National Addictions Management Service, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore,
J Gambl Stud. 2014 Mar;30(1):89-103. doi: 10.1007/s10899-012-9328-7.
Research on predictors of treatment outcome among pathological gamblers (PGs) is inconclusive and dominated by studies from Western countries. Using a prospective longitudinal design, the current study examined demographic, clinical, behavioural and treatment programme predictors of gambling frequency at 3, 6 and 12-months, among PGs treated at an addiction clinic in Singapore. Measures included the Hospital anxiety and depression scale, gambling symptom assessment scale (GSAS), personal well-being index (PWI), treatment perception questionnaire and gambling readiness to change scale. Treatment response in relation to changes in symptom severity, personal wellbeing and abstinence were also assessed. Abstinence rates were 38.6, 46.0 and 44.4 % at 3, 6 and 12-months respectively. Significant reductions in gambling frequency, GSAS, and improvement in PWI were reported between baseline and subsequent outcome assessments, with the greatest change occurring in the initial three months. No demographic, clinical, behavioural or treatment programme variable consistently predicted outcome at all three assessments, though treatment satisfaction was the most frequent significant predictor. However, being unemployed, having larger than average debts, poor treatment satisfaction and attending fewer sessions at the later stages of treatment were associated with significantly poorer outcomes, up to 1-year after initiating treatment. These findings show promise for the effectiveness of a CBT-based treatment approach for the treatment of predominantly Chinese PGs. Clinical implications and suggestions for future research are discussed. Taken together, the findings suggest early treatment satisfaction is paramount in improving short-term outcomes, with baseline gambling behaviour and treatment intensity playing a more significant role in the longer term.
病理性赌博者（PGs）治疗结果预测因素的研究尚无定论，主要是来自西方国家的研究。本研究采用前瞻性纵向设计，考察了新加坡一家成瘾诊所治疗的 PGs 在 3、6 和 12 个月时，人口统计学、临床、行为和治疗计划因素对赌博频率的预测。测量包括医院焦虑和抑郁量表、赌博症状评估量表（GSAS）、个人幸福感指数（PWI）、治疗感知问卷和赌博改变准备量表。还评估了与症状严重程度、个人幸福感和戒断相关的治疗反应。3、6 和 12 个月时的戒断率分别为 38.6%、46.0%和 44.4%。报告称，赌博频率、GSAS 和 PWI 均有显著降低，与基线相比，后续结果评估有所改善，最大变化发生在最初的三个月。尽管治疗满意度是最常见的显著预测因素，但没有任何人口统计学、临床、行为或治疗计划变量能够始终一致地预测所有三个评估的结果。然而，失业、债务大于平均水平、治疗满意度差和治疗后期就诊次数较少与治疗开始后 1 年内显著较差的结果相关。这些发现表明，基于认知行为疗法的治疗方法对治疗以华人为主的 PGs 有效。讨论了临床意义和未来研究的建议。总的来说，这些发现表明，早期的治疗满意度对于改善短期结果至关重要，而基线赌博行为和治疗强度在长期内起着更重要的作用。
