The British Journal of Psychiatry (2006) 188: 439-448. doi: 10.1192/bjp.188.5.439
© 2006 The Royal College of Psychiatrists
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Cognitive–behavioural therapy for substance use disorders in people with psychotic disorders

Randomised controlled trial

AMANDA BAKER, PhD, SANDRA BUCCI, BSc(Psych), TERRY J. LEWIN, BCom(Psych), FRANCES KAY-LAMBKIN, BSc(Psych), PAUL M. CONSTABLE, BA(Psych) and VAUGHAN J. CARR, MD, FRANZCP

Centre for Mental Health Studies, University of Newcastle, Callaghan, New South Wales, Australia

Correspondence: Dr Amanda Baker, Centre for Mental Health Studies, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia. Tel: +61 2 4924 6610; fax: +61 2 4924 6608; e-mail: amanda.baker{at}newcastle.edu.au

Declaration of interest None. Funding is detailed in Acknowledgements.

Background Few randomised controlled trials have been aimed specifically at substance use reduction among people with psychotic disorders.

Aims To investigate whether a 10-session intervention consisting of motivational interviewing and cognitive–behavioural therapy (CBT) was more efficacious than routine treatment in reducing substance use and improving symptomatology and general functioning.

Method A community sample of people with a psychotic disorder and who reported hazardous alcohol, cannabis and/or amphetamine use during the preceding month was recruited. Participants were randomly allocated to motivational interviewing/CBT (n=65) or treatment as usual (n=65), and were assessed on multiple outcomes at baseline, 15 weeks, 6 months and 12 months.

Results There was a short-term improvement in depression and a similar trend with regard to cannabis use among participants who received the motivational interviewing/CBT intervention, together with effects on general functioning at 12 months. There was no differential benefit of the intervention on substance use at 12 months, except for a potentially clinically important effect on amphetamine use.

Conclusions The motivational interviewing/CBT intervention was associated with modest improvements.


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