Brief alcohol intervention in a psychiatric outpatient setting: a randomized controlled study
Although 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.
Psychiatric 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.
In 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%).
Brief 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.
- Kaner, EF, Beyer, F, Dickinson, HO, Pienaar, E, Campbell, F, Schlesinger, C, Heather, N, Saunders, J, Burnand, B (2007) Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2: pp. CD004148
- Wilson, GB, Heather, N, Kaner, EF (2011) New developments in brief interventions to treat problem drinking in nonspecialty health care settings. Curr Psychiatry Rep 13: pp. 422-429 CrossRef
- World Health Organization: Screening and brief interventions for hazardous and harmful alcohol use: recommendations. http://www.who.int/mental_health/mhgap/evidence/alcohol/q1/en/index.html
- WHO Expert Committee on problems related to alcohol consumption. Second report.
- Berglund, M, Thelander, S, Salaspuro, M, Franck, J, Andreasson, S, Öjehagen, A (2003) Treatment of alcohol abuse: an evidence-based review. Alcohol Clin Exp Res 27: pp. 1645-1656 CrossRef
- Forsberg, L, Ekman, S, Halldin, J, Ronnberg, S (2000) Brief interventions for risk consumption of alcohol at an emergency surgical ward. Addict Behav 25: pp. 471-475 CrossRef
- Moyer, A, Finney, JW, Swearingen, CE, Vergun, P (2002) Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction 97: pp. 279-292 CrossRef
- Miller, WR, Rollnick, S (2002) Motivational interviewing. Preparing people for change. Guilford Publications, New York, USA
- Coulton, S (2011) Alcohol misuse. Clin Evid.
- McQueen, J, Howe, TE, Allan, L, Mains, D, Hardy, V (2011) Brief interventions for heavy alcohol users admitted to general hospital wards. Cochrane Database Syst Rev 8: pp. CD005191
- D'Onofrio, G, Degutis, LC (2004) Screening and brief intervention in the emergency department. Alcohol Res Health 28: pp. 63-72
- Kessler, RC (2004) The epidemiology of dual diagnosis. Biol Psychiatry 56: pp. 730-737 CrossRef
- Eberhard, S, Nordstrom, G, Hoglund, P, Ojehagen, A (2009) Secondary prevention of hazardous alcohol consumption in psychiatric out-patients: a randomised controlled study. Soc Psychiatry Psychiatr Epidemiol 44: pp. 1013-1021 CrossRef
- Hulse, GK, Tait, RJ (2003) Five-year outcomes of a brief alcohol intervention for adult in-patients with psychiatric disorders. Addiction 98: pp. 1061-1068 CrossRef
- Kaner, EF, Brown, N, Jackson, K (2011) A systemativ review of the impact of brief interventions on substance use and co-morbid physical and mental health conditions. Mental Health and Substance Use 4: pp. 38-61
- Hulse, GK, Tait, RJ (2002) Six-month outcomes associated with a brief alcohol intervention for adult in-patients with psychiatric disorders. Drug Alcohol Rev 21: pp. 105-112 CrossRef
- Saunders, JB, Aasland, OG, Babor, TF, de la Fuente, JR, Grant, M (1993) Development of the alcohol Use disorders identification test (AUDIT): WHO Collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction 88: pp. 791-804 CrossRef
- Nehlin, C, Fredriksson, A, Gronbladh, L, Jansson, L (2012) Three hours of training improve psychiatric staff's self-perceived knowledge and attitudes toward problem-drinking patients. Drug Alcohol Rev 31: pp. 544-549 CrossRef
- Wennberg, P, Källmén, H, Hermansson, U, Bergman, H (2006) AUDIT manual. Karolinska Institute, Stockholm
- World Health Organization: The alcohol Use disorders identification test. Guidelines for use in primary care. http://whqlibdoc.who.int/hq/2001/who_msd_msb_01.6a.pdf
- Darker, C, Sweeney, B, El Hassan, H, Smyth, B, Ivers, J, Barry, J (2012) Brief interventions are effective in reducing alcohol consumption in opiate-dependent methadone-maintained patients: Results from an implementation study. Drug Alcohol Rev 31: pp. 348-356 CrossRef
- Nehlin, C, Fredriksson, A, Jansson, L (2012) Brief alcohol screening in a clinical psychiatric population: Special attention needed. Drug Alcohol Rev 31: pp. 538-543 CrossRef
- Reinert, DF, Allen, JP (2007) The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res 31: pp. 185-199 CrossRef
- Rollnick, S, Heather, N, Gold, R, Hall, W (1992) Development of a short 'readiness to change' questionnaire for use in brief, opportunistic interventions among excessive drinkers. Br J Addict 87: pp. 743-754 CrossRef
- Miller, WR, Heather, N (1998) Treating addictive behaviors. Plenum Press, New York
- Forsberg, L, Ekman, S, Halldin, J, Ronnberg, S (2004) The readiness to change questionnaire: reliability and validity of a Swedish version and a comparison of scoring methods. Br J Health Psychol 9: pp. 335-346 CrossRef
- Heather, N, Rollnick, S, Bell, A (1993) Predictive validity of the readiness to change questionnaire. Addiction 88: pp. 1667-1677 CrossRef
- Rubinsky, AD, Kivlahan, DR, Volk, RJ, Maynard, C, Bradley, KA (2010) Estimating risk of alcohol dependence using alcohol screening scores. Drug Alcohol Depend 108: pp. 29-36 CrossRef
- Graeber, DA, Moyers, TB, Griffith, G, Guajardo, E, Tonigan, S (2003) A pilot study comparing motivational interviewing and an educational intervention in patients with schizophrenia and alcohol use disorders. Community Ment Health J 39: pp. 189-202 CrossRef
- McCambridge, J, Kypri, K (2011) Can simply answering research questions change behaviour? Systematic review and meta analyses of brief alcohol intervention trials. PLoS One 6: pp. e23748 CrossRef
- Bernstein, JA, Bernstein, E, Heeren, TC (2010) Mechanisms of change in control group drinking in clinical trials of brief alcohol intervention: implications for bias toward the null. Drug Alcohol Rev 29: pp. 498-507 CrossRef
- Sobell, LC, Cunningham, JA, Sobell, MB (1996) Recovery from alcohol problems with and without treatment: prevalence in two population surveys. Am J Public Health 86: pp. 966-972 CrossRef
- Bischof, G, Rumpf, HJ, Meyer, C, Hapke, U, John, U (2005) Influence of psychiatric comorbidity in alcohol-dependent subjects in a representative population survey on treatment utilization and natural recovery. Addiction 100: pp. 405-413 CrossRef
- Fiellin, DA, Reid, MC, O'Connor, PG (2000) Screening for alcohol problems in primary care: a systematic review. Arch Intern Med 160: pp. 1977-1989 CrossRef
- Hyman, Z (2006) Brief interventions for high-risk drinkers. J Clin Nurs 15: pp. 1383-1396 CrossRef
- Neumann, T, Spies, C (2003) Use of biomarkers for alcohol use disorders in clinical practice. Addiction 98: pp. 81-91 CrossRef
- Varga, A, Hansson, P, Lundqvist, C, Alling, C (1998) Phosphatidylethanol in blood as a marker of ethanol consumption in healthy volunteers: comparison with other markers. Alcohol Clin Exp Res 22: pp. 1832-1837
- Brief alcohol intervention in a psychiatric outpatient setting: a randomized controlled study
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Addiction Science & Clinical Practice
- Online Date
- October 2012
- Online ISSN
- BioMed Central
- Additional Links
- Brief intervention
- Alcohol intervention
- Hazardous use
- Harmful use
- Psychiatric outpatients