Pathological gamblers in Singapore: treatment response at 3 months

The efficacy of psychological approaches for the treatment of pathological gambling has been established in rigorous, tightly-controlled trials and limited to Western populations. To address the dearth of research on Asian pathological gamblers, we examined outcomes after 3 months of treatment for 389 pathological gamblers in Singapore.

Data generated from a treatment outcome monitoring program at a national outpatient service were examined to identify changes in gambling behaviors, problem severity, and quality of life, as well as demographic, clinical, and treatment process predictors of these outcomes after 3 months of treatment. Baseline measures were administered on patients' first visit and repeated at 3-month follow-up (n = 284) together with assessment of treatment satisfaction.

The sample was predominantly male (88.2%), Chinese (90.0%) and averaged 39.0 years of age. At 3-month follow-up, quality of life improved, 57.4% reported abstinence, and significant reductions were also observed in frequency and problem severity (all P < 0.001). Significant predictors of clinically meaningful improvement in frequency and problem severity included being a strategic gambler, exposure to gambling after 21 years of age, gambling on more days and self-reported problem seriousness at baseline, and higher treatment satisfaction. Few predictors of quality of life were found.

Pathological gamblers in Singapore seem to respond well to psychological treatment. Clinicians may consider more intensive/adjunct approaches for nonstrategic gambling patients, patients with poor motivation, or those with early exposure to gambling given their poorer prognosis. Patient satisfaction (expectations and experience) should also be assessed and managed, viewing progress toward treatment goals to ensure individual needs are met to optimize treatment responses.