Brief Alcohol Intervention with Depressed Patients

描述（由申请人提供）：重度饮酒在寻求抑郁症治疗的患者中很常见。大量饮酒与各种医疗和心理问题有关。酗酒在抑郁症患者中尤其成问题，增加了抑郁症治疗效果不佳的可能性。虽然迄今为止尚未探索减少这一人群饮酒的方法，但减少重度饮酒的简短干预措施已在许多患者人群中得到充分验证，并有望减少抑郁症患者的重度饮酒并改善抑郁症治疗结果。 我们假设，相对于单独的标准精神病护理，在标准精神病护理中加入简短的酒精干预，将减少重度饮酒抑郁症患者的总体饮酒量和重度饮酒天数。此外，我们预计接受短暂酒精干预的患者比单独接受标准精神病治疗的患者有更好的抑郁结局。我们还预计，减少饮酒量将介导短暂酒精干预对抑郁症结果的影响。此外，我们将研究个体差异变量作为酒精使用变化的预测因素。 这项研究是一项随机的两组设计，随着时间的推移进行重复测量，比较简单的，以动机为重点的酒精干预加上标准精神病护理与单独的标准精神病护理。在这项研究中，我们将招募240名符合重度抑郁症结构化诊断标准的精神科门诊患者，他们大量饮酒但不依赖酒精。 我们希望这项研究的结果将改善抑郁症患者的显著亚群的抑郁症治疗结果，这些患者大量饮酒，并且在饮酒行为没有改变的情况下可能在抑郁症治疗中表现不佳。这项研究中提出的干预措施代表了一种减少抑郁症患者大量饮酒的新方法，如果有效，可以很容易地整合到各种治疗环境中的抑郁症治疗中。此外，这项研究将提供有价值的信息之间的关联，酒精使用和抑郁症的结果和酗酒抑郁症患者中酒精使用的变化机制。

DESCRIPTION (provided by applicant): Heavy alcohol consumption is common among patients seeking treatment for depression. Heavy drinking is associated with a variety of medical and psychosocial problems. Heavy drinking is particularly problematic among depressed patients, increasing the likelihood of poor depression treatment outcomes. While methods for reducing alcohol use in this population have been unexplored to date, brief interventions to reduce heavy alcohol use have been well-validated in numerous patient populations and offer the promise to reduce heavy drinking among depressed patients and to improve depression treatment outcomes. We hypothesize that adding a brief alcohol intervention to standard psychiatric care, relative to standard psychiatric care alone, will reduce overall drinking volume and heavy drinking days among heavy-drinking depressed patients. Furthermore, we expect patients who receive the brief alcohol intervention to have better depression outcomes than patients receiving standard psychiatric care alone. We also expect that reduced alcohol consumption will mediate the effect of the brief alcohol intervention on depression outcomes. In addition, we will examine individual difference variables as predictors of change in alcohol use. The proposed study is a randomized, two-group design with repeated measures over time, comparing a brief, motivationally-focused alcohol intervention plus standard psychiatric care to standard psychiatric care alone. For this study, we will recruit a sample of 240 psychiatry clinic outpatients meeting structured diagnostic criteria for major depressive disorder who drink heavily but are not alcohol dependent. We expect that the results of this study will improve depression treatment outcomes for the significant sub-population of depressed patients who drink heavily and are likely to do poorly in depression treatment in the absence of a change in their drinking behavior. The intervention proposed in this study represents a novel approach to reducing heavy drinking among depressed patients that, if effective, can be readily integrated into depression treatment in a variety of treatment settings. In addition, this study will provide valuable information on the association between alcohol use and depression outcomes and on the mechanisms of change in alcohol use among heavy-drinking depressed patients.