Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive– Behavioural Treatment in South Australia

Author version uploaded in accordance with the publisher's policy. The final publication is available at Springer via http://dx.doi.org/10.1007/s10899-014-9465-2Aims This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive-behavioural therapy (CBT). Methods A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using Victorian Gambling Screen (VGS) ‘harm to self’ sub-scale with validated cut score 21+ (score range: 0 – 60) indicative of problem gambling behaviour. Secondary outcome measure was work and social adjustment scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale (K10). We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Results Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1(SD=13.6) years and 211 (56%) were males. At baseline, 353 (92.9%) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46%) had a very high probability of a 12-month affective or anxiety disorder, 103 (27%) in the high range and 102 (27%) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p < 0.001). Conclusions Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia gain similar significant reductions in gambling behaviours from routine cognitive-behavioural therapy in the mid-term