Baker Amanda, Bucci Sandra, Lewin Terry J, Kay-Lambkin Frances, Constable Paul M, Carr Vaughan J
Centre for Mental Health Studies, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia.
Br J Psychiatry. 2006 May;188:439-48. doi: 10.1192/bjp.188.5.439.
Few randomised controlled trials have been aimed specifically at substance use reduction among people with psychotic disorders.
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.
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.
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.
The motivational interviewing/CBT intervention was associated with modest improvements.
很少有随机对照试验专门针对减少精神障碍患者的物质使用。
研究由动机性访谈和认知行为疗法（CBT）组成的为期10节的干预措施在减少物质使用、改善症状和总体功能方面是否比常规治疗更有效。
招募了一个社区样本，这些人患有精神障碍且在前一个月报告有危险的酒精、大麻和/或苯丙胺使用情况。参与者被随机分配到动机性访谈/CBT组（n = 65）或常规治疗组（n = 65），并在基线、15周、6个月和12个月时对多个结局进行评估。
接受动机性访谈/CBT干预的参与者在抑郁方面有短期改善，在大麻使用方面有类似趋势，并且在12个月时对总体功能有影响。除了对苯丙胺使用有潜在的临床重要影响外，该干预在12个月时对物质使用没有差异益处。
动机性访谈/CBT干预带来了适度改善。
