Relations between 12-step Attendance, Depression, and Substance Use in Patients with Comorbid Substance Dependence and Major Depression.

Among patients with substance dependence and comorbid major depressive disorder (MDD) receiving treatment, we examined if differences in depression were mediated by 12-step involvement, and if the effects of 12-Step involvement on future alcohol and drug use were mediated by reductions in depression.

We examined 209 armed forces veterans diagnosed with alcohol, stimulant, or marijuana dependence and substance-independent MDD.

We measured Twelve-step attendance and affiliation, depression severity, percent days drinking, and percent days using drugs assessed at the beginning and at 3, 6, and 9 Months.

Findings

  1. Greater 12-step meeting attendance predicted lower depression and mediated the superior depression outcomes of the TSF group, explaining 24.3% of the group difference in depression.
  2. Lower depression severity predicted lower future alcohol use and mediated the effects of 12-step meetings, explaining 15.7% of their effects on future drinking.
  3. Depression had unique associations with 12-step meeting attendance and future drinking.

Conclusions

For patients with substance dependence and MDD, attendance at 12-step meetings is associated with mental health benefits that extend beyond substance use, and reduced depression could be a key mechanism whereby 12-step meetings reduce future drinking in these people.

Mediational Relations between 12-step Attendance, Depression, and Substance Use in Patients with Comorbid Substance Dependence and Major Depression. Matthew J. Worley, Susan R. Tate, Sandra A. Brown, Addiction 2012.

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