***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this study was to evaluate the 6-month outcomes of a brief intervention to reduce alcohol consumption by psychiatric in- patients in the general hospital setting and following resolution of psychiatric morbidity . Patients from the psychiatric wards of three general hospitals were screened using the Alcohol Use Disorders Identification Test . Of 144 people approached who matched the study criteria , 120 ( 83 % ) people aged 18 - 64 years ( mean 31.7 ) were recruited . Participants were r and omized to either a brief motivational interview or an information package to reduce alcohol consumption . Alcohol consumption was assessed as total weekly consumption and categorized on Australian National Health and Medical Research Council ( NH&MRC ) criteria . We delivered 62 motivational interviews and 58 information packages . At the 6-month follow-up 83 ( 69 % ) , participants were reassessed . Both groups had significantly reduced alcohol consumption . However , the motivation group had a significantly greater reduction in weekly consumption than the information group ( F = 6.8 , ( 1,65 ) p < 0.025 ) after controlling for age , sex , SCL-90-R GSI and alcohol dependence ( and baseline alcohol consumption ) . A greater proportion of the motivation group compared to the information group also ' improved ' in their classification on NH&MRC criteria ( chi(2 ) = 7.3 , df 1 , p < 0.01 ) . Brief interventions , especially motivational interviews , are effective in reducing alcohol use in persons with psychiatric disorders . They are effective across the mid-range of GSI severity scores for in- patients . Screening and brief interventions can and should be incorporated into the routine assessment and management in psychiatric units Interpersonal psychotherapy ( IPT ) has demonstrated efficacy for depression but yielded negative results for substance disorders . Alcohol abuse frequently complicates mood disorders . This pilot study compared IPT with brief supportive psychotherapy ( BSP ) for dysthymic disorder and alcohol abuse . We hypothesized that effect sizes would suggest greater IPT efficacy for both diagnoses , despite limited statistical power . Subjects with primary DSM-IV dysthymic disorder and secondary alcohol abuse/dependence were r and omly assigned 16 weeks of IPT ( N = 14 ) or BSP ( N = 12 ) . Patients in both treatments reported improved depressive symptoms and alcohol abstinence .  IPT had a large and BSP a moderate effect size in depression , whereas BSP had a moderate and IPT a small effect size in percentage of days abstinent . This pilot study offers initial data on IPT and BSP for comorbid chronic depression and alcohol abuse/dependence . Results suggest IPT may have specific antidepressant benefits for dysthymic alcoholic patients but not in treating alcoholism Substance misuse among people with severe mental disorders is very common and has been associated with a number of adverse outcomes . Most trials among people with severe mental disorders have reported general substance misuse outcomes and have argued that longer treatments are likely to be more effective . Such studies have not specifically compared intervention effectiveness for alcohol vs. cannabis misuse . The present paper reports findings from a synthesis of data sets from three r and omized controlled trials ( N=248 ) comparing brief ( 1-session advice or motivational interviewing , MI ) and extended ( 10 sessions MI/cognitive-behaviour therapy ; CBT ) interventions for substance misuse among people with psychosis or major depression and outcomes are reported separately for alcohol and cannabis use . Whilst there were comparable rates of reduction in alcohol consumption for the BI and intensive MI/CBT , BI tended to be associated with less reduction in cannabis use . A stepped care approach for substance misuse in people with severe mental disorders may help to improve cannabis outcomes , including monitoring of both mental health and substance misuse domains , with interventions stepped up or down according to treatment response . Future studies should evaluate the effectiveness of stepped care approaches BACKGROUND Social anxiety disorder ( also called social phobia ) is an anxiety disorder in which affected individuals fear the scrutiny of others . Clinical reports suggest that individuals with social anxiety disorder often use alcohol to alleviate anxiety symptoms , a practice that leads to alcohol abuse and /or dependence in approximately 20 % of affected individuals . The present study investigated whether simultaneous treatment of social phobia and alcoholism , compared with treatment of alcoholism alone , improved alcohol use and social anxiety for clients with dual diagnoses of social anxiety disorder and alcohol dependence . METHODS The design was a two-group , r and omized clinical trial that used 12 weeks of individual cognitive behavioral therapy for alcoholism only ( n = 44 ) or concurrent treatment for both alcohol and social anxiety problems ( n = 49 ) . Outcome data were collected at the end of 12 weeks of treatment and at 3 months after the end of treatment . RESULTS Results with intent-to-treat analyses showed that both groups improved on alcohol-related outcomes and social anxiety after treatment . With baseline scores covaried , there was a significant effect of treatment group on several drinking measures . Counter to the hypothesis , the group treated for both alcohol and social anxiety problems had worse outcomes on three of the four alcohol use indices . No treatment group effects were observed on social anxiety indices . CONCLUSIONS Implication s for the staging of treatments for coexisting social phobia and alcoholism are discussed , as well as ways that modality of treatments might impact outcomes Homeless shelters provide a unique opportunity to intervene with occupants who have substance abuse problems , as not addressing these issues may lead to continuation of problems playing a contributing role in homelessness . Attempts to implement Contingency Management ( CM ) with this population have often been complex , costly , and not straightforward to replicate in community setting s. We conducted a r and omized trial evaluating a simple , low-cost 4-week CM program for 30 individuals seeking shelter in a community-based homeless shelter who had both current substance and psychiatric disorders .  Behavioral assessment s were performed at baseline , weekly , and termination of the study . Overall retention in the trial was high ; participants assigned to CM reduced their cocaine and alcohol use more than those in assessment -only . This pilot trial suggests that application of low-cost CM procedures is feasible within this novel setting and may decrease substance use AIMS Alcohol use disorders and depression co-occur frequently and are associated with poorer outcomes than when either condition occurs alone . The present study ( Depression and Alcohol Integrated and Single-focused Interventions ; DAISI ) aim ed to compare the effectiveness of brief intervention , single-focused and integrated psychological interventions for treatment of coexisting depression and alcohol use problems . METHODS Participants ( n = 284 ) with current depressive symptoms and hazardous alcohol use were assessed and r and omly allocated to one of four individually delivered interventions : ( i ) a brief intervention only ( single 90-minute session ) with an integrated focus on depression and alcohol , or followed by a further nine 1-hour sessions with ( ii ) an alcohol focus ; ( iii ) a depression focus ; or ( iv ) an integrated focus . Follow-up assessment s occurred 18 weeks after baseline . RESULTS Compared with the brief intervention , 10 sessions were associated with greater reductions in average drinks per week , average drinking days per week and maximum consumption on 1 day . No difference in duration of treatment was found for depression outcomes . Compared with single-focused interventions , integrated treatment was associated with a greater reduction in drinking days and level of depression .  For men , the alcohol-focused rather than depression-focused intervention was associated with a greater reduction in average drinks per day and drinks per week and an increased level of general functioning .  Women showed greater improvements on each of these variables when they received depression-focused rather than alcohol-focused treatment . CONCLUSIONS Integrated treatment may be superior to single-focused treatment for coexisting depression and alcohol problems , at least in the short term . Gender differences between single-focused depression and alcohol treatments warrant further study OBJECTIVE Evidence has emerged which indicates that the post-treatment relapse rate for alcohol-dependent patients with a comorbid anxiety disorder is higher than for alcohol-dependent patients without a comorbid anxiety disorder . The question raised by this evidence is whether the relapse rate in these dually diagnosed patients could be reduced if they were given additional treatment for the comorbid anxiety disorder . We attempted to answer this question by conducting a trial among patients with a double diagnosis of alcohol dependence and agoraphobia or social phobia . METHOD We conducted a 32-week r and omized controlled trial among 96 abstinent patients with a primary diagnosis of alcohol dependence and a comorbid anxiety disorder involving agoraphobia or social phobia . The patients were r and omly assigned to an intensive psychosocial relapse-prevention program on its own ( n = 49 ) or in combination with an anxiety treatment program comprising cognitive behavioral therapy ( CBT ) and optional pharmacotherapy consisting of an SSRI ( n = 47 ) . The primary outcome measure was the percentage of patients who suffered an alcohol relapse during a 32-week period . The secondary outcome measures were total abstinence , a reduction in the days of heavy drinking , and less severe anxiety symptoms . RESULTS Although the additional therapy clearly reduced the anxiety symptoms , it had no significant effect on the alcohol relapse rates . CONCLUSION Anxiety treatment for alcohol-dependent patients with a comorbid anxiety disorder can alleviate anxiety symptoms , but it has no significant effect on the outcome of alcohol treatment programs This study was conducted to examine the effects of contingent monetary reinforcement ( CM ) for smoking reduction , with and without transdermal nicotine , on cigarette smoking  in individuals with schizophrenia . Fourteen out patients participated in each of 3 conditions : ( a ) CM combined with 21 mg transdermal nicotine , ( b ) CM combined with placebo patch , and ( c ) noncontingent reinforcement combined with placebo patch . Each condition lasted 5 days . Carbon monoxide levels were measured 3 times daily , and nicotine withdrawal symptoms were measured once daily in each condition . Results indicated that CM  reduced smoking but that 21 mg transdermal nicotine did not enhance that effect . These results offer further evidence supporting the efficacy of CM for reducing smoking among people with schizophrenia , but higher doses of nicotine replacement therapy , or another pharmacotherapy , may be needed to enhance that effect BACKGROUND Psychotherapy of " pure " dysthymic disorder remains understudied . This article reports outcomes of an acute r and omized trial of 94 subjects treated for 16 weeks with either interpersonal psychotherapy ( IPT ) , brief supportive psychotherapy ( BSP ) , sertraline , or sertraline plus IPT .  METHODS Recruited by clinical referral and advertising , subjects met DSM-IV criteria for early onset dysthymic disorder , with no episode of major depression in the prior six months . They were r and omly assigned to one of four 16-week treatments , with options for crossover or continuation treatment . Results were analyzed from the intention-to-treat sample by ANCOVA , controlling for baseline depressive severity . RESULTS Subjects improved in all conditions over time , with the cells including sertraline pharmacotherapy showing superiority over psychotherapy alone for response and remission . Response rates were 58 % for sertraline alone , 57 % for combined treatment , 35 % for IPT , and 31 % for BSP . LIMITATIONS The study was underpowered and may have employed too " active " a control condition . Follow-up data were unobtainable . CONCLUSIONS In this acute trial for " pure " dysthymic disorder , sertraline with or without IPT showed advantages relative to IPT and BSP . Method ological difficulties may have limited differential outcome findings . This study bolsters a small but growing literature on the treatment of dysthymic disorder , suggesting that pharmacotherapy may acutely benefit patients more than psychotherapy 
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DATA SYNTHESIS Motivational interviewing and cognitive-behavioral interventions were associated with significant reductions in alcohol consumption and depressive and /or anxiety symptoms .
Although brief interventions were associated with significant improvements in both mental health and alcohol use variables , longer interventions produced even better outcomes .
There is accumulating evidence for the effectiveness of motivational interviewing and cognitive behavior therapy for people with co-occurring alcohol and depressive or anxiety disorders