A systematic review of psychological treatment for methamphetamine use and mental health symptom outcomes

Aims: People who use methamphetamine (MA) regularly experience symptoms of mental ill-health associated with MA use. These include symptoms of psychosis, depression and anxiety. Accordingly, research examining psychological treatments often measure MA use and related mental health problems. Although there has been a substantial body of research reporting on the effectiveness of psychological treatments for reducing MA use, there is a paucity of research addressing the effectiveness of these treatments for co-occurring symptoms of mental ill-health. We addressed this gap by providing a systematic review of the evidence for psychological treatments for co-occurring MA use and symptoms of mental ill-health in experimental/controlled clinical studies. Design and method: A meta-analysis and a narrative synthesis of studies was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to inform methodology. Eight electronic peer-reviewed databases were searched. Twelve eligible articles were assessed. Findings. Most studies found an overall reduction in level of MA use and mental health symptoms among samples as a whole. There was significant heterogeneity across studies, therefore generalisability of results was limited. There was some evidence to suggest that Cognitive Behaviour Therapy (CBT) was more effective than other psychological treatments and treatment as usual for reducing levels of MA use. Cognitive Behaviour Therapy was significantly more effective than minimal treatment and was associated with significantly higher abstinence rates compared to minimal control conditions. Conclusions. Contingency Management and CBT interventions may enhance abstinence from MA. Future clinical research should consider how psychological treatment may play a role in reducing MA use and associated mental health symptoms.