Depression and alcohol misuse represent two of the major causes of disease burden in young people today. These conditions frequently co-occur and this co-occurrence is associated with increased risks 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 in treatment and those receiving it, particularly in young people. The increased availability of Internet-based programs to complement health care presents a unique opportunity in the treatment of these conditions.
This study aims to evaluate whether an automated web-based self-help intervention (DEAL Project) can be effective in treating co-occurring depression and problematic alcohol use in young people. In a randomised controlled trial 104 young people (aged 18 to 25 years) with moderate depression 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 post-treatment, and 3- and 6-months post-baseline. 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).
The DEAL Project was associated with significant improvement in depression severity (d = 0.71) and reductions in alcohol use quantity (d = 0.99) and frequency (d = 0.76) in the short-term, compared to control. At 6-month follow-up the improvements in the intervention group were maintained, however, the differences between intervention and control group disappeared, such that between group effects were in the small to moderate range.
Overall, the DEAL Project was associated with more rapid and stable improvement in both depression 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.