Effects of behavioural activation on substance use and depression: a systematic review

Abstract

IntroductionSubstance use and depression co-occurrence is a frequent phenomenon and an important public health concern. Given the clinical implications and the high prevalence of both disorders, effective interventions are needed.MethodsThe aim of this study is to review Behavioural Activation (BA) intervention effects to improve substance use behaviour and depression. A systematic review was conducted using MEDLINE, EMBASE, and PsycINFO. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of included studies. Two authors independently screened titles and abstracts, reviewed selected studies, and extracted data.ResultsOf the 7286 studies identified, eight met inclusion criteria. Designs of the studies included six randomized controlled trials (RCTs), and two pre-post design studies. One trial received weak methodological quality, six moderate, and one strong. Three studies addressed smoking behaviour; two targeted opiate dependence; two focused on alcohol/drug dependence; and, one on crystal methamphetamine abuse. Results showed that BA had a positive effect on substance use outcomes in seven of the eight reviewed studies, and improved depression over time in six studies.ConclusionsAlthough studies conducted so far are limited by their heterogeneity and sample sizes, results are promising. There is a need of well controlled and powered studies to establish and to confirm the effectiveness of BA for the treatment of substance use and depression. Future studies should include stronger methodological designs, larger sample sizes, and long-term follow-ups.Trial registrationPROSPERO registration number: CRD42016039412.Electronic supplementary materialThe online version of this article (10.1186/s13011-018-0173-2) contains supplementary material, which is available to authorized users.

A preliminary study on the application of Behavioral Activation in the treatment of smoking in women

“…It even agrees with Martínez-Vispo et al (2018), who found that the results of their systematic review suggested that BA can help improve substance use abstinence and depressive symptoms, but that further research is needed to support its effectiveness.…”

“…Therefore, since emotional comorbidity with tobacco impedes successful treatment, psychological interventions would have to be developed that enable the symptomatology to be approached simultaneously, thereby increasing the likelihood of abstinence (Martínez-Vispo et al, 2018).…”

Cognitive-behavioral treatment with behavioral activation for smoking cessation: Randomized controlled trial

“…BA has shown its efficacy and cost-effectiveness, resulting in a front-line treatment for depression [24,25]. In addition, it is also an empirically supported treatment to increase well-being in nonclinical populations [26], and it has obtained positive results when it was included in the treatment of substance use disorders [27–29].…”

The Neural Processes Interlinking Social Isolation, Social Support, and Problem Alcohol Use

“…In the treatment of substance and alcohol use disorders, social support has been incorporated as one of the core components of behavioral activation intervention that emphasizes substance-free positive reinforcement ( Daughters et al, 2018 ). Enhancement of social skills, support, and rewards can facilitate cognitive control and reduce avoidance ( Hopko et al, 2011 ), both of which have been found to disengage individuals from drug use ( Martínez-Vispo et al, 2018 ) and sustain abstinence ( Daughters et al, 2018 ). In contrast, lack of social support is associated with increased impulsivity and alcohol consumption in both light ( Pauley and Hesse, 2009 ) and dependent ( Jakubczyk et al, 2013 ) drinkers.…”