2017, Number 6
Current psychological therapeutic approaches for gambling disorder with psychiatric comorbidities: A narrative review
Language: Spanish
References: 41
Page: 299-305
PDF size: 167.99 Kb.
Text Extraction
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.REFERENCES
Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., & Christensen, D. R. (2015). Prevalence of psychiatric co-morbidity in treatment- seeking problem gamblers: A systematic review and meta-analysis. Australian and New Zealand Journal of Psychiatry, 49(6), 519-539. doi: 10.1177/0004867415575774
Hollander, E., Pallanti, S., Allen, A., Sood, E., & Rossi, N. B. (2005). Does sustained- release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders? The American Journal of Psychiatry, 162(1), 137-145. doi: 10.1176/appi.ajp.162.1.137
Abou-Saleh, M. T. (2004). Dual diagnosis: management within a psychosocial context. Advances in Psychiatric Treatment, 10(5), 352-360. doi: 10.1192/ apt.10.5.352 2. Borras, L., & Huguelet, P. (2007). Schizophrenia and pathological gambling. The American Journal on Addictions, 16(4), 269-271. doi:10.1080/10550490701389765 3. Carlbring, P., & Smit, F. (2008). Randomized trial of internet-delivered self-help with telephone support for pathological gamblers. Journal of Consulting and Clinical Psychology, 76(6), 1090-1094. doi:10.1037/a0013603 4. Chaim, C. H., Nazar, B. P., Hollander, E., & Lessa, J. M. (2014). Pathological gambling treated with lithium: The role of assessing temperament. Addictive Behaviors, 39(12), 1911-1913. doi: 10.1016/j.addbeh.2014.05.016 5. Chen, S., Barnett, P. G., Sempel, J. M., & Timko, C. (2006). Outcomes and costs of matching the intensity of dual-diagnosis treatment to patients’ symptom severity. Journal of Substance Abuse Treatment, 31(1), 95-105. doi: 10.1016/j. jsat.2006.03.015 6. Diskin, K. M., & Hodgins, D. C. (2009). A randomized controlled trial of a single session motivational intervention for concerned gamblers. Behaviour Research and Therapy, 47(5), 382-388. doi: 10.1016/j.brat.2009.01.018 7. Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., & Christensen, D. R. (2015). Prevalence of psychiatric co-morbidity in treatment- seeking problem gamblers: A systematic review and meta-analysis. Australian and New Zealand Journal of Psychiatry, 49(6), 519-539. doi: 10.1177/0004867415575774 8. Dowling, N. A., Merkouris, S. S., & Lorains, F. K. (2016). Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research. Addictive Behaviors, 58, 21-30. doi: 10.1016/j.addbeh.2016.02.012 9. Echeburúa, E., Báez, C., & Fernández-Montalvo, J. (1996). Comparative effectiveness of three therapeutic modalities in the psychological treatment of pathological gambling: Long-term outcome. Behavioural and Cognitive Psychotherapy, 24(1), 51-72. doi: 10.1017/S1352465800016830 10. Echeburúa, E., & Fernández-Montalvo, J. (2005). Psychological Treatment of Slot-Machine Pathological Gambling: New Perspectives. Journal of Gambling Studies, 21(1), 21-26. doi: 10.1007/s10899-004-1918-6 11. Echeburúa, E., Gómez, M., & Freixa, M. (2011). Cognitive-behavioural treatment of pathological gambling in individuals with chronic schizophrenia: A pilot study. Behaviour Research and Therapy, 49(11), 808-814. doi: 10.1016/j. brat.2011.08.009 12. Echeburúa, E. (2015). Clinical management of gambling disorder. In N. Guebaly, G. Carra, & M. Galanter (Eds.), Textbook of Addiction Treatment: International Perspective (vol. 3, pp. 1475-1490). Milan: Springer. 13. Echeburúa, E., Gómez, M., & Freixa, M. (2017). Prediction of relapse after cognitive- behavioral treatment of gambling disorder in individuals with chronic schizophrenia: A survival analysis. Behavior Therapy, 48(1), 69-75. doi: 10.1016/j.beth.2016.09.008 14. González-Ortega, I., Echeburúa, E., Corral, P., Polo-López, R., & Alberich, S. (2013). Predictors of pathological gambling severity taking gender differences into account. European Addiction Research, 19(3), 146-154. doi: 10.1159/000342311 15. Gooding, P., & Tarrier, N. (2009). A systematic review and meta-analysis of cognitive- behavioural interventions to reduce problem gambling: Hedging our bets?. Behaviour Research and Therapy, 47(7), 592-607. doi: 10.1016/j. brat.2009.04.002 16. Grant, J. E., Kim, S. W., Hollander, E., & Potenza, M. N. (2008). Predicting response to opiate antagonists and placebo in the treatment of pathological gambling. Psychopharmacology, 200(4), 521-527. doi: 10.1007/s00213-008-1235-3 17. Grant, J. E., Chamberlain, S. R., Odlaug, B. L., Potenza, M. N., & Kim, S. W. (2010). Memantine shows promise in reducing gambling severity and cognitive inflexibility in pathological gambling: A pilot study. Psychopharmacology, 212(4), 603-612. doi: 10.1007/s00213-010-1994-5 18. Grant, J. E., & Odlaug, B. L. (2012). Psychosocial interventions for gambling disorders. In Increasing the odds. What Clinicians Need to Know About Gambling Disorders (vol. 7, pp. 38-51). Washington, DC: National Center for Responsible Gaming. 19. Green, A. I., Drake, R. E., Brunette, M. F., & Noordsy, D. L. (2007). Schizophrenia and co-occurring substance use disorder. The American Journal of Psychiatry, 164(3), 402-408. 20. Haydock, M., Cowlishaw, S., Harvey, C., & Castle, D. (2015). Prevalence and correlates of problem gambling in people with psychotic disorders. Comprehensive Psychiatry, 58, 122-129. doi: 10.1016/j.comppsych.2015.01.003 21. Hodgins, D. C., & Holub, A. (2007). Treatment of Problem Gambling. In G. Smith, D. C. Hodgins, & R. J. Williams (Eds.), Research and Measurement Issues in Gambling Studies (pp. 372-397). Amsterdam: Elsevier. 22. Hodgins, D. C., Currie, S. R., Currie, G., &, Fick, G. H. (2009). Randomized trial of brief motivational treatments for pathological gamblers: More is not necessarily better. Journal of Consulting and Clinical Psychology, 77(5), 950-960. doi: 10.1037/a0016318 23. Hollander, E., Pallanti, S., Allen, A., Sood, E., & Rossi, N. B. (2005). Does sustained- release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders? The American Journal of Psychiatry, 162(1), 137-145. doi: 10.1176/appi.ajp.162.1.137 24. Jiménez-Murcia, S., Bove, F. I., lsrael, M., Steiger, H., Fernández-Aranda, F., Álvarez- Moya, E., … & Menchón, J. M. (2012). Cognitive-behavioral therapy for pathological gambling in Parkinson’s disease: A pilot controlled study. European Addiction Research, 18(6), 265-274. doi: 10.1159/000337442 25. Kassani, A., Niazi, M., Hassanzadeh, J., & Menati, R. (2015). Survival analysis of drug abuse relapse in addiction treatment centers. International Journal of High Risk Behaviors and Addiction, 4(3), e23402. doi: 10.5812/ijhrba.23402 26. Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., & Schaffer, H. J. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine, 38(9), 1351-1360. doi: 10.1017/S0033291708002900 27. Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., Leblond, J., & Jacques, C. (2001). Cognitive treatment of pathological gambling. Journal of Nervous and Mental Disease, 189(11), 774-780.
Oei, T. S., Raylu, N., & Casey, L. M. (2010). Effectiveness of group and individual formats of a combined motivational interviewing and cognitive behavioral treatment program for problem gambling: A randomized controlled trial. Behavioural and Cognitive Psychotherapy, 38(2), 233-238. doi: 10.1017/ S1352465809990701
Shonin, E., VanGordon, W., & Griffiths, M. D. (2014). Cognitive behavioral therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia and pathological gambling: A case study. International Journal of Mental Health and Addiction, 12(2), 181-196. doi: 10.1007/s11469- 013-9460-3