Effects of pretreatment and posttreatment depressive symptoms on alcohol consumption following treatment in Project MATCH.

Abstract

This study examined the associations of pretreatment and posttreatment depressive symptoms with drinking outcomes in the year following treatment in Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), a multisite clinical trial of behavioral treatments for alcohol-use disorders. Data from 1,726 participants were modeled using generalized estimating equations to examine drinking frequency and intensity, as reflected by percentage days abstinent (PDA) and average drinks per drinking day (DDD). We predicted that patients who reported more pretreatment and posttreatment depressive symptoms would report greater drinking frequency (PDA) and more intense drinking (DDD) across the 12-month follow-up period. Pretreatment Beck Depression Inventory (BDI) scores predicted more frequent and intense drinking in the year following treatment, although not after accounting for posttreatment BDI scores, which were associated with the drinking outcomes as hypothesized. Patients who reported more depressive symptoms in the year following treatment reported less abstinence (PDA) and more intense drinking (DDD) than patients with fewer posttreatment depressive symptoms. Our findings underscore the importance of obtaining repeated assessments of depression during the course of substance use treatment. Moreover, the data suggest the potential utility of augmenting standard chemical dependency care with depression-focused interventions for alcohol-dependent patients whose depressive symptoms do not subside during treatment.