AUTHOR=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 

TITLE=Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study

JOURNAL=Frontiers in Psychology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.761802

DOI=10.3389/fpsyg.2021.761802

ISSN=1664-1078

ABSTRACT=<p><bold>Background and Aims:</bold> 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.</p><p><bold>Methods:</bold> The sample consisted of <italic>n</italic>=86 adults, mostly men (<italic>n</italic>=79, 91.9%) and with a mean age of 45years old (<italic>SD</italic>=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).</p><p><bold>Results:</bold> The risk of dropout during the complete observational period was <italic>R</italic>=32/86=0.372 (37.2%), the Incidence Density Rate (<italic>IDR</italic>) ratio T2/T1 being equal to 0.052/0.033=1.60 (<italic>p</italic>=0.252). Shorter treatment duration (<italic>p</italic>=0.007), lower anxiety (<italic>p</italic>=0.025), depressive symptoms (<italic>p</italic>=0.045) and lower use of adaptive coping strategies (<italic>p</italic>=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (<italic>p</italic>=0.001) and higher employment concerns (<italic>p</italic>=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (<italic>p</italic>=0.005 and <italic>p</italic>&lt;0.001, respectively).</p><p><bold>Conclusion:</bold> 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.</p>