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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
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2017, Number 6

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Salud Mental 2017; 40 (6)

Current psychological therapeutic approaches for gambling disorder with psychiatric comorbidities: A narrative review

Echeburúa E, Amor PJ, Gómez M
Full text How to cite this article

Language: Spanish
References: 41
Page: 299-305
PDF size: 167.99 Kb.


Key words:

Gambling disorder, comorbidity, therapeutics, psychological treatment.

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

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  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

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Salud Mental. 2017;40