A controlled study of the effect of cognitive-behavioural group therapy for pathological gamblers.

As the number of pathological gamblers has increased recently, the need for effective treatment has become more evident. The aim of this study was to evaluate the effectiveness of a short-term cognitive-behavioural group therapy programme for pathological gamblers. Fourteen subjects (three females and 11 males), who met the criteria for pathological gambling in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV, were randomly assigned to a Treatment Group (n=7) or a waiting list Control Group (n=7). An experimental design with three repeated measures was used (pre-treatment, post-treatment/post-waiting list and follow-up). The dependent variables were DSM-IV Criteria for Pathological Gambling, Money Spent on Gambling During the Last Week and Gamblers Inventory of Negative Consequences. The Treatment Group improved on the DSM-IV Criteria for Pathological Gambling, but did not show a significant improvement on Money Spent on Gambling During the Last week from pre-treatment to post-treatment. Combining both groups at 3-months follow-up, there was a significant improvement on all three variables from pre-treatment to follow-up. The results of this controlled study indicate that a short-term cognitive-behavioural group treatment for pathological gamblers had an effect.

Outcome of pharmacological treatments of pathological gambling: a review and meta-analysis.

UNLABELLED: Although several qualitative reviews on pharmacological interventions for pathological gambling have been published, no quantitative review of this field has been conducted. METHODS: Studies of pharmacological interventions of pathological gambling were identified by computer searches in the PsychINFO and MEDLINE databases covering the period from 1966 to July 2006, as well as from relevant reference lists. The inclusion criteria were as follows: the target problem had to be pathological gambling, the interventions were pharmacological, the study was written in English, and the study reported outcomes particularly pertaining to gambling. A total of 130 potential studies were identified of which 16 met the inclusion criteria. A total of 597 subjects were included in the outcome analyses of these studies. The grand mean age was 43.3 years. The overall proportion of men was 62.8%. The included studies were coded for outcome measures of pathological gambling. For each condition, means and SDs for gambling-related outcome measures were compiled at 2 points in time: baseline and posttreatment. RESULTS: At posttreatment, the analysis showed that the pharmacological interventions were more effective than no treatment/placebo, yielding an overall effect size of 0.78 (95% confidence interval, 0.64-0.92). A multiple regression analysis showed that the magnitude of effect sizes at posttreatment was lower in studies using a placebo-control condition compared with studies using a predesign/postdesign without any control condition. Effect sizes were also negatively related to the proportion of male participants in the included studies. No differences in outcome between the 3 main classes of pharmacological interventions (antidepressants, opiate antagonists, mood stabilizers) were detected. CONCLUSION: Pharmacological interventions for pathological gambling may be an adequate treatment alternative in pathological gambling.