A brief motivational intervention for substance misuse in recent-onset psychosis

TitleA brief motivational intervention for substance misuse in recent-onset psychosis
Publication TypeJournal Article
Year of Publication2004
AuthorsKavanagh, DJ, Young, R, White, A, Saunders, JB, Wallis, J, Shockley, N, Jenner, L, Clair, A
JournalDrug and Alcohol Review
Date PublishedJun
Publication Languageeng
ISBN Number0959-5236 (Print)0959-5236 (Linking)
Accession Number15370020
Keywords*Motivation, Adolescent, Adult, Brief Psychiatric Rating Scale, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Interviews as Topic, Male, Pilot Projects, Psychotherapy, Brief/*methods, Psychotic Disorders/*etiology, Schizophrenia/etiology, Single-Blind Method, Substance-Related Disorders/*complications/diagnosis/*rehabilitation, Time Factors

Substance misuse is common in early psychosis, and impacts negatively on outcomes. Little is known about effective interventions for this population. We report a pilot study of brief intervention for substance misuse in early psychosis (Start Over and Survive: SOS), comparing it with Standard Care (SC). Twenty-five in-patients aged 18-35 years with early psychosis and current misuse of non-opioid drugs were allocated randomly to conditions. Substance use and related problems were assessed at baseline, 6 weeks and 3, 6 and 12 months. Final assessments were blind to condition. All 13 SOS participants who proceeded to motivational interviewing reported less substance use at 6 months, compared with 58% (7/12) in SC alone. Effects were well maintained to 12 months. However, more SOS participants lived with a relative or partner, and this also was associated with better outcomes. Engagement remained challenging: 39% (16/41) declined participation and 38% (5/13) in SOS only received rapport building. Further research will increase sample size, and address both engagement and potential confounds.

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