1 IFT Institut für Therapieforschung, München, Germany.
2 German Youth Institute (DJI), Department of Youth and Youth Services, München, Germany.
J Behav Addict. 2021 Jul 28;10(3):690-700. doi: 10.1556/2006.2021.00043.
Evidence on the course of gambling disorder (GD) in clients seeking help from outpatient addiction care facilities is sparse. To close this knowledge gap, this longitudinal one-armed cohort study portrays the development of GD in help-seeking clients over a 3-year timeframe.
We investigated changes in severity of GD as well as in gambling frequency and intensity in 145 gamblers in outpatient treatment in Bavaria using generalized estimation equations (GEEs). To investigate potentially different trajectories between study participants with and without migration background (MB), additional analyses were applied with time*migration interaction. All analyses were adjusted for age, gender, education, electronic gambling machine (EGM) gambling, MB, GD, related help sought before and treatment status.
Within the entire study population, improvements in severity of GD (reduction of 39.2%), gambling intensity (reduction of 75.6%) and gambling frequency (reduction of 77.0%) were observed between baseline and 36 months of follow-up. The declines were most pronounced between baseline and follow-up 1 and stabilized thereafter. Participants with MB improved consistently less than participants without MB.
Our study suggests that severity of GD and gambling patterns improve in the context of outpatient treatment. The beneficial results furthermore persist for 36 months after treatment termination. As clients with MB seem to profit less than clients without MB, improvements in outpatient gambling services to the specific needs of this clientele are required.
在寻求门诊成瘾治疗的患者中，关于赌博障碍（GD）病程的证据稀缺。为了填补这一知识空白，本纵向单臂队列研究描绘了在 3 年时间框架内寻求帮助的患者中 GD 的发展情况。
我们使用广义估计方程（GEE）研究了巴伐利亚州 145 名门诊治疗赌徒的 GD 严重程度以及赌博频率和强度的变化。为了研究有和没有移民背景（MB）的研究参与者之间是否存在不同的轨迹，我们还进行了额外的分析，包括时间*MB 交互作用。所有分析均根据年龄、性别、教育程度、电子赌博机（EGM）赌博、MB、GD、治疗前寻求相关帮助和治疗状况进行了调整。
在整个研究人群中，GD 严重程度（降低 39.2%）、赌博强度（降低 75.6%）和赌博频率（降低 77.0%）在基线和 36 个月随访之间得到改善。在基线和随访 1 之间的下降最为显著，此后趋于稳定。MB 参与者的改善始终低于非 MB 参与者。
我们的研究表明，在门诊治疗背景下，GD 的严重程度和赌博模式会得到改善。此外，治疗结束后 36 个月仍能保持这些改善结果。由于 MB 患者似乎比非 MB 患者受益较少，因此需要为门诊赌博服务制定针对特定客户群体需求的改进措施。
