Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research

Dowling, Nicki A.; Merkouris, Stephanie; Lorains, Felicity

doi:10.1016/j.addbeh.2016.02.012

Cited by 62 publications

(38 citation statements)

References 71 publications

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“…Treatment implications are similarly unclear, although there is some indication that co-occurring conditions do not necessarily interfere with the outcome of standard treatments for pathological gambling (9). Still, the presence of co-occurring psychiatric disorders may indicate poorer outcome (10) and usually calls for a modified treatment approach to pathological gambling so that these disorders are also targetted.…”

Section: Pathological Gambling (Gambling Disorder)mentioning

confidence: 99%

Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?

Starčević

Khazaal

2017

Front. Psychiatry

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This article provides a narrative review of the relationships between several behavioural addictions [pathological gambling, problematic Internet use (PIU), problematic online gaming, compulsive sexual behaviour disorder, compulsive buying, and exercise addiction] and psychiatric disorders. Associations between most behavioural addictions and depressive and anxiety disorders are strong and seem relatively non-specific. Strong links with substance use disorders may support the notion that some people are more prone to addictive behaviours, regardless of whether these involve substances or problematic activities. Other associations seem relatively specific, for example, those between PIU/online gaming and attention-deficit/hyperactivity disorder, between compulsive buying on the one hand and eating disorders and hoarding on the other hand and between exercise addiction and eating disorders. The quality of the research varies, but most studies suffer from methodological limitations, including a cross-sectional or correlational design, non-representative study populations, small sample sizes, reliance on self-report assessment instruments, diverse diagnostic criteria, and conceptual heterogeneity of most behavioural addictions. Due to these limitations, generalisability of the findings is questionable and the direction of causality, if any, is unknown in the relationships between behavioural addictions and psychiatric disorders. Regardless of the aetiological uncertainty, these relationships often call for a modified treatment approach. Prospective studies are needed to clarify the longitudinal relationships between behavioural addictions and psychiatric disorders.

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Section: Pathological Gambling (Gambling Disorder)mentioning

confidence: 99%

Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?

Starčević

Khazaal

2017

Front. Psychiatry

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“…A positive screen on a brief screening instrument should therefore trigger a more comprehensive clinical assessment of diagnostic status and/or problem severity, followed by an appropriate intervention for problem gambling, either within the mental health service or by specialist gambling services . Although a diverse range of self‐help, psychological and pharmacological options are available for the treatment of problem gambling , there is very little evidence on which to base treatment recommendations for different subpopulations of problem gamblers based on their psychiatric comorbidity .…”

Section: Discussionmentioning

confidence: 99%

Screening for problem gambling within mental health services: a comparison of the classification accuracy of brief instruments

et al. 2018

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The optimal brief screening instrument for mental health services wanting to screen for any level of gambling problem is the five-item Brief Problem Gambling Screen (BPGS). Services wanting to employ a shorter instrument or to screen only for more severe gambling problems (moderate-risk/problem gambling) can employ the NODS-CLiP or the three-item BPGS. Services that are only able to accommodate a very brief instrument can employ the Lie/Bet Questionnaire or the two-item BPGS.

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“…On the other hand, psychological approaches may be effective in treating comorbidity between GD and alcohol/ substance abuse: CBT, motivation interviewing, Internet delivered self-help CBT, 12-step therapy, solution-focused therapy, and dialectical behavior therapy (Dowling et al, 2016). In this therapeutic context, there are also positive results combining different approaches, such as MET + CBT (Petry, Rash, & Alessi, 2016).…”

Section: Treatment Of Gambling Disorder With Affective and Addictive mentioning

confidence: 99%

“…Psychological treatments effective in treating comorbidity between GD and depression are CBT and imaginal desensitisation plus motivation interviewing (Dowling et al, 2016).…”

Section: Treatment Of Gambling Disorder With Affective and Addictive mentioning

confidence: 99%

“…There are several reviews about the psychological treatment of GD in the literature, but there is only one mini-review about GD with different kinds of psychiatric comorbidities and with the main focus on drug treatment (Dowling, Merkouris, & Lorains, 2016). Therefore, the main aim of this research is to review existing evidence on the role of evidence-based psychological interventions for disordered gamblers with different co-occurring psychiatric disorders.…”

Section: Introductionmentioning

confidence: 99%

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Current psychological therapeutic approaches for gambling disorder with psychiatric comorbidities: A narrative review

Echeburúa

Amor

Gómez

2017

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Background. Although the presence of a gambling disorder (GD) together with another mental disorder poses special treatment challenges, such as relapses, severe outcomes for patients and families, and increased number of hospitalizations, there are only a few critical reviews in the literature. Objective. To review empirical evidence of psychological approaches to cope specifically with these dual disorders. Method. A narrative review of the relevant bibliography on this topic was carried out. A systematic search of original articles (2010-October 2017) was conducted in MEDLINE and PsycInfo. Key terms were: 1. gambling/gamblers, 2. treatment/intervention/therapy/therapeutics, and 3. dual diagnosis/comorbidity. Results. Current treatment for GD involves a number of different options, including inpatient treatments, intensive outpatient therapy, individual and group cognitive-behavioral options (CBT), self-help groups, and pharmacotherapy. Inpatient care is generally limited to patients with severe acute crises, treatment failures, and severe comorbid disorders, particularly depression and attempted suicide. Treatment for GD with other mental disorder needs more research. CBT, motivational enhancement therapy and self-help groups have some empirical support when GD is comorbid with other addiction, mood disorder, or schizophrenia. Programs that combine pharmacotherapy and psychosocial treatments for GD into a single comprehensive package are most likely to have good treatment outcomes, at least with regard to treatment retention. Discussion and conclusion. Interventions should be tailored to the needs of the patients. Future research should be concerned about the statistical power of the studies, implement motivational strategies for patients with poor medication adherence, and design measures to study treatment fidelity in the CBT groups.

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Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research

Cited by 62 publications

References 71 publications

Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?

Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned?

Screening for problem gambling within mental health services: a comparison of the classification accuracy of brief instruments

Current psychological therapeutic approaches for gambling disorder with psychiatric comorbidities: A narrative review

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