Brief alcohol intervention in a psychiatric outpatient setting: a randomized controlled study

Christina Nehlin,Lennart Jansson,Leif Grönbladh,Anders Fredriksson

doi:10.1186/1940-0640-7-23

Abstract

BackgroundAlthough brief alcohol intervention (BI) is widely studied, studies from psychiatric outpatient settings are rare. The aim of this study was to investigate the effects of two variants of BI in psychiatric outpatients. By using clinical psychiatric staff to perform the interventions, we sought to collect information of the usefulness of BI in the clinical setting.MethodsPsychiatric outpatients with Alcohol Use Disorders Identification Test (AUDIT) scores indicating hazardous or harmful drinking were invited to participate in the study. The outpatients were randomized to minimal (assessment, feedback, and an informational leaflet) or BI (personalized advice added). Measurements were performed at baseline and at six and 12 months after the intervention. The primary outcome was change in AUDIT score at the 12-month follow-up.ResultsIn all, 150 patients were enrolled and received either a minimal intervention (n = 68) or BI (n = 82). At 12 months, there was a small reduction in AUDIT score in both groups, with no significant differences in outcome between groups. At 12-month follow-up, 21% of participants had improved from a hazardous AUDIT score level to a nonhazardous level, and 8% had improved from a harmful level to a hazardous level (8%).ConclusionsBrief alcohol interventions may result in a reduction of AUDIT score to a small extent in psychiatric patients with hazardous or harmful alcohol use. Results suggest that BI may be of some value in the psychiatric outpatient setting. Still, more profound forms of alcohol interventions with risky-drinking psychiatric patients need elaboration.

Highlights

Brief alcohol intervention (BI) is widely studied, studies from psychiatric outpatient settings are rare
The minimal intervention produced similar results as the more intense brief alcohol intervention (BI): i.e., assessment, feedback, and a leaflet, with or without brief advice, reduced Alcohol Use Disorders Identification Test (AUDIT) score in risky-drinking patients
It is notable that a large percentage of the patients in the control group in the Eberhard study (27.7%) reduced their AUDIT score to nonhazardous levels after assessment and after declaring interest to take part in the study

Summary

Introduction

Brief alcohol intervention (BI) is widely studied, studies from psychiatric outpatient settings are rare. The aim of this study was to investigate the effects of two variants of BI in psychiatric outpatients. By using clinical psychiatric staff to perform the interventions, we sought to collect information of the usefulness of BI in the clinical setting. Over the past two decades, numerous investigations of the effectiveness of brief intervention (BI) for hazardous or harmful drinking have been performed [1,2]. When measured by reduction of weekly alcohol consumption, BI delivered in primary and emergency care has been found to be effective at reducing hazardous drinking at 12 months or longer [1,9]. The mean difference (MD) in weekly alcohol consumption was −38 grams (95% CI: -54 to −23). In a review of BI among heavy drinkers in hospital wards, a reduction in consumption was found at six months (MD −69.43 grams: 95% CI −128.14 to −10.72) and nine months (MD −182.88 grams: 95% CI - 360.00 to −5.76) but not at 12 months [10]

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