Association Between Early Dropout from a Gambling Disorder Group Program and Subsequent Loss of Outpatient Contact: A...

Objective early discontinuation of structured gambling disorder (GD) programs is common; however, whether stopping after the first session indicates subsequent loss of outpatient contact is unclear. We examined the association between early program dropout and short-term loss of outpatient follow-up. Methods this single-center retrospective cohort study included 155 adults (≥ 18 years) with GD, diagnosed by psychiatrists according to ICD-10 criteria, who attended a group-based GD program for the first time. Early dropout was defined as attending only the first session. Loss to follow-up (LTFU) was defined as an absence of outpatient visit for ≥ 90 days within 180 days after the first session, excluding program sessions, reflecting loss of outpatient contact. Adjusted associations were estimated using logistic and modified Poisson regression with robust standard errors, adjusting for age, sex, South Oaks Gambling Screen score, comorbid psychiatric disorders, referral pathway, waiting time to program entry, and living arrangement. Results of the 155 participants, 64 (41.3%) were LTFU, and 60 (38.7%) discontinued the program early. LTFU was more frequent among early dropouts than among non-early dropouts (58.3% vs. 30.5%; crude risk ratio 1.91, 95% CI 1.32 to 2.77). The association remained after adjustment (adjusted odds ratio 2.79, 95% CI 1.36-5.82; adjusted risk ratio 1.68, 95% CI 1.15-2.46). Conclusions stopping after the first program session was associated with subsequent loss of outpatient contact within 180 days. Early dropout may be a pragmatic risk marker that triggers standardized early follow-up procedures to maintain clinical contact.