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- Alcohol Use (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 18 of 18 Research Studies DisplayedMarks MR, Dux MC, Rao V
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
Investigators examined psychotropic medication use and psychotherapy patterns among individuals diagnosed with anxiety disorders and PTSD post-traumatic brain injury (TBI). They found that receipt of pharmacotherapy pre- and post-TBI was considerably more common than receipt of psychotherapy. Individuals diagnosed with anxiety were 66% less likely to receive psychotherapy compared with individuals diagnosed with PTSD. Overall, psychotropic medication use and rates of antidepressant prescription use in the anxiety group were higher compared to those in the PTSD group.
AHRQ-funded; HS024560.
Citation: Marks MR, Dux MC, Rao V .
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
J Neuropsychiatry Clin Neurosci 2022 Summer;34(3):247-53. doi: 10.1176/appi.neuropsych.21040104..
Keywords: Anxiety, Behavioral Health, Trauma, Brain Injury, Treatments, Practice Patterns, Medication
Korthuis PT, Cook RR, Lum PJ
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Opioid Use Disorder (OUD) treatment medications can improve outcomes for human immunodeficiency virus (HIV) and also reduce opioid use. The purpose of the study was to determine if outpatient naltrexone treatment could also reduce opioid use and improve outcomes for HIV. The researchers reported that enrollment was stopped early because of slower than expected recruitment, resulting in 114 final participants with untreated OUD and HIV, with 62% positive for fentanyl, 60% positive for cocaine, and 47% positive for other opioids at the baseline. The intervention compared treatment as usual (TAU) of methadone or buprenorphine with extended-release naltrexone (XR-NTX) on group differences in viral suppression at 24 weeks and past 30-day use of opioids at 24 weeks. The study reported that at 24 weeks the outcome of viral suppression was similar for TAU and XR-NTX, and that fewer XR-NTX participants initiated medication than TAU participants. The outcome of previous 30-day use of opioids was similar for TAU as compared to XR-NTX. Of those participants who did initiate medication, those administered XR-NTX experienced less days of opioid use when compared with TAU in the prior 30 days. The researchers reported that the study evidence was not conclusive but did support that XR-NTX is not inferior to TAU for HIV viral suppression, and that study participants who started XR-NTX used less opioids at 24 weeks than participants who were administered TAU.
AHRQ-funded; HS026370.
Citation: Korthuis PT, Cook RR, Lum PJ .
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Addiction 2022 Jul;117(7):1961-71. doi: 10.1111/add.15836..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Behavioral Health, Medication, Treatments, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Wright JH, Owen J, Eells TD
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression. The purpose of this study was to evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.
AHRQ-funded; HS024047.
Citation: Wright JH, Owen J, Eells TD .
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
JAMA Netw Open 2022 Feb;5(2):e2146716. doi: 10.1001/jamanetworkopen.2021.46716..
Keywords: Depression, Behavioral Health, Primary Care, Treatments, Comparative Effectiveness
Rhee TG, Sint K, Olfson M
Association of ECT with risks of all-cause mortality and suicide in older Medicare patients.
This observational study examined the effects of electroconvulsive therapy (ECT) on suicide and all-cause mortality risk in Medicare psychiatric patients age 65 or older. Patients receiving ECT were exact matched to control subjects in a 1-to-3 ratio on age, gender, principal hospital diagnosis, past-year psychiatric hospitalizations, past-year suicide attempts, and Elixhauser comorbidity index. A total of 10,46 patients were in the ECT group and 31,160 in the control group. Compared with the control group, patients receiving ECT had lower all-cause mortality for up to 1 year following hospital discharge. For death by suicide, ECT was associated with short-lived effects which waned over time.
AHRQ-funded; HS023000.
Citation: Rhee TG, Sint K, Olfson M .
Association of ECT with risks of all-cause mortality and suicide in older Medicare patients.
Am J Psychiatry 2021 Dec;178(12):1089-97. doi: 10.1176/appi.ajp.2021.21040351..
Keywords: Elderly, Behavioral Health, Mortality, Treatments
Andreae SJ, Andreae LJ, Richman JS
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Researchers examined whether a cognitive behavioral therapy (CBT)-based program intended to increase physical activity despite chronic pain in patients with diabetes delivered by community members trained as peer coaches also improved depressive symptoms and perceived stress. They found that this peer-delivered CBT-based program improved depressive symptoms and stress in individuals with diabetes and chronic pain. They recommended training community members as a feasible strategy for offering CBT-based interventions in rural and under-resourced communities.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Richman JS .
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Ann Behav Med 2021 Oct 4;55(10):970-80. doi: 10.1093/abm/kaab034..
Keywords: Depression, Behavioral Health, Diabetes, Chronic Conditions, Treatments, Pain, Lifestyle Changes
Crits-Christoph P, King C, Goldstein E
Use of cognitive techniques is associated with change in positive compensatory skills in the treatment of major depressive disorder in a community mental health setting.
Investigators sought to examine the association between adherence and competence in cognitive therapy (CT) techniques and change in positive compensatory skills and depressive symptoms within a community mental health setting. They found that adherence and competence were both significantly associated with linear change in positive compensatory skills from baseline to month 5. They concluded that their results support the hypothesis that use of CT techniques is associated with change in compensatory skills in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Crits-Christoph P, King C, Goldstein E .
Use of cognitive techniques is associated with change in positive compensatory skills in the treatment of major depressive disorder in a community mental health setting.
Psychother Res 2021 Sep;31(7):909-20. doi: 10.1080/10503307.2020.1866785..
Keywords: Depression, Behavioral Health, Treatments
Wilkinson ST, Kitay BM, Harper A
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder; yet, its use is confined to <1% of individuals with this disorder. In this study, the authors aimed to examine barriers to ECT from the perspective of the provider. The investigators concluded that coordinated efforts to overcome identified barriers may allow ECT to be more broadly implemented. Investments in education may increase the number of competent practitioners.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Kitay BM, Harper A .
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Psychiatr Serv 2021 Jul;72(7):752-57. doi: 10.1176/appi.ps.202000387..
Keywords: Depression, Behavioral Health, Treatments
Rhee TG, Olfson M, Sint K
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
Electroconvulsive therapy (ECT) is an important therapy for treatment-resistant depression and is especially effective for elderly individuals with depression. This study provides the first US nationally representative description of ECT in the elderly. The investigators concluded that despite substantial evidence of efficacy, ECT use remained rare among elderly patients with depression.
AHRQ-funded; HS023000.
Citation: Rhee TG, Olfson M, Sint K .
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
J Clin Psychiatry 2020 Jul 7;81(4). doi: 10.4088/JCP.19m13186.
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Keywords: Elderly, Medicare, Depression, Behavioral Health, Treatments, Patient-Centered Outcomes Research
Davoudian PA, Wilkinson ST
Clinical overview of NMDA-R antagonists and clinical practice.
This study examines the promise of new therapies for treatment of depression, which is only treatable about half the time with medication. Recent research has found that therapies that target the glutamatergic system, especially NMDA receptor antagonists have shown efficacy in several clinical trials. The authors specifically discuss treatment using ketamine as well as other newer compounds that have also shown recent promise in clinical trials.
AHRQ-funded; HS023000.
Citation: Davoudian PA, Wilkinson ST .
Clinical overview of NMDA-R antagonists and clinical practice.
Adv Pharmacol 2020;89:103-29. doi: 10.1016/bs.apha.2020.04.004..
Keywords: Medication, Depression, Behavioral Health, Treatments
Whiteside SPH, Sim LA, Morrow AS
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement.
AHRQ-funded; 290201500013I.
Citation: Whiteside SPH, Sim LA, Morrow AS .
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Clin Child Fam Psychol Rev 2020 Mar;23(1):102-21. doi: 10.1007/s10567-019-00303-2..
Keywords: Children/Adolescents, Anxiety, Behavioral Health, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Ochs-Ross R, Daly EJ, Zhang Y
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
This phase 3 double-blind study randomized patients with treatment-resistant depression age 65 or older to flexibly-dosed esketamine nasal spray and new oral antidepressant (esketamine/antidepressant) or new oral antidepressant and placebo nasal spray (antidepressant/placebo). The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) over 28 days from baseline. Results showed that esketamine/antidepressant did not achieve statistical significance for patients ages 75 and older; however, greater differences were seen for patients ages 65-74 and patients with earlier onset of depression younger than age 55.
AHRQ-funded; HS023000.
Citation: Ochs-Ross R, Daly EJ, Zhang Y .
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
Am J Geriatr Psychiatry 2020 Feb;28(2):121-41. doi: 10.1016/j.jagp.2019.10.008..
Keywords: Medication, Depression, Behavioral Health, Elderly, Comparative Effectiveness, Treatments, Evidence-Based Practice
Jonassaint CR, Belnap BH, Huang Y
Racial differences in the effectiveness of Internet-delivered mental health care.
The purpose of this study was to examine race differences in the impact of computerized cognitive behavioral therapy (cCBT) use on mental health outcomes among White and African American primary care patients. Participants were patients aged 18-75 who were referred by their primary care physicians and who met the eligibility criteria. Findings showed that, compared to usual care, cCBT had no effect on quality of life, depression, or anxiety for Whites. However, for African American patients, cCBT was associated with a significant 6-month decrease in depression and anxiety scores; thus, cCBT may be an efficient and scalable first step to eliminating disparities in mental health care.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Belnap BH, Huang Y .
Racial differences in the effectiveness of Internet-delivered mental health care.
J Gen Intern Med 2020 Feb;35(2):490-97. doi: 10.1007/s11606-019-05542-1..
Keywords: Behavioral Health, Telehealth, Racial and Ethnic Minorities, Disparities, Primary Care, Treatments
Rudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
AHRQ-funded; HS000084.
Citation: Rudd BN, Last BS, Gregor C .
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Wilkinson ST, Holtzheimer PE, Gao S
Leveraging neuroplasticity to enhance adaptive learning: the potential for synergistic somatic-behavioral treatment combinations to improve clinical outcomes in depression.
This article reviews the potential of synergistically combining plasticity-enhancing and behavioral therapies to develop translational treatment approaches for depression. After reviewing relevant neuroplasticity deficits in depression, the article surveys biological treatments that appear to reverse such deficits in humans; evidence that directly or indirectly supports the hypothesis that a robust enhancement of neuroplasticity through these methods might promote the uptake of cognitive and behavioral interventions to enhance longer-term treatment outcomes is then reviewed. The authors identify missing pieces of key evidence and discuss future directions that could enhance this line of research.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Holtzheimer PE, Gao S .
Leveraging neuroplasticity to enhance adaptive learning: the potential for synergistic somatic-behavioral treatment combinations to improve clinical outcomes in depression.
Biol Psychiatry 2019 Mar 15;85(6):454-65. doi: 10.1016/j.biopsych.2018.09.004..
Keywords: Behavioral Health, Depression, Patient-Centered Outcomes Research, Treatments
Antle BF, Owen JJ, Eells TD
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care was evaluated in a trial with 240 patients randomly assigned to CCBT or treatment as usual (TAU). The study, described in this paper, disseminated a therapy method found to be effective in psychiatric settings into primary care - a setting in which there have been significant problems in the delivery of adequate, evidence-based treatment for depression.
AHRQ-funded; HS024047.
Citation: Antle BF, Owen JJ, Eells TD .
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Contemp Clin Trials 2019 Mar;78:46-52. doi: 10.1016/j.cct.2018.11.001..
Keywords: Behavioral Health, Depression, Primary Care, Treatments
Goode AP, Coeytaux RR, Maslow GR
Nonpharmacologic treatments for attention-deficit/hyperactivity disorder: a systematic review.
The authors assessed the comparative effectiveness of non-pharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) among individuals 17 years of age and younger. Non-pharmacologic treatments they identified included neurofeedback, cognitive training, cognitive behavioral therapy, child or parent training, dietary omega fatty acid supplementation, and herbal and/or dietary approaches. They identified no new guidance regarding the comparative effectiveness of non-pharmacologic treatments, concluding that, despite wide use, there are significant gaps in knowledge regarding the effectiveness of ADHD non-pharmacologic treatments.
AHRQ-funded; 290201500004I.
Citation: Goode AP, Coeytaux RR, Maslow GR .
Nonpharmacologic treatments for attention-deficit/hyperactivity disorder: a systematic review.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2018-0094.
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Keywords: Children/Adolescents, Behavioral Health, Comparative Effectiveness, Treatments, Evidence-Based Practice
Cochran G, Field C, DiClemente C
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
The purpose of this study was to identify differential improvement in alcohol use among injured patients following brief intervention. Increases in both clinical trials for days abstinent were reported by classes characterized by multiple risks and minimal risks. Decreases in volume consumed for both studies were also reported by classes characterized by multiple risks and minimal risks.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, DiClemente C .
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
Behav Med 2016;42(1):29-38. doi: 10.1080/08964289.2014.951305.
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Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Treatments
Bobo WV, Reilly-Harrington NA, Ketter TA
Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: results from the Bipolar CHOICE trial.
This study investigated the longer-term effects of adjunctive benzodiazepines on symptom response during treatment in patients with bipolar disorders. The investigators concluded that adjunctive benzodiazepines may not significantly affect clinical outcome in lithium- or quetiapine-treated patients with bipolar I or II disorder over 6 months, after controlling for potential confounding factors.
AHRQ-funded; HS019371.
Citation: Bobo WV, Reilly-Harrington NA, Ketter TA .
Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: results from the Bipolar CHOICE trial.
J Affect Disord 2014 Jun;161:30-5. doi: 10.1016/j.jad.2014.02.046..
Keywords: Comparative Effectiveness, Depression, Medication, Behavioral Health, Treatments