Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders

Objective: Comorbidity of substance abuse disorders with schizophrenia is a ssociated with a greater risk for serious illness complications and poorer outcome. Methodologically sound studies investigating treatment approaches for patients with these disorders are rare, although recommendations for in tegrated and comprehensive treatment programs abound. This study investigat es the relative benefit of adding an integrated psychological and psychosoc ial treatment program to routine psychiatric care for patients with schizop hrenia and substance use disorders. Method. The authors conducted a randomized, single-blind controlled compari son of routine care with a program of routine care integrated with motivati onal interviewing, cognitive behavior therapy, and family or caregiver inte rvention. Results: The integrated treatment program resulted in significantly greater improvement in patients' general functioning than routine care alone at th e end of treatment and 12 months after the beginning of the study. Other be nefits of the program included a reduction in positive symptoms and in symp tom exacerbations and an increase in the percent of days of abstinence from drugs or alcohol over the 12-month period from baseline to follow-up. Conclusions: These findings demonstrate the effectiveness of a program of r outine care integrated with motivational interviewing, cognitive behavior t herapy, and family intervention over routine psychiatric care alone for pat ients with comorbid schizophrenia and alcohol or drug abuse or dependence.