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Pathological Gamblers in Singapore: Treatment Response at 3 Months

Manning, Victoria BSc, MSc, PhD; Ng, Andrew BSocSc; Koh, Puay Kee BA; Guo, Song MBBS, MMed, PhD; Gomathinayagam, Kandasami MBBS; Wong, Kim Eng MBBS, MCRPsych, FAMS

doi: 10.1097/ADM.0000000000000082
Original Research

Objectives: The efficacy of psychological approaches for the treatment of pathological gambling has been established in rigorous, tightly-controlled trials and limited to Western populations. To address the dearth of research on Asian pathological gamblers, we examined outcomes after 3 months of treatment for 389 pathological gamblers in Singapore.

Methods: Data generated from a treatment outcome monitoring program at a national outpatient service were examined to identify changes in gambling behaviors, problem severity, and quality of life, as well as demographic, clinical, and treatment process predictors of these outcomes after 3 months of treatment. Baseline measures were administered on patients' first visit and repeated at 3-month follow-up (n = 284) together with assessment of treatment satisfaction.

Results: The sample was predominantly male (88.2%), Chinese (90.0%) and averaged 39.0 years of age. At 3-month follow-up, quality of life improved, 57.4% reported abstinence, and significant reductions were also observed in frequency and problem severity (all P < 0.001). Significant predictors of clinically meaningful improvement in frequency and problem severity included being a strategic gambler, exposure to gambling after 21 years of age, gambling on more days and self-reported problem seriousness at baseline, and higher treatment satisfaction. Few predictors of quality of life were found.

Conclusions: Pathological gamblers in Singapore seem to respond well to psychological treatment. Clinicians may consider more intensive/adjunct approaches for nonstrategic gambling patients, patients with poor motivation, or those with early exposure to gambling given their poorer prognosis. Patient satisfaction (expectations and experience) should also be assessed and managed, viewing progress toward treatment goals to ensure individual needs are met to optimize treatment responses.

Supplemental Digital Content is Available in the Text.

From the National Addictions Management Service (VM, AN, PKK, SG, KG, KEW), Institute of Mental Health, Singapore; Turning Point (VM), Eastern Health, Fitzroy, Australia; and Eastern Health Clinical School (VM), Monash University, Box Hill, Australia.

The study was conducted at the National Addictions Management Service, Institute of Mental Health, Singapore.

The treatment outcome monitoring program from which this article has derived its findings, is funded by the Ministry of Health, Singapore.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Send correspondence and reprint requests to Victoria Manning, BSc, MSc, PhD, National Addictions Management Service, Institute of Mental Health, 10 Buangkok View, Singapore 539747. E-mail:

Received October 07, 2013

Accepted August 16, 2014

© 2014 American Society of Addiction Medicine