Initial depression and subsequent drinking during alcoholism treatment

Objective: Individuals entering treatment for alcoholism have elevated depressive symptoms that in turn may affect response to treatment, including drinking outcomes. The purpose of the study is to examine the impact of depression at treatment entry on drinking over the course of treatment. Method: The Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) data set, a randomized, multisite psychosocial treatment trial for alcoholism, was analyzed. The sample consisted of 1,450 subjects, of whom 1,102 (76.0%) were male and 348 (24.0%) were female. Cross-lagged analyses of (1) depression and drinking intensity and (2) depression and drinking frequency were conducted using path analysis. Covariates were age, gender, race, and treatment assignment. Analyses focused on the 3-month active treatment phase of the trial. Results: Depression at treatment entry predicted more intense drinking and more frequent drinking, respectively, in the first month of treatment but showed little association with drinking in Months 2 and 3. Conclusions: Individuals entering treatment for alcoholism with elevated levels of depression may be slower to benefit from treatment. Because the initial phase of treatment may be crucial to successful engagement and retention, the development of interventions to improve early success in treatment among individuals with elevated levels of depression may be beneficial. Future studies should examine the long-term, bidirectional relationship of depression and drinking following treatment.