Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Strasse 46, Dresden 01187, Germany; Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany.
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Strasse 46, Dresden 01187, Germany; IFT Institut fuer Therapieforschung, Parzivalstrae 25, Munich 80804, Germany.
Drug Alcohol Depend. 2014 Jan 1;134:185-193. doi: 10.1016/j.drugalcdep.2013.09.028. Epub 2013 Oct 8.
In a recent paper, we reported the efficacy of a modular cognitive-behavioral intervention for treating adolescents and adults with cannabis use disorders (CUD). In this study, we examine the outcome of this intervention after translating it into clinical practice.
A multi-site, randomized controlled trial of 279 treatment seekers with ICD-10 cannabis use disorders aged 16- 63 years was conducted in 11 outpatient addiction treatment centers in Germany. Patients were randomly assigned to an Active Treatment (AT, n=149) or Delayed Treatment Control (DTC, n=130). Treatment consisted of 10 sessions of fully manualized individual psychotherapy that combined Cognitive-Behavioral Therapy, Motivational EnhancementTherapy and problem-solving training. Assessments were conducted at baseline, during each therapy session, at post-treatment and at three and six month follow-ups.
At post assessment 53.3% of AT patients reported abstinence (46.3% negative urine screenings) compared to 22% of DTC patients (17.7% negative drug screenings) (p<0.001, Intention-to-treat analysis). AT patients improved in the frequency of cannabis use, number of cannabis dependence criteria, severity of dependence, as well as number and severity of cannabis-related problems. Effect sizes were moderate to high. While abstinence rates in the AT group decreased over the 3-month (negative urine screenings: 32.4%) and 6-month (negative urine screenings: 35.7%) follow-up periods, the effects in secondary outcomes were maintained.
The intervention can successfully be translated to and applied in clinical practice. It has the potential to improve access to evidence-based care for chronic CUD patients.
在最近的一篇论文中，我们报告了一种模块化认知行为干预治疗青少年和成人 cannabis 使用障碍（CUD）的疗效。在这项研究中，我们研究了将该干预措施转化为临床实践后的结果。
在德国 11 家门诊成瘾治疗中心进行了一项多中心、随机对照试验，共有 279 名年龄在 16-63 岁的符合 ICD-10 cannabis 使用障碍的治疗寻求者参与。患者被随机分配到积极治疗（AT，n=149）或延迟治疗对照（DTC，n=130）组。治疗包括 10 节完全手动的个体心理治疗，结合认知行为疗法、动机增强疗法和问题解决训练。评估在基线、每次治疗期间、治疗后以及 3 个月和 6 个月随访时进行。
在治疗后评估时，AT 组的 53.3%的患者报告了戒断（46.3%的尿液检测呈阴性），而 DTC 组的 22%的患者报告了戒断（17.7%的药物检测呈阴性）（p<0.001，意向治疗分析）。AT 组患者的 cannabis 使用频率、cannabis 依赖标准数量、依赖严重程度、cannabis 相关问题的数量和严重程度均有所改善。效应大小为中等至较大。虽然 AT 组的戒断率在 3 个月（尿液检测阴性：32.4%）和 6 个月（尿液检测阴性：35.7%）随访期间有所下降，但次要结果的效果仍然保持。
该干预措施可以成功地转化为并应用于临床实践。它有可能改善慢性 CUD 患者获得循证治疗的机会。
