CANDIS treatment program for cannabis use disorders: Findings from a randomized multi-site translational trial
CANDIS treatment program for cannabis use disorders: Findings from a randomized multi-site translational trial
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DOI：
10.1016/j.drugalcdep.2013.09.028
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发表时间：
2014-01-01
影响因子：
4.2
通讯作者：
Wittchen, H. U.
中科院分区：
文献类型：
--
作者：
Hoch, E.;Buehringer, G.;Wittchen, H. U.
背景资料：在最近的一篇论文中，我们报告了模块化认知行为干预治疗青少年和成人大麻使用障碍（CUD）的疗效。在这项研究中，我们研究这种干预的结果后，将其转化为临床practice.Methods：一个多站点，随机对照试验，279治疗寻求者与ICD-10大麻使用障碍，年龄在16 - 63岁，在11个门诊成瘾治疗中心在德国进行。患者被随机分配到积极治疗组（AT，n = 149）或延迟治疗对照组（DTC，n = 130）。治疗包括10次完全手动的个人心理治疗，结合认知行为疗法，动机增强疗法和解决问题的训练。结果：在评估后，53.3%的AT患者报告禁欲（46.3%的阴性尿液筛查），而DTC患者为22%（17.7%的阴性药物筛查）（p <0.001，意向治疗分析）。AT患者在大麻使用频率、大麻依赖标准数量、依赖严重程度以及大麻相关问题的数量和严重程度方面有所改善。效应量为中度至高度。虽然禁欲率在AT组下降了3个月（阴性尿液筛查：32.4%）和6个月（阴性尿液筛查：35.7%）的后续期间，在次要outcomes的影响maintained.Conclusions：干预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患者获得循证护理的机会。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Background: 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.Methods: 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.Results: At post assessment 53.3% of AT patients reported abstinence (46.3% negativesurine 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.Conclusions: 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. (C) 2013 Elsevier Ireland Ltd. All rights reserved.