Saint Louis University, 3700 Lindell Blvd, St. Louis, MO 63108, United States; San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121, United States; University of California San Francisco, 505 Parnassus Ave., San Francisco, CA 94143, United States.
Saint Louis University, 3700 Lindell Blvd, St. Louis, MO 63108, United States.
Addict Behav. 2021 Sep;120:106953. doi: 10.1016/j.addbeh.2021.106953. Epub 2021 Apr 20.
Patients in methadone maintenance treatment (MMT) with problem gambling (PG) experience worse psychosocial outcomes than their non-PG counterparts. Interventions targeting PG in MMT may enhance psychosocial functioning beyond gambling reduction and abstinence. The present study was a secondary data analysis that examined the trajectories of non-gambling outcomes of three brief PG interventions (i.e., brief psychoeducation, brief advice, motivational enhancement therapy plus cognitive-behavioral therapy [MET + CBT]) among MMT patients.
Participants (N = 109) were engaged in substance use disorder treatment, met criteria for PG, and had a current or lifetime history of MMT. Latent growth curve models examined outcome trajectories of psychiatric, medical, legal, employment, and social problems, as well as psychological distress and quality of life. Follow-up analyses examined clinically significant change.
MET + CBT patients reported lower medical problems at baseline and over time than the brief interventions. There was no evidence of differences between interventions on the other outcomes. Psychiatric problems and psychological distress decreased over time for the entire sample, regardless of the PG intervention. About 24% and 13% of the sample demonstrated clinically significant improvements in psychological distress from baseline to 5 months, and 5 months to 12 months, respectively. Nearly 21% of the sample showed clinically significant improvements in psychiatric problems from 5 months to 12 months. Among all patients, men and those with more severe opioid dependence symptoms demonstrated the greatest psychological improvements.
Many patients in MMT with PG experience improvements in psychological problems, including long-term improvement, regardless of the PG intervention offered.
接受美沙酮维持治疗(MMT)且存在赌博问题(PG)的患者比无 PG 问题的患者经历更差的心理社会结局。针对 MMT 中 PG 的干预措施可能会增强心理社会功能,而不仅仅是减少赌博和戒除。本研究是对三种简短 PG 干预措施(即简短心理教育、简短建议、动机增强治疗加认知行为治疗[MET+CBT])对 MMT 患者的非赌博结局轨迹的二次数据分析。
参与者(N=109)参与了物质使用障碍治疗,符合 PG 标准,且有当前或既往 MMT 史。潜在增长曲线模型考察了精神病学、医学、法律、就业和社会问题以及心理困扰和生活质量的结局轨迹。随访分析考察了临床显著变化。
MET+CBT 患者报告的基线和随时间推移的医疗问题低于简短干预组。干预措施之间在其他结局上没有差异。整个样本的精神病问题和心理困扰随时间减少,无论是否接受 PG 干预。约 24%和 13%的样本在心理困扰方面从基线到 5 个月,从 5 个月到 12 个月分别表现出临床显著改善。约 21%的样本在 5 个月到 12 个月期间在精神病问题上表现出临床显著改善。在所有患者中,男性和那些具有更严重的阿片类依赖症状的患者表现出最大的心理改善。
许多接受 MMT 且存在 PG 的患者经历了心理问题的改善,包括长期改善,而不论提供何种 PG 干预措施。