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Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study

Abstract

COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout. The sample consisted of =86 adults, mostly men (=79, 91.9%) and with a mean age of 45years old (=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown). The risk of dropout during the complete observational period was =32/86=0.372 (37.2%), the Incidence Density Rate () ratio T2/T1 being equal to 0.052/0.033=1.60 (=0.252). Shorter treatment duration (=0.007), lower anxiety (=0.025), depressive symptoms (=0.045) and lower use of adaptive coping strategies (=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (=0.001) and higher employment concerns (=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (=0.005 and <0.001, respectively). The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations.

References
1.
Estevez A, Jauregui P, Lopez-Gonzalez H, Mena-Moreno T, Lozano-Madrid M, Macia L . The Severity of Gambling and Gambling Related Cognitions as Predictors of Emotional Regulation and Coping Strategies in Adolescents. J Gambl Stud. 2020; 37(2):483-495. DOI: 10.1007/s10899-020-09953-2. View

2.
Hakansson A . Changes in Gambling Behavior during the COVID-19 Pandemic-A Web Survey Study in Sweden. Int J Environ Res Public Health. 2020; 17(11). PMC: 7312016. DOI: 10.3390/ijerph17114013. View

3.
Jimenez-Murcia S, Granero R, Fernandez-Aranda F, Arcelus J, Aymami M, Gomez-Pena M . Predictors of Outcome among Pathological Gamblers Receiving Cognitive Behavioral Group Therapy. Eur Addict Res. 2015; 21(4):169-78. DOI: 10.1159/000369528. View

4.
Fernandez-Aranda F, Munguia L, Mestre-Bach G, Steward T, Etxandi M, Baenas I . COVID Isolation Eating Scale (CIES): Analysis of the impact of confinement in eating disorders and obesity-A collaborative international study. Eur Eat Disord Rev. 2020; 28(6):871-883. PMC: 7537123. DOI: 10.1002/erv.2784. View

5.
Islam M, Ferdous M, Potenza M . Panic and generalized anxiety during the COVID-19 pandemic among Bangladeshi people: An online pilot survey early in the outbreak. J Affect Disord. 2020; 276:30-37. PMC: 7362838. DOI: 10.1016/j.jad.2020.06.049. View