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Treatment Success For Gamblers More Than Just Roll of the Dice

Keeping pathological gamblers in treatment is a difficult feat. But gamblers who respond early to treatment and have emotional support are less likely to drop out.

Although research on pathological gambling is increasing, little is known about what it takes to keep pathological gamblers in treatment.

Jon Grant, M.D., J.D., an assistant professor of psychiatry at Brown University, and coworkers conducted a study of pathological gamblers to try to identify such factors.

Fifty adult outpatients with a primary DSM-IV diagnosis of pathological gambling were enrolled in the study. All had sought help for their disorder, all were receiving medication, and some were getting psychotherapy as well. The subjects had been in treatment for a year on average, although some had been in treatment for as short as 20 days or as long as four years.

The researchers then used the Clinical Global Impressions Scale for Pathological Gambling and the Gambling Symptom Assessment Scale to evaluate the clinical status of the subjects at the start of the study and then again every two months for a year.

Subjects who dropped out of treatment during the study period were contacted by telephone to determine why they had discontinued treatment.

Almost half of the subjects—48 percent—stopped treatment during the one-year study period, Grant and his colleagues reported in the March-April Comprehensive Psychiatry. Those who discontinued treatment gave two primary reasons—they missed the thrill of gambling or felt certain that they could win and reduce their gambling-related financial debts.

On a more positive note, however, 52 percent of the subjects did stay in treatment during the study period, and two of the predictors of staying in treatment, Grant and his team found, were feeling at least minimally improved within 60 days of starting treatment and having someone in their lives whom they considered supportive of their receiving treatment and of their attempt to stop gambling.

An abstract of the study, "Retrospective Review of Treatment Retention in Pathological Gambling," is posted online at www.sciencedirect.com. Click "Browse A-Z of journals," "C," "Comprehensive Psychiatry," and then the March-April 2004 issue.

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