Predictors of early dropout in treatment for gambling disorder: The role of personality disorders andclinical syndromes

Several treatment options for gambling disorder (GD) have been tested in recent years; however dropout levelsstill remain high. This study aims to evaluate whether the presence of psychiatric comorbidities predictstreatment outcome according to Millon's evolutionary theory, following a six-month therapy for GD. The role ofseverity, duration of the disorder, typology of gambling (mainly online or offline) and pharmacological treatmentwere also analysed. The recruitment included 194 pathological gamblers (PGs) to be compared with 78healthy controls (HCs). Psychological assessment included the South Oaks Gambling Screen and the MillonClinical Multiaxial Inventory-III. The “treatment failure” group (n = 70) comprised PGs who prematurelydropped out of the treatment whereas the “abstinent group” (n = 124) included PGs who completed thetreatment regardless of whether the outcome was successful or not. As expected, the presence of psychiatriccomorbidities was highlighted as a significant predictor in dropping out of the therapy. Specifically negativisticpersonality disorder, antisocial personality disorder, drug dependence and PTSD were associated with earlydropout. These variables were predictive of treatment outcome independently from the typology of gambling,severity, duration of the disorder and pharmacological treatment. Implications for psychological and psychiatriccare are discussed.