A systematic review and meta-analysis of psychosocial interventions for persons with comorbid anxiety and substance use disorders

May combine two claims.

Sequential or parallel treatments have produced health improvements but are generally considered suboptimal and less effective than integrated care for A-SUD.

“These approaches have historically led to health improvement, but are not considered optimal and generally underperform relative to integrated care for A-SUD(Brewer et al., 2017; Fantuzzi & Mezzina, 2020; McGovern et al., 2014; Mueser, 2003; Spivak et al., 2020).”

• cites Brewer et al., 2017 sourceNot checked — no full text of the source
• cites Fantuzzi & Mezzina, 2020 sourceNot checked — no full text of the source
• cites McGovern et al., 2014 sourcePartly supported

  The introductory passage labeled Abstract (page unavailable) says integrated treatment for co-occurring mental health and substance use disorders is associated with improved patient outcomes. The Discussion, Summary of Findings (page unavailable) says integrated services should be in place. Neither passage establishes that sequential or parallel treatment historically improved health or directly compares its effectiveness with integrated care; the paper also does not make this claim specifically for A-SUD. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

May combine two claims.

Several studies since 2021 report that integrated psychological treatment outperforms usual care for anxiety and for substance-specific outcomes like alcohol and cannabis use.

“As recently as 2021, several studies have found that integrated psychological interventions are significantly more effective than standard of care on anxiety as well as substance specific outcomes (e.g., alcohol use, cannabis use; Davoudi et al., 2021; Hashemi et al., 2022; Stapinski et al., 2021; Wolitzky-Taylor, Glasner, et al., 2022; K. Wolitzky-Taylor et al., 2018; Wolitzky-Taylor, Sewart, et”

• cites Davoudi et al., 2021Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Hashemi et al., 2022 sourcePartly supported

  The Discussion reports that acceptance and commitment therapy significantly reduced anxiety in people with substance use disorders compared with the control group. But the Methods say the control group received no specific active treatment, not standard care, and the study measured depression and anxiety—not alcohol or cannabis use. This paper therefore supports the anxiety finding, but not the claimed comparator or substance-specific outcomes. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Stapinski et al., 2021 sourceNot checked — no full text of the source

May combine two claims.

A-SUD is associated with worse retention, higher relapse risk, more distress, internalized stigma, lower quality of life, and more polysubstance use than SUD alone.

“relapse for SUD, experience increased distress, internalized stigma, lower quality of life, and a higher likelihood of using multiple substances than people diagnosed with SUD alone(Carpentier et al., 2009; Chang et al., 2019; Conway et al., 2006; Lejuez et al., 2008; Rogers et al., 2019).”

• cites Carpentier et al., 2009 sourceNot checked — no full text of the source
• cites Chang et al., 2019 sourcePartly supported

  The Results and Discussion report psychological distress, self-stigma, and lower quality of life among treatment-seeking opioid-dependent individuals. They do not compare people with A-SUD against people with SUD alone, or establish worse retention, higher relapse risk, or more polysubstance use in that comparison. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites Conway et al., 2006 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Bias risk was evaluated by two reviewers with the Cochrane RoB 2.0 instrument.

“Risk of bias was assessed by 2 reviewers (WN, AR) using the Cochrane Collaboration’s Risk of Bias (RoB) tool version 2.0.(Sterne et al., 2019)”

• cites Sterne et al., 2019 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Previous reviews have identified various individual, intervention, and organizational level factors affecting the relationship between psychological treatments and anxiety or substance use outcomes.

“Previous reviews have identified various individual (e.g., race/ethnicity, gender), intervention (e.g., loss to follow-up, length of treatment), and organizational level factors (e.g., inpatient versus outpatient setting) affecting the relationship between psychological treatments and anxiety or substance use outcomes.(NIDA, 2020; Committee on Developing Evidence-Based Standards for Psychosocial”

• cites NIDA, 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Committee on Developing Evidence-Based Standards for Psychosocial Interventions for Mental et al., 2015Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Guerrero et al., 2013 sourcePartly supported

  The Discussion (p. 1460) says individual, service, and system factors played a role in substance-abuse treatment completion across racial and ethnic groups. The source is an original study of outpatient treatment completion, not a review of psychological treatments, and it does not establish effects on anxiety or substance-use outcomes or compare inpatient with outpatient settings. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Another recent review found similar effects on depression and substance-use related outcomes as our review but was not able to analyze anxiety due to insufficient numbers of studies.

“Another recent review found similar effects on depression and substance-use related outcomes as our review but was not able to analyze anxiety due to insufficient numbers of studies.(Hesse, 2009)”

• cites Hesse, 2009 sourcePartly supported

  The Results report meta-analyses of depression symptoms and substance-use outcomes, and confirm that no anxiety meta-analysis was conducted. But the Results section on anxiety attributes that limitation to two of five trials reporting only multivariate outcomes, not to an insufficient number of studies. The cited paper cannot establish whether its effects were similar to those of the citing authors’ review. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

May combine two claims.

Recent reviews have highlighted the lack of research regarding psychological interventions for patients with comorbid anxiety and opioid use and the potential of psychological interventions to be paired with medication to address both anxiety and opioid use concurrently.

“Recent reviews have highlighted the lack of research regarding psychological interventions (e.g., Integrated CBT) for patients with comorbid anxiety and opioid use and specifically the potential of psychological interventions to be paired with medication (e.g., suboxone) to address both anxiety and opioid use concurrently.(Dugosh et al., 2016; Langdon et al., 2019)”

• cites Dugosh et al., 2016 sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured
• cites Langdon et al., 2019 sourceSupported

May combine two claims.

Anxiety is an important treatment target for addressing mechanisms of substance use and numerous models suggest that substances are often used to mitigate anxiety.

“Anxiety is an important treatment target for addressing mechanisms of substance use and numerous models (e.g., self-medication, tension reduction and negative reinforcement) suggest that substances are often used to mitigate anxiety.(Baker et al., 2004; Conger, 1956; Ummels et al., 2022)”

• cites Baker et al., 2004 sourceNot checked — no full text of the source
• cites Conger, 1956 sourceNot checked — no full text of the source
• cites Ummels et al., 2022 sourcePartly supported

  In §4.2, Main findings (page unavailable), the paper says its findings are consistent with people using alcohol to decrease anxiety symptoms, as proposed by the self-medication hypothesis. It does not establish that anxiety is an important treatment target, and its discussion concerns alcohol rather than substances generally or all three named models. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Methamphetamine use is highly comorbid with anxiety disorders and psychological interventions are currently the front-line treatment for stimulants, yet studies investigating the effectiveness of psychological interventions among patients with comorbid anxiety disorders remain under researched.

“Methamphetamine use is highly comorbid with anxiety disorders and psychological interventions are currently the front-line treatment for stimulants, yet studies investigating the effectiveness of psychological interventions among patients with comorbid anxiety disorders remain under researched.(Salo et al., 2011; Stuart et al., 2020)”

• cites Salo et al., 2011 sourcePartly supported

  Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured
• cites Stuart et al., 2020 sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

Only one study considered multiple substances and this sample was still largely alcohol focused.

“Only one study considered multiple substances and this sample was still largely alcohol focused.(Wüsthoff et al., 2014)”

• cites Wüsthoff et al., 2014 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Methamphetamine use is another growing global public health concern.

“Likewise, methamphetamine use is another growing global public health concern.(Jones et al., 2022; Paulus & Stewart, 2020)”

• cites Jones et al., 2022 sourceSupported
• cites Paulus & Stewart, 2020 sourceSupported

Classified as probably not a substantial claim.

Previous reviews have found integrated treatments more effective than parallel or single disorder options.

“We anticipated that integrated versus non-integrated treatments would be a significant moderator of anxiety and substance use as previous reviews have found integrated treatments more effective then parallel or single disorder options.(Kelly & Daley, 2013; Mangrum et al., 2006; Mueser, 2003; Torchalla et al., 2012; van Wamel et al., 2015; Yule & Kelly, 2019)”

• cites Kelly & Daley, 2013 sourceSupported
• cites Mangrum et al., 2006 sourceNot checked — no full text of the source
• cites Mueser, 2003Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Opioid use and anxiety disorders frequently co-occur and patients with elevated anxiety are more likely to relapse and/or drop out of opioid treatment as well as experience psychological distress.

“For example, opioid use and anxiety disorders frequently co-occur and patients with elevated anxiety are more likely to relapse and/or drop out of opioid treatment as well as experience psychological distress (e.g., pain intolerance, distress intolerance).(Langdon et al., 2019)”

• cites Langdon et al., 2019 sourcePartly supported

  The Introduction reports frequent co-occurrence, and “Impact of Comorbidity on Treatment Outcomes” says elevated anxiety may be associated with relapse or premature treatment discontinuation. The paper discusses distress intolerance, but does not establish that patients with elevated anxiety are more likely to experience it; its “Distress Intolerance” section reports that distress intolerance was not associated with measured pain tolerance. Page numbers were not available in our copy. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

In adults with co-occurring anxiety and substance use disorders, psychosocial interventions produced a large post-treatment effect on depression (Hedges' g = 0.88), with high heterogeneity.

“Large effects were observed on depression (g= 0.88) at post intervention with high heterogeneity.”

• AssumptionRests on an assumption: The 16 included RCTs are representative of psychosocial interventions for adults with A-SUD, so the pooled effects generalize to that population.
• AssumptionRests on an assumption: The different control conditions across included studies are sufficiently comparable to pool into single effect sizes.

May combine two claims.

Moderation tests for demographic variables, intervention features, community-level variables, anxiety reduction, and alcohol reduction were not significant.

“Moderation analyses for demographic factors, intervention characteristics, community level factors, anxiety reduction, and alcohol use reduction, were non-significant.”

• AssumptionRests on an assumption: The 16 included RCTs are representative of psychosocial interventions for adults with A-SUD, so the pooled effects generalize to that population.

May combine two claims.

Trim and fill for depression at follow up imputed three studies on the left side and significance was maintained in the omnibus effect (g=0.38, 95% [0.12, 0.63], p=0.0043).

“Trim and fill for depression at follow up showed three studies imputed on the left side and significance was maintained in omnibus effect (g=0.38, 95% [0.12, 0.63], p=0.0043).”

May combine two claims.

The follow-up anxiety model heterogeneity was low (I2= 0%, t2=0) and non-significant (Q[9]=9.9, p=0.35).

“The follow-up model heterogeneity was low at (I2= 0%, t2=0) and non-significant (Q[9]=9.9, p=0.35).”

May combine two claims.

The follow-up depression model heterogeneity was low (I2= 0%, t2=0) and non-significant (Q[2]=0.74, p=0.69).

“The follow-up model heterogeneity was low at (I2= 0%, t2=0), and non-significant (Q[2]=0.74, p=0.69).”

May combine two claims.

Many of the included studies lacked important demographic information of the study populations, potentially affecting both the exploratory moderator analyses as well as the generalizability of the main results.

“First, many of the included studies lacked important demographic information of the study populations, potentially affecting both the exploratory moderator analyses as well as the generalizability of the main results.”

May combine two claims.

Anxiety had marginal significance as a moderator of alcohol specific outcomes at follow-up (k=6, g=0.47, 95% CI=[−0.04, 0.98], p= 0.07) and accounted for a considerable amount of heterogeneity in the model (R2=99.84%).

“Notably, anxiety had marginal significance as a moderator of alcohol specific outcomes at follow-up (k=6, g=0.47, 95% CI=[−0.04, 0.98], p= 0.07) and accounted for a considerable amount of heterogeneity in the model (R2=99.84%).”

May combine two claims.

The follow-up other substance use model heterogeneity was moderate (I2= 39.82%, t2=0.04) and non-significant (Q[3]=6.67, p=0.08).

“The follow-up model heterogeneity was moderate at (I2= 39.82%, t2=0.04) and non-significant in reviewing the Q-statistic (Q[3]=6.67, p=0.08).”

May combine two claims.

Only 7 of 16 studies reported race/ethnicity, five studies reported income, gender was largely operationalized as a binary, sexual orientation was not included in any of the studies, and few reported educational levels.

“Specifically, only 7 of 16 studies reported race/ethnicity, five studies reported income, gender was largely operationalized as a binary, sexual orientation was not included in any of the studies, and few reported educational levels.”

May combine two claims.

Trim and fill analyses for anxiety related outcomes imputed one study on the left side and the omnibus effect remained significant yet smaller (g=0.37, 95% [0.23, 0.50], p<0.0001).

“Trim and fill analyses for anxiety related outcomes showed one study imputed on the left side and omnibus effect remained significant yet smaller in size (g=0.37, 95% [0.23, 0.50], p<0.0001).”

May combine two claims.

All studies included active controls, 12 reported loss to follow up, and eight indicated using a time-matched control condition.

“All studies included active controls, 12 reported loss to follow up and eight indicated using a time-matched control condition.”

May combine two claims.

Heterogeneity for the post-intervention depression model was high (I2= 88.82%, t2=0.52) and significant (Q[5]=35.29, p<0.0001).

“However, these results should be interpreted with caution as heterogeneity was high (I2= 88.82%, t2=0.52) and significant (Q[5]=35.29, p<0.0001).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Only models for psychotherapeutic interventions on alcohol related outcomes required imputation.

“Only models for psychotherapeutic interventions on alcohol related outcomes required imputation.”

May combine two claims.

In the existing literature, psychological interventions were tested among a wide range of anxiety diagnoses but largely focused on alcohol use and cannabis use.

“We found that in the existing literature, psychological interventions were tested among a wide range of anxiety diagnoses but largely focused on alcohol use and cannabis use consistent with previous literature.”

May combine two claims.

Heterogeneity for the other substance use post-intervention model was low (I2= 0%, t2=0.0) and non-significant (Q[3]=0.85, p=0.84).

“Heterogeneity was low as assessed through the I2 statistic (I2= 0%, t2=0.0) and non-significant in reviewing the Q-statistic (Q[3]=0.85, p=0.84).”

May combine two claims.

The included studies were largely in-person and CBT based interventions.

“Fourth the studies were largely in-person and CBT based interventions, again limiting the generalizability of these findings.”

May combine two claims.

Eight included studies targeted any anxiety diagnoses, five targeted social anxiety disorder, one included agoraphobia and panic disorder, and two required only elevated anxiety symptoms.

“Concerning co-occurring anxiety, eight studies included any anxiety diagnoses, (Buckner et al., 2019; Ciraulo et al., 2013; Hashemi et al., 2022; Kushner et al., 2013; Morley et al., 2015; Toneatto & Calderwood, 2015; K. Wolitzky-Taylor et al., 2018; Wüsthoff et al., 2014) five targeted social anxiety disorder,(Randall et al., 2001; Schadé et al., 2005; Stapinski et al., 2021; Toneatto, 2005; Wol”

May combine two claims.

Seven of the 16 studies used a non-integrated treatment approach, while the remaining studies used integrated treatments.

“Seven studies utilized a non-integrated treatment approach (e.g., stand alone, parallel, sequential)(Bowen et al., 2000; Ciraulo et al., 2013; davoudi et al., 2021; Hashemi et al., 2022; Schadé et al., 2005; Toneatto, 2005; Toneatto & Calderwood, 2015) while all others investigated integrated treatments.”

May combine two claims.

Heterogeneity for the post-intervention alcohol model was moderate (I2= 45.12%, t2=0.03) and significant (Q[10]=19.31, p=0.03).

“Heterogeneity was moderate (I2= 45.12%, t2=0.03) and significant (Q[10]=19.31, p=0.03).”

May combine two claims.

Heterogeneity for the post-intervention anxiety model was high (I2= 60.5%, t2=0.07) and significant (Q[12]=38.43, p=0.0002).

“Heterogeneity was high (I2= 60.5%, t2=0.07) and significant (Q[12]=38.43, p=0.0002).”

May combine two claims.

Alcohol was the primary substance in most included studies (k=12), three trials investigated cannabis use, and one study did not report specific substances.

“Alcohol was the primary substance in most studies (k=12),(Bowen et al., 2000; Ciraulo et al., 2013; Kushner et al., 2013; Morley et al., 2015; Randall et al., 2001; Schadé et al., 2005; Stapinski et al., 2021; Toneatto, 2005; Toneatto & Calderwood, 2015; K. Wolitzky-Taylor et al., 2018; Wolitzky-Taylor, Sewart, et al., 2022; Wüsthoff et al., 2014) three trials investigated cannabis use,(Buckner et”

Classified as probably not a substantial claim.

Integrated treatment is recommended as the first-line evidence-based approach for A-SUD.

“Integrative treatment is recommended as the front-line evidence-based approach and involves the simultaneous treatment of multiple clinical issues via a comprehensive model of care, including individual/group therapeutic approaches that may be combined with psychopharmacological approaches(NIDA, 2020; UNODC, 2022).”

• cites NIDA, 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites UNODC, 2022Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

The review was preregistered on PROSPERO under registration CRD42021240059.

“The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Statement (PRISMA-P) and was preregistered on PROSPERO (Registration: CRD42021240059; Nardi, 2018).”

• cites Nardi, 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Psychosocial interventions are important treatment components for people with co-occurring A-SUD who need comprehensive care addressing both conditions at the same time.

“Psychosocial interventions (e.g., cognitive behavioral therapy, motivational interviewing, contingency management) are important elements of treatment for people with co-occurring A-SUD who require comprehensive treatment addressing both conditions concurrently(NIDA, 2020; Services, 2009).”

• cites NIDA, 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Services, 2009Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Earlier reviews either concentrated on SUD with severe mental illness or PTSD, or covered SUD with many mental health conditions, combining anxiety with depression and other disorders.

“First, prior reviews have either narrowly focused on the co-occurrence of SUD with severe mental health conditions (e.g., schizophrenia, bipolar disorder) and post-traumatic stress disorder (PTSD), or have broadly focused on the co-occurrence of SUD with a wide variety of mental health concerns, aggregating anxiety with depression and other conditions(Hunt et al., 2019; Mehta et al., 2021; Roberts”

• cites Hunt et al., 2019 sourceNot checked — no full text of the source
• cites Mehta et al., 2021 sourceNot checked — no full text of the source
• cites Roberts et al., 2015 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The review followed the PRISMA-P statement.

“The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Statement (PRISMA-P) and was preregistered on PROSPERO (Registration: CRD42021240059; Nardi, 2018).”

• cites Nardi, 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Some reviews concluded that psychosocial treatment for severe mental illness with co-occurring SUD does not significantly improve mental health, global functioning, or substance use.

“For instance, several reviews have concluded that psychosocial treatments for persons with severe mental illness and co-occurring SUD do not have significant effects on mental health, global functioning, or substance use outcomes(Hunt et al., 2019; Mehta et al., 2021; Roberts et al., 2015).”

• cites Hunt et al., 2019 sourceNot checked — no full text of the source
• cites Mehta et al., 2021 sourceNot checked — no full text of the source
• cites Roberts et al., 2015 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Data were first extracted by one coder and then checked for accuracy by two additional coders.

“Data were preliminarily extracted independently by a single coder (WN) and then all records were reviewed for accuracy by second coders (AR, PJAK).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Heterogeneity was measured with the Q-statistic, I2, and t2, with I2 ≥50% considered high.

“Three approaches were used to measure heterogeneity. Specifically, we used the Q-statistic with a significance level of >0.05, the I2 statistic, and the t2 statistic. Any I2 value of ≥50% was considered high heterogeneity.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A preliminary audit of 20% of abstracts checked reviewer consistency and reliability.

“A preliminary audit of 20% of the abstracts was conducted to evaluate reviewer consistency/reliability.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Publication bias was assessed with funnel plots and trim-and-fill analyses.

“Funnel plots are presented for both the main outcomes (i.e., anxiety, alcohol, substances other than alcohol) and for exploratory outcomes (i.e., depression). The standardized mean differences are presented against the standard error and used to assess publication bias. In addition, we conducted trim and fill analyses to investigate funnel plot asymmetry and report intervention effects adjusted”

• cites Borenstein, M. et al., 2009Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim. May combine two claims.

These findings offer encouraging evidence for comprehensive, transdiagnostic treatments for patients with co-occurring anxiety and substance use while highlighting critical gaps in knowledge to be addressed in future research.

“These findings offer encouraging evidence for comprehensive, transdiagnostic treatments for patients with co-occurring anxiety and substance use while highlighting critical gaps in knowledge to be addressed in future research.”

May combine two claims.

Our study offers important findings regarding the efficacy of psychosocial interventions for A-SUD populations on substance use outcomes, predominantly for alcohol and cannabis use as there was a paucity of studies examining additional substances.

“Our study also offers important findings regarding the efficacy of psychosocial interventions for A-SUD populations on substance use outcomes, predominantly for alcohol and cannabis use as there was a paucity of studies examining additional substances.”

May combine two claims.

None of the studies indicated blinding by outcome assessors and all used self-report for the primary outcomes.

“With regard to measurement bias, none of the studies indicated blinding by outcome assessors and all used self-report for the primary outcomes.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The discrepancy between our findings and the CBI review is possibly due to the small number of studies in the CBI review and the non-significant pooled effects on substance use outcomes overall.

“This discrepancy is possibly due to the small number of studies in the CBI review and the fact that pooled effects on substance use outcomes overall were non-significant.(Mehta et al., 2021)”

• cites Mehta et al., 2021 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Opioids and methamphetamines present a growing public health concern globally and are highly comorbid with anxiety disorders.

“We expected to find additional studies investigating other substances, such as opioids and methamphetamines, which present a growing public health concern globally and are highly comorbid with anxiety disorders.(Krausz et al., 2021; Stoneberg et al., 2018)”

• cites Krausz et al., 2021 sourceNot checked — no full text of the source
• cites Stoneberg et al., 2018 sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

A recent review of integrated cognitive behavioral interventions found that overall integrated CBI did not outperform active controls, only outperforming single disorder treatment for substance use outcomes (g=0.27, p=0.025), and had significant effects on mental health outcomes only among PTSD samples (g=0.26, p=0.048).

“A recent review of integrated cognitive behavioral interventions (CBI) on substance-use and co-occurring mental health conditions found that overall integrated CBI did not outperform active controls, only outperforming single disorder treatment for substance use outcomes (g=0.27, p=0.025), and had significant effects on mental health outcomes only among PTSD samples (g=0.26, p=0.048).(Mehta et al.”

• cites Mehta et al., 2021 sourceNot checked — no full text of the source

May combine two claims.

Our review offers novel findings demonstrating the effectiveness of psychosocial interventions for A-SUD populations on anxiety, while building on evidence supporting their effectiveness on substance use outcomes and depression.

“Our review offers novel findings demonstrating the effectiveness of psychosocial interventions for A-SUD populations on anxiety, while building on the evidence supporting their effectiveness on substance use outcomes and depression.”

May combine two claims.

Of the included studies, only 2 were deemed high risk of bias and all others were found to have 'Some Concerns'.

“Of the included studies only 2 were deemed high risk of bias all others were found to have ‘Some Concerns’ (Figure 6).”

May combine two claims.

The requirement that interventions be anxiety-specific may have limited the number of included studies, but the current review offers novel findings regarding the effects on anxiety comorbidities specifically.

“This specificity may have limited the number of included studies, but as previous reviews have considered mixed mental health comorbidities, the current review offers novel findings regarding the effects on anxiety comorbidities specifically.”