Motivational enhancement therapy versus cognitive behavioral therapy in a cohort of men and women with alcohol use disorder

G. Coriale, F. Rosa, G. Battagliese, S. Gencarelli, M. Fiore, G. Ferraguti, M. Vitali, C. Rotondo, M. Messina, M. L. Attilia
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引用次数: 1

Abstract

The clinical manifestations of alcohol dependence are not homogeneous. Many studies described both cognitive impairments and psychiatric disorders among people with Alcohol use disorder (AUD). However, AUD can be present without comorbid psychiatric disorders or severe cognitive deficits, namely, “pure alcoholics”. Until now, knowledge about effective treatments for this typology of AUD patients remains unknown. The aim of the present study was to assess two psychological methods of intervention: Cognitive-behavioral treatment (CBT) in the short format and the Motivational enhancement therapy (MET). We then opted to compare the efficacy of methods in treating AUD in both men and women pure alcoholics. We performed a controlled and randomized study consisting of 325 people affected by AUD (244 men, 81 women). 72.3% (n=235; 181 men 54 women) were excluded according to selection criteria. The major percentage of exclusion (38.7%; n=91; 63 men 28 women) regarded patients with comorbid psychiatric disorders. Only the 90 remaining test subjects (27.7% of the sample population; 63 men and 27 women) classified as pure alcoholics were eligible for this study. The test subjects were divided into two groups. One group underwent MET (n=47; 35 men and 12 women) and the other underwent CBT (n=43; 28 men and 15 women). We found a significant adherence to the treatment in the CBT group (19 men and 9 women) compared to the MET group (3 men and 1 woman). At the end of treatment, the dropout rates for the CBT and MET therapy groups were 34.9% and 91.5%, respectively. Moreover, we found no differences in the percentage of abstinent days between CBT and MET groups at three months (CBT: n=36; mean 91.40±15.34; MET: n=18; mean 93.90±11.95; t(52)= 0.605, p=0.550), at six months (CBT: N=30; mean 85.00±30.71; MET: n=9; mean 87.78±33.08; t(37)=-0.234, p=0.820) and at twelve months from the beginning of treatment (CBT: n=28; mean 90.14±22.06; MET: n=4; mean 100±0; t(30)=-0.881, p=0.838). In conclusion, we disclose that CBT in the short format could be an effective treatment strategy for pure alcoholics without psychiatric disorders or severe cognitive deficits.
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动机增强疗法与认知行为疗法在酒精使用障碍男性和女性队列中的比较
酒精依赖的临床表现不尽相同。许多研究描述了酒精使用障碍(AUD)患者的认知障碍和精神障碍。然而,AUD可以在没有共病精神障碍或严重认知缺陷的情况下出现,即“纯粹的酗酒者”。到目前为止,关于这种类型AUD患者的有效治疗方法仍然未知。本研究的目的是评估两种心理干预方法:短格式的认知行为治疗(CBT)和动机增强治疗(MET)。然后,我们选择比较治疗男性和女性纯酗酒者AUD的方法的疗效。我们进行了一项对照和随机研究,包括325名AUD患者(244名男性,81名女性)。72.3% (n = 235;根据选择标准,181名男性(54名女性)被排除在外。主要排除率(38.7%;n = 91;63名男性28名女性)共病精神障碍患者。只剩下90名测试对象(占样本总人数的27.7%;63名男性和27名女性)被归类为纯酗酒者,符合这项研究的条件。测试对象被分成两组。一组行MET治疗(n=47;35名男性和12名女性),另一名接受CBT治疗(n=43;男性28人,女性15人)。我们发现CBT组(19名男性和9名女性)与MET组(3名男性和1名女性)相比有显著的治疗依从性。治疗结束时,CBT组和MET组的辍学率分别为34.9%和91.5%。此外,我们发现CBT组和MET组在三个月时的戒断天数百分比没有差异(CBT: n=36;平均91.40±15.34;遇见:n = 18;平均93.90±11.95;t(52)= 0.605, p=0.550), 6个月时(CBT: N=30;平均85.00±30.71;遇见:n = 9;平均87.78±33.08;t(37)=-0.234, p=0.820)和治疗开始后12个月(CBT: n=28;平均90.14±22.06;遇见:n = 4;意思是100±0;t (30) = -0.881, p = 0.838)。综上所述,我们揭示了简短形式的CBT对于没有精神疾病或严重认知缺陷的纯酗酒者可能是一种有效的治疗策略。
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