Byrne Simon P, Haber Paul, Baillie Andrew, Costa Daniel S J, Fogliati Vincent, Morley Kirsten
Discipline of Addiction Medicine, National Health and Medical Research Council Centre for Excellence in Mental Health and Substance Use, University of Sydney, NSW, Australia.
Drug Health Services, Royal Prince Alfred Hospital, Level 6 King George V Building, Camperdown, NSW, Australia.
Alcohol Alcohol. 2019 Mar 1;54(2):159-166. doi: 10.1093/alcalc/agy089.
Third wave therapies have shown efficacy for treating emotional disorders and potential for treating substance use disorders. There is developing interest in whether they can more specifically be used for treating alcohol use disorders (AUDs). We were interested in whether third wave therapies have value alongside current evidence-based psychosocial treatments for AUDs.
We conducted systematic reviews of third wave therapies for AUDs. We searched PsycINFO, Embase and Medline for peer reviewed journal articles where mindfulness or Acceptance and Commitment Therapy (ACT) were used to treat adults with AUDs or alcohol use that caused impairment.
We identified 11 studies where mindfulness was used for treating AUDs and 6 where ACT was used for AUDs. The studies identified included RCTs, non-randomized controlled studies and uncontrolled studies. We found preliminary support that both third wave therapies are better than no treatment, treatments of minimal efficacy, as well as some evidence they are comparable to effective psychosocial treatments for AUDs.
We conclude ACT and mindfulness provide an alternative to existing treatments, particularly for patients who have not responded to, or have disengaged from, standard treatments. We also found some evidence ACT and mindfulness are useful for comorbid mental health conditions. Yet while these results are promising, further research is needed to determine their utility, ideally employing randomized-controlled designs, larger clinical samples and longer follow-ups. Furthermore, few studies in this review directly compared third wave therapies to first line treatments, making it difficult to determine their relative efficacy.
第三波疗法已显示出对治疗情绪障碍有效，且对治疗物质使用障碍具有潜力。人们越来越关注它们是否能更具体地用于治疗酒精使用障碍（AUDs）。我们感兴趣的是，在目前基于证据的AUDs心理社会治疗之外，第三波疗法是否具有价值。
我们对治疗AUDs的第三波疗法进行了系统评价。我们在PsycINFO、Embase和Medline中检索了同行评审的期刊文章，这些文章使用正念或接受与承诺疗法（ACT）来治疗患有AUDs或因饮酒导致功能损害的成年人。
我们确定了11项使用正念治疗AUDs的研究和6项使用ACT治疗AUDs的研究。所确定的研究包括随机对照试验、非随机对照研究和非对照研究。我们发现初步证据表明，这两种第三波疗法都优于不治疗、疗效甚微的治疗方法，也有一些证据表明它们与AUDs的有效心理社会治疗方法相当。
我们得出结论，ACT和正念为现有治疗方法提供了一种替代方案，特别是对于那些对标准治疗没有反应或已经脱离标准治疗的患者。我们还发现一些证据表明，ACT和正念对合并的心理健康状况有用。然而，尽管这些结果很有前景，但仍需要进一步研究来确定它们的效用，理想情况下采用随机对照设计、更大的临床样本和更长的随访时间。此外，本综述中很少有研究直接将第三波疗法与一线治疗进行比较，因此难以确定它们的相对疗效。
