Background

Patients in methadone maintenance treatment (MMT) with problem gambling (PG) experience worse psychosocial outcomes than their non-PG counterparts. Interventions targeting PG in MMT may enhance psychosocial functioning beyond gambling reduction and abstinence. The present study was a secondary data analysis that examined the trajectories of non-gambling outcomes of three brief PG interventions (i.e., brief psychoeducation, brief advice, motivational enhancement therapy plus cognitive-behavioral therapy [MET + CBT]) among MMT patients.

Methods

Participants (N = 109) were engaged in substance use disorder treatment, met criteria for PG, and had a current or lifetime history of MMT. Latent growth curve models examined outcome trajectories of psychiatric, medical, legal, employment, and social problems, as well as psychological distress and quality of life. Follow-up analyses examined clinically significant change.

Results

MET + CBT patients reported lower medical problems at baseline and over time than the brief interventions. There was no evidence of differences between interventions on the other outcomes. Psychiatric problems and psychological distress decreased over time for the entire sample, regardless of the PG intervention. About 24% and 13% of the sample demonstrated clinically significant improvements in psychological distress from baseline to 5 months, and 5 months to 12 months, respectively. Nearly 21% of the sample showed clinically significant improvements in psychiatric problems from 5 months to 12 months. Among all patients, men and those with more severe opioid dependence symptoms demonstrated the greatest psychological improvements.

Conclusions

Many patients in MMT with PG experience improvements in psychological problems, including long-term improvement, regardless of the PG intervention offered.

中文翻译：

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与美沙酮患者问题赌博的短暂干预相关的次要结局变化

背景

患有问题赌博 (PG) 的美沙酮维持治疗 (MMT) 患者的心理社会结果比非 PG 患者更差。在 MMT 中针对 PG 的干预可能会增强心理社会功能，而不仅仅是减少赌博和禁欲。本研究是一项二次数据分析，检查了 MMT 患者中三种简短的 PG 干预（即简短的心理教育、简短的建议、动机增强疗法加认知行为疗法 [MET + CBT]）的非赌博结果轨迹。

方法

参与者 ( N  = 109) 从事物质使用障碍治疗，符合 PG 标准，并且当前或终生有 MMT 病史。潜在增长曲线模型检查了精神、医疗、法律、就业和社会问题的结果轨迹，以及心理困扰和生活质量。后续分析检查了临床上显着的变化。

结果

MET + CBT 患者在基线和随着时间的推移报告的医疗问题低于简短干预。没有证据表明干预措施对其他结果有差异。无论 PG 干预如何，整个样本的精神问题和心理困扰都会随着时间的推移而减少。大约 24% 和 13% 的样本分别显示从基线到 5 个月和 5 个月到 12 个月的心理困扰在临床上有显着改善。近 21% 的样本显示，从 5 个月到 12 个月，精神问题在临床上有显着改善。在所有患者中，男性和具有更严重阿片类药物依赖症状的患者表现出最大的心理改善。

结论

无论提供何种 PG 干预，许多患有 PG 的 MMT 患者的心理问题都得到了改善，包括长期改善。