Duration of untreated illness in gambling disorder

Abstract

Background: gambling disorder (also known as pathological gambling) is common, affects 0.5-2% of the population, and is under-treated. Duration of untreated illness (DUI) has emerged as a clinically important concept in the context of other mental disorders – for example being linked to worse outcomes in psychosis and to some degree mood and anxiety disorders, and in obsessive-compulsive disorder (OCD). However, DUI in gambling disorder has received little (if any) research scrutiny.

Methods: data were aggregated from eight previous clinical trials conducted in people with gambling disorder who had never previously received any treatment for the disorder. Duration of untreated illness was quantified. Demographic and clinical characteristics were compared as a function of DUI status (higher DUI vs lower DUI).

Results: the sample comprised 298 individuals, and the overall DUI was mean (standard deviation) 8.9 (8.4) years, and the median DUI was 6 years. Longer DUI was significantly associated with male gender, older age, earlier age when the person first started to gamble, and family history of alcohol use disorder (in one or more first degree relatives). Longer DUI was not significantly associated with racial-ethnic status, gambling symptom severity, current depressive or anxiety severity, presence of mainstream mental disorders (including alcohol use disorders), or disability/functioning. The two groups did not differ in their subsequent propensity to drop out of the clinical trials, nor in the overall improvement in symptom severity associated with participation in those trials.

Conclusions: these data suggest that gambling disorder has a relatively long typical DUI. This highlights the need to raise awareness and foster early intervention for affected and at-risk individuals. Because earlier age at first gambling in any form was strongly linked to longer DUI, this highlights the need for more rigorous legislation and education to reduce exposure of younger people to gambling. In terms of treatment, the findings suggest that people with long DUI still benefit from participation in a clinical trial to the same extent as those with shorter DUI, in terms of improvement in gambling symptoms, if they choose to take part in such a trial.

More information

Identifiers

ORCID for Samuel R. Chamberlain: orcid.org/0000-0001-7014-8121

Catalogue record

Export record