***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: Although negative affect is a common precipitant of alcohol relapse , there are few interventions for alcohol dependence that specifically target negative affect . In this stage 1a/1b treatment development study , several affect regulation strategies ( e.g. , mindfulness , prolonged exposure , distress tolerance ) were combined to create a new treatment supplement called affect regulation training ( ART ) , which could be added to enhance cognitive-behavioral therapy ( CBT ) for alcohol dependence . A draft therapy manual was given to therapists and treatment experts before being administered to several patients who also provided input . After two rounds of manual development ( stage 1a ) , a pilot r and omized clinical trial ( N=77 ) of alcohol-dependent out patients who reported drinking often in negative affect situations was conducted ( stage 1b ) . Participants received 12-weekly , 90-minute sessions of either CBT for alcohol dependence plus ART ( CBT+ART ) or CBT plus a healthy lifestyles control condition ( CBT+HLS ) . Baseline , end-of-treatment , and 3- and 6-month posttreatment interviews were conducted . For both treatment conditions , participant ratings of treatment satisfaction were high , with CBT+ART rated significantly higher . Drinking outcome results indicated greater reductions in alcohol use for CBT+ART when compared to CBT+HLS , with moderate effect sizes for percent days abstinent , drinks per day , drinks per drinking day , and percent heavy drinking days . Overall , findings support further research on affect regulation interventions for negative affect drinkers AIMS Acamprosate in combination with psychosocial treatment has been shown to be effective for the treatment of alcohol dependence . The goal of the present study was to determine whether the addition of psychosocial intervention to the medical prescription of acamprosate contributes to treatment outcome . METHODS Patients ( n = 248 ) meeting DSM-IV criteria for alcohol dependence or abuse were recruited in 14 outpatient treatment centres and r and omized into one of three treatment conditions : acamprosate ; acamprosate plus minimal intervention aim ed at motivational enhancement ( 3-weekly sessions of 20 min ) ; and acamprosate plus brief cognitive behavioural therapy ( 7-weekly sessions of 60 min ) . Acamprosate was prescribed for 28 weeks , medically monitored by a physician on six occasions lasting 10 min . Drinking behaviour , medication compliance and psychological distress were assessed throughout the treatment period . Follow-up assessment was undertaken 6 months after termination of pharmacological treatment . RESULTS Of 241 patients with intention to treat ( ITT ) , 114 ( 47.3 % ) remained in treatment for the full 28 weeks ; 169 of the ITT population ( 70.1 % ) were seen for follow-up . No statistically significant differences were found between treatment groups for any of the drinking outcomes either at the end of the 28 weeks of treatment or at 6-month follow-up . There were no statistically significant differences in medication compliance , drop-out rates , or psychological distress . However , a significant interaction effect was observed between treatment centre and treatment group , indicating that brief interventions were differentially effective in different treatment centres . CONCLUSIONS A clear supplemental value of minimal and brief psychosocial interventions to the prescription of acamprosate was not demonstrated . The widely held belief that pharmacotherapy for alcohol dependence should always be combined with psychosocial intervention is debatable and merits further research BACKGROUND This study evaluated the serotonergic antidepressant nefazodone versus placebo and specific cognitive-behavioral therapy ( CBT ) versus nondirective group counseling ( GC ) for relapse prevention in alcohol dependence in a large prospect i ve , r and omized , and placebo-controlled double-blind study at 3 German university centers . METHOD 242 male patients fulfilling at least 5 criteria for alcohol dependence according to DSM-IV and ICD-10 were eligible , after detoxification , for one of the following treatment combinations : nefazodone + CBT , nefazodone + GC , placebo + CBT , and placebo + GC . Either nefazodone or placebo was administered throughout the evaluation period of 15 months . Either CBT or GC was applied during the first 12 weeks as group therapy according to operationalized manuals . The main outcome measures ( assessed at 3 and 12 months of treatment ) were the cumulative number of abstinent days , the amount of ethanol consumed during specified evaluation periods of 3 and 12 months , the number of relapses , and the duration of time until first relapse . RESULTS After 12 weeks of treatment , no statistically significant differences were observed between the 4 treatment combinations in any outcome measure . After 52 weeks , the only significant difference was observed in the amount of ethanol consumed , with the nefazodone + GC group showing higher alcohol intake than the other 3 groups . CONCLUSIONS The results from this carefully design ed clinical trial suggest that the 4 treatment combinations do not differ substantially in their efficacy for relapse prevention in nondepressed , severely alcohol-dependent patients .  Nefazodone might even increase the risk of consuming a larger amount of ethanol per relapse in a subset of patients . CBT as performed in this study was associated with little additional benefit compared with structured GC Summary The comparative effects of alcoholism treatment programmes were examined by r and omly assigning 113 male and female detoxified alcoholics to either : a 6-week inpatient programme , a 6-week outpatient programme or a single confrontational interview . On a variety of outcome measures , that included both levels of drinking and general functioning taken 6 and 18 months after intake , no treatment appeared to be consistently more effective than another . Furthermore , those who stayed in treatment did not show significantly more long-term improvement than those who refused or dropped out of treatment . Abstinent subjects felt more often than drinkers that they had achieved the goals they had set themselves and by the final follow-up there were many positive differences in apparent lifestyle . Although individual drinking patterns were unstable , on average , almost half the subjects located had either abstained or were drinking moderately . Patient and treatment variables combined explained up to 57 % of the variance in amount drunk after treatment , with patient variables providing the strongest associations OBJECTIVE This study was design ed to conduct a r and omized controlled trial of motivational enhancement therapy ( MET ) with two control conditions : nondirective reflective listening ( NDRL ) and no further counseling ( NFC ) ; and to conduct this study in a sample of patients with a primary diagnosis of mild to moderate alcohol dependence , in a " real-life " clinical setting . METHOD Patients with mild to moderate alcohol dependence were recruited , assessed and treated at the Community Alcohol and Drug Service of Christchurch , New Zeal and . All patients received a feedback/education session before r and omization to either four sessions of MET , four sessions of NDRL , or NFC . Outcome data on 122 subjects ( 57.4 % men ) were obtained 6 months following the end of treatment , by an interviewer who was blind to the treatment condition . The primary drinking outcome was unequivocal heavy drinking , defined as drinking 10 or more st and ard drinks six or more times in the follow-up period . Global assessment scale ( GAS ) measured general personal/social functioning . RESULTS Of patients treated with MET , 42.9 % showed unequivocal heavy drinking compared with 62.5 % of the NDRL and 65.0 % of the NFC groups ( p = .04 ) . No significant differences were found for GAS score according to treatment condition . CONCLUSIONS In patients with mild to moderate alcohol dependence , MET is more effective for reducing unequivocal heavy drinking than either a feedback/education session alone or four sessions of NDRL . MET can be considered an effective " value added " counseling intervention in a real-life clinical setting . In patients with mild to moderate alcohol dependence , nondirective reflective listening provides no additional advantage over a feedback/education session alone CONTEXT Alcohol dependence treatment may include medications , behavioral therapies , or both . It is unknown how combining these treatments may impact their effectiveness , especially in the context of primary care and other nonspecialty setting s. OBJECTIVES To evaluate the efficacy of medication , behavioral therapies , and their combinations for treatment of alcohol dependence and to evaluate placebo effect on overall outcome . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial conducted January 2001-January 2004 among 1383 recently alcohol-abstinent volunteers ( median age , 44 years ) from 11 US academic sites with Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition , diagnoses of primary alcohol dependence . INTERVENTIONS Eight groups of patients received medical management with 16 weeks of naltrexone ( 100 mg/d ) or acamprosate ( 3 g/d ) , both , and /or both placebos , with or without a combined behavioral intervention ( CBI ) . A ninth group received CBI only ( no pills ) . Patients were also evaluated for up to 1 year after treatment . MAIN OUTCOME MEASURES Percent days abstinent from alcohol and time to first heavy drinking day . RESULTS All groups showed substantial reduction in drinking . During treatment , patients receiving naltrexone plus medical management ( n = 302 ) , CBI plus medical management and placebos ( n = 305 ) , or both naltrexone and CBI plus medical management ( n = 309 ) had higher percent days abstinent ( 80.6 , 79.2 , and 77.1 , respectively ) than the 75.1 in those receiving placebos and medical management only ( n = 305 ) , a significant naltrexone x behavioral intervention interaction ( P = .009 ) . Naltrexone also reduced risk of a heavy drinking day ( hazard ratio , 0.72 ; 97.5 % CI , 0.53 - 0.98 ; P = .02 ) over time , most evident in those receiving medical management but not CBI . Acamprosate showed no significant effect on drinking vs placebo , either by itself or with any combination of naltrexone , CBI , or both . During treatment , those receiving CBI without pills or medical management ( n = 157 ) had lower percent days abstinent ( 66.6 ) than those receiving placebo plus medical management alone ( n = 153 ) or placebo plus medical management and CBI ( n = 156 ) ( 73.8 and 79.8 , respectively ; P<.001 ) . One year after treatment , these between-group effects were similar but no longer significant . CONCLUSIONS Patients receiving medical management with naltrexone , CBI , or both fared better on drinking outcomes , whereas acamprosate showed no evidence of efficacy , with or without CBI . No combination produced better efficacy than naltrexone or CBI alone in the presence of medical management . Placebo pills and meeting with a health care professional had a positive effect above that of CBI during treatment . Naltrexone with medical management could be delivered in health care setting s , thus serving alcohol-dependent patients who might otherwise not receive treatment . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00006206 OBJECTIVE To assess the benefits of matching alcohol dependent clients to three different treatments with reference to a variety of client attributes . METHODS Two parallel but independent r and omized clinical trials were conducted , one with alcohol dependent clients receiving outpatient therapy ( N = 952 ; 72 % male ) and one with clients receiving aftercare therapy following inpatient or day hospital treatment ( N = 774 ; 80 % male ) . Clients were r and omly assigned to one of three 12-week , manual-guided , individually delivered treatments : Cognitive Behavioral Coping Skills Therapy , Motivational Enhancement Therapy or Twelve-Step Facilitation Therapy . Clients were then monitored over a 1-year posttreatment period . Individual differences in response to treatment were modeled as a latent growth process and evaluated for 10 primary matching variables and 16 contrasts specified a priori . The primary outcome measures were percent days abstinent and drinks per drinking day during the 1-year posttreatment period . RESULTS Clients attended on average two-thirds of treatment sessions offered , indicating that substantial amounts of treatment were delivered , and research follow-up rates exceeded 90 % of living subjects interviewed at the 1-year posttreatment assessment . Significant and sustained improvements in drinking outcomes were achieved from baseline to 1-year posttreatment by the clients assigned to each of these well-defined and individually delivered psychosocial treatments . There was little difference in outcomes by type of treatment . Only one attribute , psychiatric severity , demonstrated a significant attribute by treatment interaction : In the outpatient study , clients low in psychiatric severity had more abstinent days after 12-step facilitation treatment than after cognitive behavioral therapy . Neither treatment was clearly superior for clients with higher levels of psychiatric severity . Two other attributes showed time-dependent matching effects : motivation among out patients and meaning-seeking among aftercare clients . Client attributes of motivational readiness , network support for drinking , alcohol involvement , gender , psychiatric severity and sociopathy were prognostic of drinking outcomes over time . CONCLUSIONS The findings suggest that psychiatric severity should be considered when assigning clients to outpatient therapies . The lack of other robust matching effects suggests that , aside from psychiatric severity , providers need not take these client characteristics into account when triaging clients to one or the other of these three individually delivered treatment approaches , despite their different treatment philosophies AIMS To determine the efficacy of motivational enhancement therapy ( MET ) on alcohol use in patients with the hepatitis C virus ( HCV ) and an alcohol use disorder ( AUD ) . DESIGN R and omized , single-blind , controlled trial comparing MET to a control education condition with 6-month 
    Output:
    
Mean follow-up time : 43 ( 8 - 104 ) weeks with a mean of 6 ( 2 - 18 ) research assessment s. Neither planned weeks , duration of sessions , frequency of sessions per week , nor actual attended sessions were associated with long-term alcohol use outcomes .
However , frequency of research assessment s was positively associated with PDA and PHD .
CONCLUSION No associations between long-term alcohol use outcomes and planned or actual attended duration of psychosocial treatment in outpatient care .
Research assessment s and , accordingly , the research project in itself may influence outcome in studies of psychosocial treatment for alcohol use disorder