Integrated Treatment at the First Stage: Increasing Motivation for Alcohol Patients with Comorbid Disorders during Inpatient Detoxification

AIMS: Co-occurring mental disorders can complicate the detoxification treatment process and outcome. The aim of this study is to examine whether a brief psychoeducational group counseling session during detoxification treatment can increase the motivation for and utilization of subsequent treatments. SHORT SUMMARY: Interventions increased utilization of post-detoxification treatment and reduced alcohol-related readmissions. Higher depression or trauma scores were associated with higher rates of utilization of treatment. METHODS: Patients received either a brief manualised group intervention on the interrelation of alcohol use disorder (AUD) and major depression (MD) or AUD and post-traumatic stress disorder (PTSD) or a cognitive training session (control group). Of the 784 patients treated in the study period, 171 participants were quasi-randomly allocated to groups. Self-reported motivation was measured before and after intervention, transition into AUD treatment and readmissions were collected after detoxification treatment. RESULTS: Participating in any of the intervention groups increased the utilization of AUD treatment after inpatient detoxification (χ2 = 6.15, P = 0.02) and decreased readmissions 6 months after discharge (χ2 = 7.46, P = 0.01). Depression and trauma scores moderated the effect: associations with the utilization of post-detoxification treatment were found in participants with higher depression (OR = 5.84, 95% CI = 1.17-29.04) or trauma scores (OR = 10.17, 95% CI = 1.54-67.1). CONCLUSIONS: An integrated intervention approach for dual diagnosis at the beginning of the treatment can increase motivation for continued AUD treatment. Especially affected dual diagnosis patients can benefit from this treatment.