title: Pathological gambling: understanding relapses and dropouts.
abstract: There is little available information on the factors that influence relapses and dropouts during therapy for pathological gambling (PG). The aim of this study was to determine socio-demographic, clinical, personality, and psychopathological predictors of relapse and dropout in a sample of pathological gamblers seeking treatment. A total of 566 consecutive outpatients diagnosed with PG according to DSM-IV-TR criteria were included. All patients underwent an individualized cognitive-behavioral treatment program. We analyzed predictors of relapse during 6months of treatment and during the subsequent 6months of follow-up, and predictors of dropout over the entire therapeutic program. Eighty patients (14.1%) experienced at least one relapse during the entire follow-up of the study: 50 (8.8%) within the treatment period and 12 (2.1%) during the subsequent 6-month follow-up period. The main predictors of relapse were single marital status, spending less than 100euros/week on gambling, active gambling behavior at treatment inclusion, and high scores on the TCI-R Harm Avoidance personality dimension. One hundred fifty-seven patients (27.8%) missed 3 or more therapeutic sessions over the entire therapeutic program. The main predictors of dropout were single marital status, younger age, and high scores on the TCI-R Novelty Seeking personality dimension. The presence of these factors at inclusion should be taken into account by physicians dealing with PG patients.
authors.affiliation: Pathological Gambling Unit, Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain. Electronic address: naragay@cst.cat.
authors.forename: Núria
authors.initials: N
authors.lastname: Aragay
authors.affiliation: Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona,Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Jiménez-Murcia
authors.affiliation: Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona,Spain.
authors.forename: Roser
authors.initials: R
authors.lastname: Granero
authors.affiliation: Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona,Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Aranda
authors.affiliation: Pathological Gambling Unit, Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Ramos-Grille
authors.affiliation: Pathological Gambling Unit, Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Cardona
authors.affiliation: Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Garrido
authors.affiliation: Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Anisul Islam
authors.affiliation: Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona,Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Menchón
authors.affiliation: Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain.
authors.forename: Vicenç
authors.initials: V
authors.lastname: Vallès
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D005106:Exploratory Behavior; D005260:Female; D005715:Gambling; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D010551:Personality; D011599:Psychopathology; D012008:Recurrence; D012307:Risk Factors