Premium
The influence of depression and other co‐occurring conditions on treatment outcomes for problem gamblers: a cohort study
Author(s) -
Smith David P,
Battersby Malcolm W,
Harvey Peter W,
Pols Rene G,
Baigent Michael F,
Oakes Jane E
Publication year - 2011
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2011.tb03267.x
Subject(s) - depression (economics) , cohort , medicine , cohort study , psychiatry , psychology , economics , macroeconomics
Objective: To examine the influence of co‐occurring conditions on gambling treatment outcomes. Design, setting and participants: Prospective cohort study of problem gamblers. Participants were recruited from consecutive referrals to a gambling therapy service in 2008. Inclusion criteria were: (i) assessed as a problem gambler based on a screening interview including DSM‐IV criteria for pathological gambling, and (ii) suitable for admission to a treatment program. Cognitive‐behavioural therapy was based on graded exposure‐to‐gambling urge. One‐to‐one treatment was conducted with 1‐hour sessions weekly for up to 12 weeks. Main outcome measures: Problem gambling screening and co‐occurring conditions including depression, anxiety and alcohol use. Results: Of 127 problem gamblers, 69 were males (54%), mean age was 43.09 years, and 65 (51%) reported a duration of problem gambling greater than 5 years. Median time for participants’ enrolment in the study was 8.9 months. Results from mixed effects logistic regression analysis indicated that individuals with higher depression levels had a greater likelihood (13% increase in odds [95% CI, 1%–25%]) of problem gambling during treatment and at follow‐up. Conclusion: Addressing depression may be associated with improved treatment outcomes in problem gambling; conversely, treatment of problem gambling improves affective instability. We therefore recommend a dual approach that treats both depression and problem gambling.