Dual Diagnosis Clinical Trial
Official title:
Single Blind Randomised Trial of Supportive Text Messages for Patients With Alcohol Use Disorder and a Co-morbid Depression
Most patients who present with problem drinking also present with mood problems. Problem
drinking and mood problems co-occurring together in individuals lead them to have more severe
symptoms, greater disability and poorer quality of life than individuals with only problem
drinking, and they pose a greater economic burden to society due to their higher use of
health services. This study aims to assess the efficacy of a new, innovative and cost
effective treatment strategy aimed at reducing the burden that these co-occurring conditions
impose on the suffers and their families as well as the community and health systems.
In a recent pilot study of supportive text messages for patients with problem drinking and
co-occurring depression, the investigators established that patients who received twice daily
supportive text messages for three months had significantly less depressive symptoms than
those who did not receive such messages. There was also a trend to finding that patients who
received the supportive text messages were more likely to have higher alcohol free days than
those who did not receive any supportive text messages.
This study seeks to extend the knowledge gained from the pilot study. A larger group of
patients with alcohol use disorder and a depressive disorder will be randomly assigned to two
groups. One group will receive supportive text messages for six months duration whilst the
other group will receive no supportive text messages. The patients will be followed up at 3,
6, 9 and 12 months to determine which of the two groups have less alcohol and mood problems.
It is anticipated that patients receiving supportive text messages will report significantly
greater alcohol free days as well as significantly less relapses, hospitalizations and mood
symptoms than those not receiving such messages.
Co-morbidity of alcohol use disorder (AUD) and mood disorders presents a great challenge to
health systems and exacts a tremendous toll world-wide. Individuals with a dual diagnosis
have more severe symptoms, greater disability and poor quality of life than those with either
diagnosis alone, and pose a greater economic burden to society due to their higher use of
treatment services. New, enhanced, efficient, innovative and cost effective treatment
strategies aimed at reducing the burden that the disorders impose on the suffers and their
families as well as the community and health systems are required. In a pilot trial of
supportive text messages for patients with alcohol use disorders and co-morbid depression,
the investigators established that patients who received twice daily supportive text messages
for three months had significantly less depressive symptoms than those who did not receive
such messages. There was also a trend to finding that patients who received the supportive
text messages were more likely to have higher cumulative abstinence duration than those who
did not receive any supportive text messages.
This research seeks to extend the knowledge gained from the pilot trial. A randomised trial
will be conducted on a larger sample size of patients with alcohol use disorder and a
co-morbid depressive disorder (including bipolar depression) for an extended duration (6
months of supportive text messages and 1 year follow-up instead of 3 months text messages
with 6 months follow-up in the pilot trial). It is hypothesised that patients receiving
supportive text messages will report significantly greater cumulative abstinence duration as
well as significantly less relapses, hospitalizations and mood symptoms than those not
receiving such messages. It is anticipated that this technology intervention for relapse
prevention will be acceptable to patients as well as cost effective.
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