Historique
Périodique
Psychosocial treatments for cocaine dependence: National Institute on Drug Abuse Collaborative Cocaine Treatment Study
(Traitements psychosociaux de la dépendance à la cocaïne)
Auteur(s) :
CRITS-CHRISTOPH, P. ;
SIQUELAND, L. ;
BLAINE, J. ;
FRANK, A. ;
LUBORSKY L. ;
ONKEN, L. S. ;
MUENZ, L. R. ;
THASE M. E. ;
WEISS, R. D. ;
GASTFRIEND, D. R. ;
WOODY, G. E. ;
BARBER, J. P. ;
BUTLER, S. F. ;
DALEY, D. ;
SALLOUM I. ;
BISHOP, S. ;
NAJAVITS L. M. ;
LIS J. ;
MERCER, D. ;
GRIFFIN, M. L. ;
MORAS, K. ;
BECK, A. T.
Année
1999
Page(s) :
493-502
Langue(s) :
Anglais
ISBN :
0003-990X
Refs biblio. :
44
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
COCAINE
;
DEPENDANCE
;
THERAPIE DE GROUPE
;
THERAPIE COGNITIVO-COMPORTEMENTALE
;
PSYCHOTHERAPIE
;
COMPARAISON
;
EFFICACITE
Note générale :
Archives of General Psychiatry, 1999, 56(6), 493-502
Résumé :
FRANÇAIS :
Quatre modèles de traitements ont été comparés : entretiens individuels plus entretiens en groupe, psychothérapie cognitive plus entretiens en groupe, psychothérapie de soutien plus entretien en groupe ou thérapie de groupe seule. Comparée aux 2 psychothérapies et à la thérapie de groupe seule, la formule entretiens individuels plus entretiens en groupe semblait obtenir les meilleurs résultats. L'hypothèse selon laquelle une plus grande indication des psychothérapies par rapports aux formules avec entretiens en groupe, pour les patients cocaïnomanes présentant des troubles psychiatriques ou une personnalité antisociale serait plus efficace ne semble pas confirmée.
ENGLISH :
BACKGROUND: This was a multicenter investigation examining the efficacy of 4 psychosocial treatments for cocaine-dependent patients.
METHODS: Four hundred eighty-seven patients were randomly assigned to 1 of 4 manual-guided treatments: individual drug counseling plus group drug counseling (GDC), cognitive therapy plus GDC, supportive-expressive therapy plus GDC, or GDC alone. Treatment was intensive, including 36 possible individual sessions and 24 group sessions for 6 months. Patients were assessed monthly during active treatment and at 9 and 12 months after baseline. Primary outcome measures were the Addiction Severity Index-Drug Use Composite score and the number of days of cocaine use in the past month.
RESULTS: Compared with the 2 psychotherapies and with GDC alone, individual drug counseling plus GDC showed the greatest improvement on the Addiction Severity Index-Drug Use Composite score. Individual group counseling plus GDC was also superior to the 2 psychotherapies on the number of days of cocaine use in the past month. Hypotheses regarding the superiority of psychotherapy to GDC for patients with greater psychiatric severity and the superiority of cognitive therapy plus GDC compared with supportive-expressive therapy plus GDC for patients with antisocial personality traits or external coping style were not confirmed.
CONCLUSION: Compared with professional psychotherapy, a manual-guided combination of intensive individual drug counseling and GDC has promise for the treatment of cocaine dependence.
Quatre modèles de traitements ont été comparés : entretiens individuels plus entretiens en groupe, psychothérapie cognitive plus entretiens en groupe, psychothérapie de soutien plus entretien en groupe ou thérapie de groupe seule. Comparée aux 2 psychothérapies et à la thérapie de groupe seule, la formule entretiens individuels plus entretiens en groupe semblait obtenir les meilleurs résultats. L'hypothèse selon laquelle une plus grande indication des psychothérapies par rapports aux formules avec entretiens en groupe, pour les patients cocaïnomanes présentant des troubles psychiatriques ou une personnalité antisociale serait plus efficace ne semble pas confirmée.
ENGLISH :
BACKGROUND: This was a multicenter investigation examining the efficacy of 4 psychosocial treatments for cocaine-dependent patients.
METHODS: Four hundred eighty-seven patients were randomly assigned to 1 of 4 manual-guided treatments: individual drug counseling plus group drug counseling (GDC), cognitive therapy plus GDC, supportive-expressive therapy plus GDC, or GDC alone. Treatment was intensive, including 36 possible individual sessions and 24 group sessions for 6 months. Patients were assessed monthly during active treatment and at 9 and 12 months after baseline. Primary outcome measures were the Addiction Severity Index-Drug Use Composite score and the number of days of cocaine use in the past month.
RESULTS: Compared with the 2 psychotherapies and with GDC alone, individual drug counseling plus GDC showed the greatest improvement on the Addiction Severity Index-Drug Use Composite score. Individual group counseling plus GDC was also superior to the 2 psychotherapies on the number of days of cocaine use in the past month. Hypotheses regarding the superiority of psychotherapy to GDC for patients with greater psychiatric severity and the superiority of cognitive therapy plus GDC compared with supportive-expressive therapy plus GDC for patients with antisocial personality traits or external coping style were not confirmed.
CONCLUSION: Compared with professional psychotherapy, a manual-guided combination of intensive individual drug counseling and GDC has promise for the treatment of cocaine dependence.
Affiliation :
Dept Psychiat., Univ. Pennsylvania, 3600 Market St., Philadelphia, PA 19104. Etats-Unis. United States.