol frequency: d=0.24). Overall, the DEAL Project was associated with more rapid improvement in both depression symptoms and alcohol use outcomes in young people with these co-occurring conditions relative to an attention-control condition. However, long-term outcomes are less clear. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000033741; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363461 (Archived by WebCite at http://www.webcitation.org/6fpsLEGOy).

• Publisher: Journal of Medical Internet Research,Gunther Eysenbach MD MPH, Associate Professor,JMIR Publications Inc
• Subject: Adolescent / Adult / Adults / Alcohol and youth / Alcohol Drinking - therapy / Alcohol use / Alcoholism - complications / Alcoholism - therapy / Attention / Australia / Clinical trials / Cognitive Behavioral Therapy - methods / Comorbidity / Depression - complications / Depression - therapy / Depressive Disorder - complications / Depressive Disorder - therapy / Diagnosis, Dual (Psychiatry) / Drinking behavior / Drinking of alcoholic beverages / Efficacy / Feasibility / Feasibility Studies / Female / Groups / Humans / Internet / Intervention / Male / Medical treatment / Mental depression / Mental health / Original Paper / Psychological aspects / Questionnaires / Self help / Severity / Severity of Illness Index / Social isolation / Social media / Symptoms / Telemedicine - methods / Therapy, Computer-Assisted - methods / Treatment methods / Treatment needs / Young Adult / Young adults / Youth