Evaluation of cognitive behavioral therapy/motivational enhancement therapy (CBT/MET) in a treatment trial of comorbid MDD/AUD adolescents

Jack R. Cornelius, Antoine Douaihy, Oscar G. Bukstein, Dennis C. Daley, Scott D. Wood, Thomas M. Kelly, Ihsan M. Salloum

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Objective: Behavioral therapies developed specifically for co-occurring disorders remain sparse, and such therapies for comorbid adolescents are particularly rare. This was an evaluation of the long-term (2-year) efficacy of an acute phase trial of manualized cognitive behavioral therapy/motivation enhancement therapy (CBT/MET) vs. naturalistic treatment among adolescents who had signed consent for a treatment study involving the SSRI antidepressant medication fluoxetine and CBT/MET therapy for comorbid major depressive disorder (MDD) and an alcohol use disorder (AUD). We hypothesized that improvements in depressive symptoms and alcohol-related symptoms noted among the subjects who had received CBT/MET would exceed that of those in the naturalistic comparison group that had not received CBT/MET therapy. Methods: We evaluated levels of depressive symptoms and alcohol-related symptoms at a two-year follow-up evaluation among comorbid MDD/AUD adolescents who had received an acute phase trial of manual-based CBT/MET (in addition to the SSRI medication fluoxetine or placebo) compared to those who had received naturalistic care. Results: In repeated measures ANOVA, a significant time by enrollment status difference was noted for both depressive symptoms and alcohol-related symptoms across the two-year time period of this study, with those receiving CBT/MET demonstrating superior outcomes compared to those who had not received protocol CBT/MET therapy. No significant difference was noted between those receiving fluoxetine vs. those receiving placebo on any outcome at any time point. Conclusions: These findings suggest long-term efficacy for an acute phase trial of manualized CBT/MET for treating comorbid MDD/AUD adolescents. Large multi-site studies are warranted to further clarify the efficacy of CBT/MET therapy among various adolescent and young adult comorbid populations.

Original languageEnglish (US)
Pages (from-to)843-848
Number of pages6
JournalAddictive Behaviors
Volume36
Issue number8
DOIs
StatePublished - Aug 2011

Keywords

  • Adolescents
  • Alcohol use disorder
  • Cognitive behavioral therapy
  • Comorbidity
  • Major depression
  • Motivational enhancement therapy

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Toxicology
  • Medicine (miscellaneous)

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