Abstract
To examine the influence of co-occurring conditions on gambling treatment outcomes. 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 12weeks. Problem gambling screening and co-occurring conditions including depression, anxiety and alcohol use. Of 127problem gamblers, 69were males (54%), mean age was 43.09years, and 65(51%) reported a duration of problem gambling greater than 5years. Median time for participants' enrolment in the study was 8.9months. 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. 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.
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