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01-06 Cognitive behaviour therapy for substance use disorders in people with psychotic disorders

Published online by Cambridge University Press:  24 June 2014

A Baker ,
S Bucci ,
T Lewin ,
F Kay-Lambkin ,
P Constable  and
V Carr
A Baker
Affiliation:
Neuroscience Institute of Schizophrenia and Allied Disorders (NISAD), New South Wales, Australia The University of Newcastle, Callaghan, New South Wales, Australia
S Bucci
Affiliation:
Hunter New England Health, Newcastle, Australia
T Lewin
Affiliation:
Neuroscience Institute of Schizophrenia and Allied Disorders (NISAD), New South Wales, Australia Hunter New England Health, Newcastle, Australia
F Kay-Lambkin
Affiliation:
The University of Newcastle, Callaghan, New South Wales, Australia
P Constable
Affiliation:
Hunter New England Health, Newcastle, Australia
V Carr
Affiliation:
Neuroscience Institute of Schizophrenia and Allied Disorders (NISAD), New South Wales, Australia The University of Newcastle, Callaghan, New South Wales, Australia
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Abstract

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Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006 , pp. 315 - 316
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

Despite the widespread co-occurrence of psychosis and substance use disorders and the adverse effects of substance use on functioning and outcome among people with psychosis, few randomized controlled trials specifically aimed at reducing substance use among people with psychotic disorders have been conducted.

Aim:

The aim of the study was to investigate whether a 10-session motivational interviewing and cognitive behavioural therapy (MI/CBT) intervention among a sample of people with psychosis and substance use disorders was more efficacious than routine treatment in reducing substance use and improving symptomatology and general functioning.

Methods:

Participants were a community sample who met a clinical diagnosis for a psychotic illness in accordance with the Diagnostic Interview for Psychosis and reported hazardous alcohol, cannabis and/or amphetamine use on the Opiate Treatment Index during the past month. Participants were randomly allocated to receive 10 sessions of MI and CBT (n = 65) or treatment as usual (n = 65) and were assessed on multiple outcomes at posttreatment, 6 and 12 months after pretreatment.

Results:

There was a short-term improvement in cannabis use and depression among those receiving the MI/CBT intervention, together with impacts on general functioning at 12 months. There was no differential benefit of the intervention on substance use at 12 months, except for a potentially clinically important effect on amphetamine use. Assessment and brief advice in the context of ongoing monitoring appeared to have an overall beneficial effect on alcohol consumption.

Conclusions:

Further research is needed to evaluate the specific impacts on regular amphetamine use and to develop more efficacious interventions among regular cannabis users. A stepped-care approach to interventions for excessive alcohol consumption among people with a psychotic disorder is recommended.