Schouten Maria J E, Goudriaan Anna E, Schaub Michael P, Dekker Jack J M, Blankers Matthijs
Department of Research, Arkin Mental Health Care, 1033 NN Amsterdam, the Netherlands.
Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, the Netherlands.
Psychol Med. 2024 Aug;54(11):2887-2898. doi: 10.1017/S0033291724000953. Epub 2024 May 22.
Problematic drinking frequently co-occurs with depression among young adults, but often remains unaddressed in depression treatment. Evidence is insufficient on whether digital alcohol interventions can be effective in this young comorbid population. In a randomized controlled trial, we examined the effectiveness of Beating the Booze (BtB), an add-on digital alcohol intervention to complement depression treatment for young adults.
Participants were randomized to BtB + depression treatment as usual (BTB + TAU, = 81) or TAU ( = 82). The primary outcome was treatment response, a combined measure for alcohol and depression after 6-month follow-up. Secondary outcomes were number of weekly drinks (Timeline Follow-back) and depressive symptoms (Center for Epidemiologic Studies Depression scale). Treatment response was analyzed using generalized linear modeling and secondary outcomes using robust linear mixed modeling.
Low treatment response was found due to lower than expected depression remission rates. No statistically significant between-group effect was found for treatment response after 6-month follow-up (odds ratio 2.86, = 0.089, 95% confidence interval [CI] 0.85-9.63). For our secondary outcomes, statistically significant larger reductions in weekly drinks were found in the intervention group after 3-month ( = -4.00, = 0.009, 95% CI -6.97 to -1.02, = 0.27) and 6-month follow-up ( = -3.20, = 0.032, 95% CI -6.13 to -0.27, = 0.23). We found no statistically significant between-group differences on depressive symptoms after 3-month ( = -0.57, = 0.732, 95% CI -3.83 to 2.69) nor after 6-month follow-up ( = -0.44, = 0.793, 95% CI -3.69 to 2.82).
The add-on digital alcohol intervention was effective in reducing alcohol use, but not in reducing depressive symptoms and treatment response among young adults with co-occurring depressive disorders and problematic alcohol use.
Pre-registered on October 29, 2019 in the Overview of Medical Research in the Netherlands (OMON), formerly the Dutch Trial Register(https://onderzoekmetmensen.nl/en/trial/49219).
有问题饮酒在青年成年人中常与抑郁症同时出现，但在抑郁症治疗中往往未得到解决。关于数字酒精干预对这一年轻的共病群体是否有效，证据不足。在一项随机对照试验中，我们研究了“战胜酒瘾”（BtB）的有效性，这是一种附加的数字酒精干预措施，用于辅助青年成年人的抑郁症治疗。
参与者被随机分为BtB + 常规抑郁症治疗组（BtB + TAU，n = 81）或常规治疗组（n = 82）。主要结局是治疗反应，这是6个月随访后酒精使用和抑郁情况的综合指标。次要结局是每周每周每周饮酒量（时间线追溯法）和抑郁症状（流行病学研究中心抑郁量表）。使用广义线性模型分析治疗反应，使用稳健线性混合模型分析次要结局。
由于抑郁症缓解率低于预期，发现治疗反应较低。6个月随访后，治疗反应在组间未发现统计学上的显著差异（优势比2.86，P = 0.089，95%置信区间[CI] 0.85 - 9.63）。对于次要结局，干预组在3个月（β = -4.00，P = 0.009，95% CI -6.97至-1.02，η² = 0.27）和6个月随访后（β = -3.20，P = 0.032，95% CI -6.13至-0.27，η² = 0.23），每周饮酒量有统计学上显著更大幅度的减少。我们发现3个月后（β = -0.57，P = 0.732，95% CI -3.83至2.69）和6个月随访后（β = -0.44，P = 0.793，95% CI -3.69至2.82），抑郁症状在组间无统计学上的显著差异。
附加的数字酒精干预在减少酒精使用方面有效，但在减少同时患有抑郁症和有问题饮酒的青年成年人的抑郁症状和治疗反应方面无效。
于2019年10月29日在荷兰医学研究概述（OMON，前身为荷兰试验注册中心，https://onderzoekmetmensen.nl/en/trial/49219）进行预注册。
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