Cognitive-behavioral therapy in young adults with major depression and alcohol dependence

Abstract

Background

Adolescents and young adults are a vulnerable population to both alcohol use disorders and depressive major disorder. Use of cognitive-behavioral therapy (CBT) could help in diminishing depressive symptoms severity as well as alcohol dependence severity.

Objective

To evaluate CBT efficacy in young adults diagnosed with major depressive disorder and alcohol dependence.

Methods

A number of 12 patients, age 23–35, 7 male and 5 female, outpatients, diagnosed with alcohol dependence and major depressive disorder, moderate or mild episodes, according to ICD-10 criteria, were included in a 3 months CBT oriented program. All subjects were evaluated using a Visual Analogic Scale (VAS) for self-evaluation of alcohol problems severity (score ranging from 0 – absent to 10 – extremely severe), AUDIT scale, Hamilton Depression Rating Scale (HDRS) – 17 items, and Global Assessment of Functioning (GAF). Patients participated in 30 minutes individual CBT sessions, twice per week, for 12 weeks. Cognitive restructuring based on patients’ diary, coping skills training, and activation techniques have been applied in the CBT sessions.

Results

After 12 weeks all patients reported decreases on VAS and AUDIT scores, with mean percentages of 55 and 50, while GAF increased with 45%. HDRS scores decreased with 65%. These changes were considered significant when compared to initial values (P = 0.007 for VAS, P = 0.009 for AUDIT, P = 0.012 for GAF and P < 0.001 for HDRS), according to dependent samples t-test P < 0.05, bivariate.

Conclusion

Cognitive-behavioral therapy, focused on cognitive restructuring, coping skills training, and activating techniques is an efficacious intervention in young patients with comorbid depressive and alcohol dependence.

Disclosure of interest

The presenting author was speaker for Astra Zeneca, Bristol-Myers Squibb, CSC Pharmaceuticals, Eli Lilly, Janssen-Cilag, Lundbeck, Organon, Pfizer, Servier, Sanofi Aventis and participated in clinical research funded by Janssen-Cilag, Astra Zeneca, Eli Lilly, Sanofi Aventis, Schering Plough, Organon, Bioline Rx, Forenap, Wyeth, Otsuka Pharmaceuticals, Dainippon Sumitomo, Servier.

The other author has not supplied his/her declaration of competing interest.