Optimizing Outpatient Treatment Outcomes Among Methamphetamine-using Gay and Bisexual Men Through a Computerized Depression Intervention

Overview

Journal J Subst Abuse Treat

Specialty Psychiatry

Date 2021 Nov 21

PMID 34801284

Authors

Jesse B Fletcher

Cathy J Reback

Affiliations

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Abstract

Introduction: Depression is a common sequelae of frequent methamphetamine use, and may influence rates of engagement in sexual risk-taking among methamphetamine-using cisgender gay, bisexual, and other men who have sex with men (GBMSM). The study team hypothesized that layering a brief, computerized depression intervention (i.e., MoodGym; based on Cognitive Behavioral Therapy [CBT] and Interpersonal Therapy) on top of a long-running outpatient methamphetamine treatment program (based on CBT and Contingency Management) for GBMSM could optimize reductions in methamphetamine use and sexual risk-taking among program participants.

Methods: This pilot study, which also included analysis of historical data, employed nearest-neighbor matching algorithms to match current pilot study participants (N = 39) to prior participants of an outpatient methamphetamine treatment program (N = 703) and employed treatment effects analyses to determine the observed effects of adding depression intervention content to GBMSM-specific methamphetamine treatment.

Results: Pilot study participants who received the MoodGym intervention were significantly less likely to submit methamphetamine-metabolite positive urine samples (Adjusted Treatment Effect [ATE] = -0.72; p < 0.01), and evidenced significantly greater reductions in receptive condomless anal intercourse with non-primary partners in the past 30 days (ATE = -1.39; p < 0.05), relative to prior participants of the outpatient methamphetamine treatment program who did not receive depression intervention content.

Conclusion: Preliminary results suggest layering a brief computerized depression intervention onto outpatient methamphetamine treatment for GBMSM may optimize reductions in methamphetamine use and/or sexual risk-taking.

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