title: The influence of depression and other co-occurring conditions on treatment outcomes for problem gamblers: a cohort study.
abstract: OBJECTIVE
  To examine the influence of co-occurring conditions on gambling treatment outcomes.
  
  
  METHODS
  Prospective cohort study of problem gamblers. Participants were recruited from consecutive referrals to a gambling therapy service in 2008. Inclusion criteria were: (i) assessed as a problem gambler based on a screening interview including DSM-IV criteria for pathological gambling, and (ii) suitable for admission to a treatment program. Cognitive-behavioural therapy was based on graded exposure-to-gambling urge. One-to-one treatment was conducted with 1-hour sessions weekly for up to 12 weeks.
  
  
  METHODS
  Problem gambling screening and co-occurring conditions including depression, anxiety and alcohol use.
  
  
  RESULTS
  Of 127 problem gamblers, 69 were males (54%), mean age was 43.09 years, and 65 (51%) reported a duration of problem gambling greater than 5 years. Median time for participants' enrolment in the study was 8.9 months. Results from mixed effects logistic regression analysis indicated that individuals with higher depression levels had a greater likelihood (13% increase in odds [95% CI, 1%-25%]) of problem gambling during treatment and at follow-up.
  
  
  CONCLUSIONS
  Addressing depression may be associated with improved treatment outcomes in problem gambling; conversely, treatment of problem gambling improves affective instability. We therefore recommend a dual approach that treats both depression and problem gambling.
authors.affiliation: Department of Psychiatry, Flinders University, Adelaide, SA, Australia. david.smith2@health.sa.gov.au
authors.forename: David P
authors.initials: DP
authors.lastname: Smith
authors.forename: Malcolm W
authors.initials: MW
authors.lastname: Battersby
authors.forename: Peter W
authors.initials: PW
authors.lastname: Harvey
authors.forename: Rene G
authors.initials: RG
authors.lastname: Pols
authors.forename: Michael F
authors.initials: MF
authors.lastname: Baigent
authors.forename: Jane E
authors.initials: JE
authors.lastname: Oakes
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005715:Gambling / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome