Baenas Isabel, Etxandi Mikel, Codina Ester, Granero Roser, Fernández-Aranda Fernando, Gómez-Peña Mónica, Moragas Laura, Rivas Sandra, Potenza Marc N, Håkansson Anders, Del Pino-Gutiérrez Amparo, Mora-Maltas Bernat, Valenciano-Mendoza Eduardo, Menchón José M, Jiménez-Murcia Susana
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
Front Psychol. 2021 Dec 14;12:761802. doi: 10.3389/fpsyg.2021.761802. eCollection 2021.
COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout. The sample consisted of =86 adults, mostly men (=79, 91.9%) and with a mean age of 45years old (=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown). The risk of dropout during the complete observational period was =32/86=0.372 (37.2%), the Incidence Density Rate () ratio T2/T1 being equal to 0.052/0.033=1.60 (=0.252). Shorter treatment duration (=0.007), lower anxiety (=0.025), depressive symptoms (=0.045) and lower use of adaptive coping strategies (=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (=0.001) and higher employment concerns (=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (=0.005 and <0.001, respectively). The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations.
新冠疫情及封锁措施对患有赌博障碍（GD）的患者构成了挑战。在治疗结果方面，治疗中断可能受到了这些不利情况的影响。本研究的目的是：（a）分析在两个时期（封锁期间和封锁之后）患有GD的患者的治疗中断率，以及（b）评估可能代表治疗中断易患因素的临床特征。样本包括86名成年人，大多数为男性（79名，91.9%），平均年龄45岁（标准差16.85）。患者根据《精神疾病诊断与统计手册》第五版（DSM - 5）标准被诊断为患有GD，在封锁开始时正在行为成瘾科接受治疗。临床数据通过半结构化访谈和标准化心理测评收集。在封锁开始时还进行了一项与新冠疫情相关担忧的简短电话调查。在为期九个月的观察期内的两个时间点评估治疗中断数据（T1：封锁期间，T2：封锁之后）。整个观察期内治疗中断的风险为32/86 = 0.372（37.2%），发病率密度率（IDR）的T2/T1比值等于0.052/0.033 = 1.60（p = 0.252）。治疗时间较短（p = 0.007）、焦虑程度较低（p = 0.025）、抑郁症状较轻（p = 0.045）以及适应性应对策略使用较少（p = 0.046）是封锁期间放弃治疗患者的特征。治疗时间较短（p = 0.001）和就业担忧较高（p = 0.044）在封锁后退出治疗的个体中较为突出。治疗时间在两个时期都是治疗中断的一个预测因素（分别为p = 0.005和p < 0.001）。目前的结果表明，新冠疫情对封锁期间及之后患有GD的患者的治疗中断有影响，治疗时间是治疗中断的一个预测因素。评估GD中的易患特征可能有助于临床医生识别高危个体，并在未来类似情况下加强预防和治疗方法。
