An online intervention for co-occurring depression and problematic alcohol use in young people: Primary outcomes from a randomized controlled trial

Background: depression and problematic alcohol use represent two of the major causes of disease burden in young adults. these conditions frequently co-occur and this is associated with increased harm and poorer outcomes than either disorder in isolation. integrated treatments have been shown to be effective; however,there remains a significant gap between those in need of treatment and those receiving it. the increased availability of ehealth programs presents a unique opportunity to treat these conditions. objective: this study aimed to evaluate the feasibility and preliminary efficacy of an automated web-based self-help intervention (deal project) in treating co-occurring depressive symptoms and problematic alcohol use in young people. methods: young people (aged 18 to 25 years) with moderate depression symptoms and drinking at hazardous levels (recruited largely via social media) were randomly allocated to the deal project (n=60) or a web-based attention-control condition (healthwatch; n=44). the trial consisted of a 4-week intervention phase with follow-up assessment at posttreatment and at 3 and 6 months postbaseline. the primary outcomes were change in depression severity according to the patient health questionnaire-9 as well as quantity and frequency of alcohol use (tot-al). results: the deal project was associated with statistically significant improvement in depression symptom severity (d=0.71) and reductions in alcohol use quantity (d=0.99) and frequency (d=0.76) in the short term compared to the control group. at 6-month follow-up,the improvements in the intervention group were maintained; however,the differences between the intervention and control groups were no longer statistically significant,such that between-group effects were in the small to moderate range at 6 months (depression symptoms: d=0.39; alcohol quantity: d=-0.09; alcohol frequency: d=0.24). conclusions: overall,the deal project was associated with more rapid improvement in both depression symptoms and alcohol use outcomes in young people with these co-occurring conditions relative to an attention-control condition. however,long-term outcomes are less clear.