Group Therapy for Women Prisoners With Comorbid Substance Use and Depression

Official Title: “Group IPT for Women Prisoners With Comorbid Substance Use and Depression”

The purpose of the study is to determine whether interpersonal psychotherapy is effective for treating co-occurring depression and substance use among women prisoners.

Incarcerated women are a vulnerable and rapidly expanding population with high lifetime rates of both substance use disorder (SUD; abuse or dependence on alcohol, illegal drugs, or prescription drugs; 70%) and depressive disorder (DD; major depressive disorder and dysthymic disorder; 20-27%). DDs tend to worsen the course of SUDs for incarcerated women by increasing their risk for suicide attempts, contributing to the persistence of substance abuse, and reducing the likelihood of a successful transition to an independent, sober life in the community. Recent evidence indicates that DDs are common in persons with SUDs, often do not remit with SUD treatment, and should be treated. Despite growing recognition that co-occurring disorders, such as DDs, among substance abusing incarcerated women present an important public health concern, integrated treatments for SUD-DD have not been well-developed for or systematically tested in this population. Group Interpersonal Psychotherapy (IPT-G) has been shown to be efficacious in treating DD in other populations and may be especially pertinent to the needs of incarcerated women with SUD-DD because interpersonal difficulties not only affect severity of depression, but are also strong predictors of drinking to cope, SUD relapse, and prison recidivism in women.

This study tests the hypotheses that as adjuncts to prison SUD treatment, IPT-G, relative to psychoeducation on co-occurring disorders, will produce at least moderate effect sizes for: - Reduction in the risk and severity of substance use relapse after release from prison - Recovery from depressive disorder and reduction in depressive symptoms - Improvement in social support and interpersonal functioning - Reduction in the severity of legal problems during the 3 month follow-up period

Intervention(s) in this Clinical Trial

• Behavioral: Group interpersonal psychotherapy (IPT-G)
• Behavioral: Psychoeducation on co-occurring disorders (PSYCHOED)

Primary Measures

• Substance-free days after release from prison, measured by the Timeline Followback method
• Severity of substance use after release from prison, measured by the Addiction Severity Index
• Verification of substance-free status using breath alcohol tests and urine drug screens
• Depression diagnosis measured by the Structured Clinical Interview for DSM-IV Axis I Disorders
• Depression symptom severity measured by the Modified Hamilton Rating Scale for Depression
• Depression symptom severity measured by the Beck Depression Inventory

Secondary Measures

• Severity of legal problems after release, measured by the Legal Composite of the Addiction Severity Index
• Interpersonal problems, measured by the Inventory of Interpersonal Problems
• Peer support and social support, measured by the Criminal Justice client Evaluation of Self and Treatment
• Perceived social support measured by the Multidimensional Scale of Perceived Social Support
• Social support for recovery, measured by the Important People and Activities scale
• Social functioning, measured by the Social Adjustment Scale

Inclusion Criteria:

• Participants are recruited from prison substance use treatment programs.
• Current primary (non-substance-induced, as defined by the SCID) depressive disorder (major depressive or dysthymic disorder) after at least 4 weeks of prison SUD treatment and abstinence.
• A minimum Hamilton Depression score of 18 or higher, indicating moderate to severe depression.
• Depressive disorder at any time while not incarcerated.
• Substance use disorder one month prior to incarceration.
• Between 10 and 18 weeks away from release from prison.

Exclusion Criteria:

• Lifetime criteria for bipolar disorder
• Lifetime criteria for a psychotic disorder
• Actively suicidal

Gender Eligibility for this Clinical Trial: Female

Minimum Age for this Clinical Trial: 18 Years

Maximum Age for this Clinical Trial: 65 Years

Are Healthy Volunteers Accepted for this Clinical Trial?: No

Lead Investigator: National Institute on Drug Abuse (NIDA) NIH

Overall Clinical Trial Officials and Contacts

Jennifer E. Johnson, Ph.D. Principal Investigator Department of Psychiatry and Human Behavior, Brown University  

Overall Contact: Jennifer E. Johnson, PhD 401-444-1916 Jennifer_Johnson@brown.edu

Information obtained from ClinicalTrials.gov on February 12, 2012

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00606996

Study ID Number: 1 K23 DA021159-01

ClinicalTrials.gov Identifier: NCT00606996

Health Authority: United States: Federal Government