Cognitive-Behavioral Interventions Targeting Alcohol or Other Drug Use and Co-Occurring Mental Health Disorders: A Meta-Analysis.
Cognitive-Behavioral Interventions Targeting Alcohol or Other Drug Use and Co-Occurring Mental Health Disorders: A Meta-Analysis.
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针对酒精或其他药物使用和同时发生的心理健康障碍的认知行为干预措施：荟萃分析。
DOI：
10.1093/alcalc/agab016
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Magill,Molly
中科院分区：
文献类型：
--
作者：
Mehta,Kahini;Hoadley,Ariel;Ray,LaraA;Kiluk,BrianD;Carroll,KathleenM;Magill,Molly
本荟萃分析回顾了15项临床试验（18个研究中心/组），研究了对酒精或其他药物使用障碍和合并精神健康障碍（AOD/MHD）的个体进行综合认知行为干预（CBI）的有效性。结果是酒精或其他药物的使用和心理健康症状在治疗后通过follow-up.MethodsThe逆方差加权效应大小计算为每个研究和汇总下随机效应assumptions. ResultsIntegratedCBI显示了一个小的效应大小为AOD（g = 0.188，P =0.061;I2= 86%，τ2= 0.126，k =18）和MHD（g = 0.169，P =0.024;I2= 58%，τ2= 0.052，k =18）结果，尽管只有MHD结果具有统计学意义。按亚组进行的分析表明，效应程度因对比条件类型（综合CBI +常规治疗vs.仅常规治疗;综合CBI vs.单一疾病干预）、随访时间点（治疗后vs. 3-6个月）和主要AOD/MHD诊断而异，尽管这些亚组通常包含显著的残余异质性。在一系列混合效应、荟萃回归模型中，人口统计学因素是研究间异质性的非显著预测因素。对于AOD结果，在高质量的研究中观察到更大的效果，但研究质量与MHD outcomes.ConclusionsThe当前的荟萃分析显示，与单一疾病干预相比，综合CBI观察到的最有希望的效果大小相比，综合CBI的效果大小较小且可变（通常是一个AOD干预）的后续结果，并针对酒精使用和/或创伤后应激障碍的干预措施。鉴于样本中的临床和方法学变异性，结果应被视为我们理解合并AOD/MHD治疗的初步但重要的一步。
AimsThis meta-analysis reviewed 15 clinical trials (18 study sites/arms), examining the efficacy of an integrated cognitive-behavioral intervention (CBI) delivered to individuals with an alcohol or other drug use disorder and a co-occurring mental health disorder (AOD/MHD). Outcomes were alcohol or other drug use and mental health symptoms at post-treatment through follow-up.MethodsThe inverse-variance weighted effect size was calculated for each study and pooled under random effects assumptions.ResultsIntegrated CBI showed a small effect size for AOD (g =0.188,P =0.061;I2= 86%,τ2= 0.126,k =18) and MHD (g =0.169,P =0.024;I2= 58%,τ2= 0.052,k =18) outcomes, although only MHD outcomes were statistically significant. Analysis by subgroup suggested that effect magnitude varied by type of contrast condition (integrated CBI + usual care vs. usual care only; integrated CBI vs. a single-disorder intervention), follow-up time point (post-treatment vs. 3–6 months) and primary AOD/MHD diagnosis, although these sub-groups often contained significant residual heterogeneity. In a series of mixed effects, meta-regression models, demographic factors were non-significant predictors of between-study heterogeneity. For AOD outcomes, greater effects were observed in higher quality studies, but study quality was not related to effect size variability for MHD outcomes.ConclusionsThe current meta-analysis shows a small and variable effect for integrated CBI with the most promising effect sizes observed for integrated CBI compared with a single disorder intervention (typically an AOD-only intervention) for follow-up outcomes, and for interventions targeting alcohol use and/or post-traumatic stress disorder. Given the clinical and methodological variability within the sample, results should be considered a preliminary, but important step forward in our understanding of treatment for co-occurring AOD/MHD.
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第二版
DOI：
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发表时间：
2008
期刊：
影响因子：
--
作者：
Fujita J. Springer;Berlin;Schwab;M.(ed.)
通讯作者：
M.(ed.)
影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
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作者：
K. van Emmerik;E. Vedel;Floor J Kramer;M. Blankers;J. Dekker;W. van den Brink;R. Schoevers
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影响因子：
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作者：
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