Clinical trial NCT06789250: Co-occurence of Mental Illness and Problematic Alcohol Use: an Internet-based Cognitive Behavior Therapy Intervention
Official title: Co-occurence of Mental Illness and Problematic Alcohol Use: an Internet-based Cognitive Behavior Therapy Intervention
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Alcohol Drinking Related Problems
Alcohol Use Disorders
Depressive Disorders
Mental Illness
Mental Stress
Mental and Behavioral Disorders
Sleep Problems
Stress Disorders
Anxiety Disorder/Anxiety State
Keywords: Internet intervention
Depression
Anxiety
Individually tailored
Transdiagnostic
Internet-based cognitive behavioral therapy (ICBT)
Stress
Sleeping disorders
Mental illness
Harmful alcohol use
Alcohol addiction
Lead sponsor: Linkoeping University
Sponsor class: OTHER_GOV
First posted: 2025-01-23
Enrollment: 240
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The goal of this clinical trial is to learn if internet-based cognitive behavior therapy (ICBT ) works to treat co-occurent of problematic alcohol use and mental illness including mild to moderate symptoms of either depression, anxiety, stress or disturbed sleep.

The main questions the study aims to answer are:

* Does the ICBT program lower the self-rated suffering from mental illness?
* Does the ICBT program lower the self-reported alcohol intake? Researchers will compare the ICBT program to the participants who are rancomized to a control grout that receives weekly attention from the research team, to see if the treatment works. In both groups, the participants will have the opportunity to ask for support from a therapist during the week days.

Participants are adults living in Sweden. They will:

* Receive an ICBT program supported by a trained therapist. It consists of modules that the participants will work with on their computer for 10 weeks. Some modules will be compulsory and other optional for the participants.
* Fill out forms to rate their mental illness and alcohol intake at the start and the end of the study as well as once every week during treatment.

Primary outcome measures are depression, anxiety and stress symptoms (measured with Depression Anxiety and Stress Scale 21 (DASS-21)) and alcohol intake measured with self-reported amounts. Other, secondary, outcome measures used will for example be about insomnia symptoms and disability assessment. Pre-treatment measurement, post-treatment measurement and 6-months and 12-months follow up is planned to be collected through an online survey.


Eligibility criteria: Inclusion Criteria:

* Age ≥18 years
* AUDIT ≥ 6 points for women and ≥ 8 points for men
* Symptoms of depression, anxiety disorder and/or stress-related illness
* Adequate ability to speak, read and write Swedish
* Having access to the internet and a smartphone, computer or other device.

Exclusion Criteria:

* Ongoing psychological treatment.
* Ongoing medication for AUD
* Recent changes (within the past three months) in psychiatric medication or planned changes during the treatment period. New medication prescribed during the study shall be reported but will not lead to exclusion
* Severe psychiatric disorders based on a Mini-International Neuropsychiatric Interview (MINI) interview and reported medical history
* Severe medical conditions that may impede participation in the study
* Severe cognitive impairment
* Current suicidality
* Severe alcohol addiction where specialized treatment is more appropriate
* Risk for severe alcohol withdrawal symptoms with a need for medical treatment. Participation is possible after completing alcohol withdrawal treatment within the ordinary health-care system, accessible to the Swedish population.
* Substance use disorder, other than alcohol or nicotine, within the past six months.

Primary outcomes:
measure: High-risk alcohol drinking days (HDD)
timeFrame: Change between baseline and end of treatment (expected 3 months after baseline). Additionally the change between baseline and 6 months and 12 months follow-up after end of treatment (hence expected 9 months and 15 months after baseline).
measure: The Depression Anxiety Stress Scales (DASS-21)
timeFrame: Change between baseline and end of treatment (expected 3 months after baseline). Additionally the change between baseline and 6 months and 12 months follow-up after end of treatment (hence expected 9 months and 15 months after baseline).
Secondary outcomes:
measure: Number of self-reported alcohol abstinent days
timeFrame: At baseline, every 7 days during treatment, at end of treatment (expected 3 months after baseline) and 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: Total amount of alcohol intake
timeFrame: At baseline, every 7 days during treatment, at end of treatment (expected 3 months after baseline) and 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: Alcohol craving Visual analogue scale (AC-VAS)
timeFrame: At baseline, every 7 days during treatment, at end of treatment (expected 3 months after baseline) and 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: Insomnia Severity Index (ISI)
timeFrame: At baseline, at end of treatment (expected 3 months after baseline) and follow-up 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: Perceived Stress Scale (PSS-10)
timeFrame: At baseline, at end of treatment (expected 3 months after baseline) and follow-up 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: The World Health Organization Disability Assessment Schedule (WHODAS-12)
timeFrame: At baseline, at end of treatment (expected 3 months after baseline) and follow-up 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: The Short Index of Problems (SIP)
timeFrame: At baseline, at end of treatment (expected 3 months after baseline) and follow-up 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: Montgomery-Åsberg Depression Rating Scale (MADRS)
timeFrame: At baseline, at mid-treatment (expected 6 weeks after baseline), at end of treatment (expected 3 months after baseline) and follow-up at 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: Alcohol Use Disorder Identification Test
timeFrame: At baseline, at end of treatment (expected 3 months after baseline) and follow-up 6 months and 12 months after end of treatment (expected 9 months and 15 months after baseline).
measure: B-Phosphatidylethanol (PEth)
timeFrame: At baseline and at end of treatment (expected 3 months after baseline).
Other outcomes:
Locations:
city: Linköping
country: Sweden
facility: Linköping University
city: Linköping
country: Sweden
facility: Department of Behavioral Sciences and Learning, Linköping University
state: Östergötland
Study officials:
affiliation: Linkoeping University
name: Gerhard Andersson, Professor
role: PRINCIPAL_INVESTIGATOR
References: