Levels of alcohol use and depression severity as predictors of missed therapy sessions in cognitive behavioural psycho-educational group treatment for depression

Abstract

In this study, we investigate levels of depression and levels of alcohol use as predictors of unstable attendance in a therapeutic intervention. A sample of 154 patients scoring a mean of 26 on BDI-II attended a cognitive behavioural psycho-educational group treatment – ‘Coping and relapse prevention of depression’. We investigated the influence of alcohol use and depression on attendance using a model based on the count of missed therapy sessions as a function of AUDIT and BDI-II, as well as a multiplicative AUDIT × BDI-II interaction term. AUDIT-scores were statistically significantly associated with more unstable attendance in treatment. Level of depression (BDI-II) was not found to predict count of missed therapy sessions in the sample. Interaction effect between levels of depression and levels of alcohol use was not statistically significant in this sample. Demographic factors were not statistically associated with count of missed therapy sessions. Despite the statistically significant relation between AUDIT-score and count of missed therapy sessions, patients with risky alcohol patterns attended the intervention almost as stably as participants without risky alcohol use. The findings provide a basis for questioning the clinical usefulness of distinguishing between patients with and without comorbid alcohol problem before attending a psycho-educational group treatment addressing depression. Missed therapy sessions in patients with alcohol problems may be counteracted with general strategies to prevent dropout from treatment.