Effectiveness of a digital alcohol moderation intervention as an add-on to depression treatment for young adults: study protocol of a multicentre pragmatic randomized controlled trial

Abstract

Background Depressive disorders and problematic drinking often co-occur, also among young adults. These co-occurring conditions are associated with various negative health outcomes compared to both conditions alone. Early intervention by addressing alcohol use and depressive symptoms simultaneously in the same treatment might improve both conditions. However, evidence on the (cost-) effectiveness of digital combined depression and alcohol interventions for young adults is currently insufficient. We therefore developed an add-on digital alcohol moderation adherence-focussed guided intervention to complement treatment as usual (TAU) for depressive disorders. The digital intervention is a web-app, including 6 modules based on motivational interviewing and cognitive behavioural therapy. This study aims to evaluate the (cost-)effectiveness of a digital alcohol moderation intervention + TAU compared to TAU on alcohol and depression outcomes among young adults with co-occurring depressive disorders and problematic alcohol use. Methods One hundred fifty-six participants, aged 18–35 years, with problematic alcohol use and a diagnosed depressive disorder will participate in a pragmatic multicentre two-arm randomized controlled trial. Problematic alcohol use is operationalised as scoring ≥5 for women and ≥ 8 for men on the Alcohol Use Disorder Identification Test (AUDIT). Participants will be randomized to either the experimental group (digital alcohol intervention + TAU) or control group (TAU only). Participants will be recruited at three Dutch mental health care centres and through social media. Assessments take place at baseline and after 3, 6 and 12 months post-randomization. The primary outcome is treatment response at 6-month follow-up, operationalized as a composite score that combines alcohol use and depression measures and indicates whether treatment has been successful or not. Secondary outcomes are depressive symptoms and alcohol use (i.e. number of weekly standard drinks and AUDIT score). An economic evaluation will be conducted alongside the trial. Discussion This study evaluates the (cost-) effectiveness of an add-on digital alcohol moderation intervention for young adults who are in treatment for depressive disorders. If proven effective, the digital intervention could be implemented in mental health care and improve treatment for people with co-occurring depressive disorders and problematic alcohol use. Trial registration Pre-registered on October 29, 2019 in The Netherlands Trial Register (NL8122).

Preferences of young adults on the development of a new digital add-on alcohol intervention for depression treatment: A qualitative study

“…1 ). A detailed overview of the content and features of the final digital intervention has been published elsewhere ( Schouten et al, 2021 ).

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“…This qualitative study was conducted to inform the development of a novel add-on digital alcohol intervention to complement depression treatment for young adults with co-occurring depression and problematic alcohol use. The development of the digital alcohol intervention was part of a larger study in which we aimed to develop and evaluate the (cost-)effectiveness of this digital alcohol intervention for depression treatment ( Schouten et al, 2021 ). The randomized controlled trial protocol and detailed overview of the content and features of the final digital intervention have been published elsewhere ( Schouten et al, 2021 ).…”

“…The development of the digital alcohol intervention was part of a larger study in which we aimed to develop and evaluate the (cost-)effectiveness of this digital alcohol intervention for depression treatment ( Schouten et al, 2021 ). The randomized controlled trial protocol and detailed overview of the content and features of the final digital intervention have been published elsewhere ( Schouten et al, 2021 ). The add-on digital alcohol intervention was developed to be followed simultaneously, but not integrated with, regular outpatient depression treatment (treatment as usual, TAU).…”

“…Given the relative scarcity of suitable digital treatments specifically for young adults with co-occurring depression and problematic alcohol use, more tailored digital interventions are warranted ( Schouten et al, 2022 ). As part of a larger research project, we developed a new add-on digital alcohol intervention to complement depression for young adults with co-occurring depression and problematic alcohol use (for details, see Schouten et al, 2021 ). The current qualitative study was conducted using focus group data collected among young adults to inform the development of this digital alcohol intervention.…”

Digital Mental Health Amid COVID-19

“…A systematic review also concluded there needs to be higher understanding of the (cost-)effectiveness of digital psychological interventions [80]. A randomized controlled trial is currently partly evaluating the (cost-)effectiveness of a digital alcohol moderation intervention (web app based on motivational interviewing and CBT) which was added to an existing depression treatment for young adults [81].…”