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社会问题有关。大量饮酒在抑郁症患者中尤其严重，增加了抑郁症治疗结果不佳的可能性。虽然到目前为止还没有探索在这一人群中减少酒精使用的方法，但减少重度酒精使用的简短干预已经在许多患者群体中得到了很好的验证，并提供了减少抑郁症患者大量饮酒和改善抑郁症治疗结果的承诺。 我们假设，与单纯的标准精神护理相比，在标准精神护理中增加短暂的酒精干预，将减少酗酒抑郁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护理的患者有更好的抑郁结果。我们还预计，减少饮酒量将在短暂的酒精干预对抑郁结果的影响中起到中介作用。此外，我们还将检验个体差异变量作为酒精使用变化的预测因子。 这项拟议的研究是一项随机的两组设计，随着时间的推移重复测量，比较简短的、以激励为重点的酒精干预加上标准的精神治疗与单独的标准精神治疗。在这项研究中，我们将招募240名符合严重抑郁障碍结构化诊断标准的精神科门诊患者，他们酗酒但不依赖酒精。 我们预计，这项研究的结果将改善大量饮酒的抑郁症患者的抑郁症治疗结果，这些患者在饮酒行为没有改变的情况下，很可能在抑郁症治疗方面做得很差。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，这项研究将提供酒精使用与抑郁结果之间的关联以及大量饮酒抑郁患者酒精使用改变的机制方面的有价值的信息。

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.