Exploring the relationship between proactive e-alcohol therapy and symptoms of anxiety or/and depression: Post-hoc analyses from a randomized controlled trial.

Background: Individuals with problematic alcohol use often face anxiety and depressive symptoms, which can hinder treatment engagement, compliance, and effectiveness. Psychosocial therapy through video conference (e-alcohol therapy) may reduce these barriers. We explored whether 1) anxiety or/and depressive symptoms modify the effect of proactive e-alcohol therapy on treatment initiation, compliance, and alcohol intake, 2) proactive e-alcohol therapy impacts anxiety or/and depressive symptoms compared to standard care.

Methods: Participants with problematic alcohol use were recruited online and randomly assigned to proactive e-alcohol therapy or standard care. Problematic alcohol use was defined by an 8+ score on the Alcohol Use Disorders Identification Test. Anxiety and depressive symptoms were measured using the Patient Health Questionnaire-4.

Results: 356 individuals participated; 133 showed moderate-severe symptoms of anxiety and depression at baseline. There were no significant differences between individuals with and without moderate-severe anxiety or/and depressive symptoms in the effect of proactive e-alcohol therapy versus standard care on treatment initiation (3 mo: p = 0.64; 12 mo: p = 0.97), compliance (3 mo: p = 0.40; 12 mo: p = 0.58), or alcohol intake (3 mo: p = 0.86; 12 mo: p = 0.90). No significant differences were found in the proportion of participants with moderate-severe anxiety and depressive symptoms between the two intervention groups after 3 months (OR 0.6; 95 % CI 0.3 to 1.4; p = 0.27).

Conclusions: We found no evidence that anxiety or/and depressive symptoms modify the effect of proactive e-alcohol therapy on treatment initiation, compliance, or alcohol intake. Proactive e-alcohol therapy matched standard care in reducing anxiety or/and depressive symptoms over a 3-month follow-up.