View clinical trials related to Gambling Disorder.
Filter by:This is a quality register for the monitoring of clinical assessment and treatment for gambling disorder and gaming disorder in Swedish health care. This register is held by Region Skåne, the health care organization of Skåne in southern Sweden, and administered by Register center South, which is associated with health care services in the southern regions of Sweden (the establishment of quality registers in Swedish health care relies upon a national legislation). Quality registers by themselves do not represent formal research projects. However, future research projects can use quality registers, such as the present one, as a data source for future research projects in case they are approved by an ethics authority. Clinical study variables collected in the register include the following (examples): - gender, age, occupation, living conditions - if applicable, types of gambling associated with the treatment needs - if applicable, type of problematic video gaming - type of referral to the present treatment contact - treatment history in psychiatry, social services, enforcement agency - history of suicidal behavior - alcohol and drugs problems requiring assessment or treatment - violence victimization - type of treatment provided to the patient
Background: Gambling disorder (GD), is a behavioral addiction based on keeping play despite medical, economic and social consequences. GD is characterized by progressive and persistent brain circuits alterations (reward, stress, memory, impulse control and cognitive functions), so a possible treatment could be based on neuromodulation of specific brain areas. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation, which provides magnetic stimuli on certain brain areas parts with short and long-term effects. rTMS has the FDA approval for some neurological (headache) and psychiatric (treatment-resistant depression, obsessive-compulsive disorder) disease. Nowadays several evidence in scientific literature lead to a promise use of rTMS also in addiction field with a possible indication also for GD. Objectives: the main outcome is to assess symptoms related to GD (craving, play frequencies, money lost) before and after rTMS stimulation on left dorsolateral prefrontal cortex (DLPFC). Eligibility: Healthy, right-handed adults ages 18-65 with a diagnosis of GD. Design: This is a randomized, sham-controlled study. The study includes two phases:1) a rTMS continued treatment phase and 2) a follow-up without rTMS stimulation (30 days). In order to be enrolled, participants will be screened with: - Questionnaires - Medical history - Physical exam - f-MRI After being enrolled, baseline behavioral and imaging data will be collected. In particular, participants will submit: - Questionnaires - Functional MRI - Cognitive tasks During the continued rTMS phase, participants with gambling disorder will be randomized to receive real or sham rTMS. RTMS will be delivered during 5 outpatient treatment days, (3 times/die). After the last stimulation and at the end of the 30-days of follow-up period, subjects will undergo the neurocognitive and psychometric evaluation. Twenty randomized patients of whole enrolled group will undergo fMRI at baseline and at the end of arTMS treatment phase. Treatment includes: - rTMS: A weak electrical current passes through a coil placed on the head. During each stimulation day, participants will receive three rTMS sessions (13 min), with a 50 min of interval. - fMRI: Participants lie on a table that slides into a cylinder that takes pictures of the brain. They respond to images while in the scanner. - Repeat of screening tests and questionnaires
The primary objective of this study is to determine whether favorable response to naltrexone orally taken in treatment of GD can be predicted by patterns of visual scanning, assessed by eye-tracking technology before, at the start and throughout gambling treatment with naltrexone.
The present overall project evaluates an intervention carried out by the Swedish state-owned gambling operator AB Svenska Spel, in order to help high-risk gamblers reduce or quit their gambling. The intervention is a motivational telephone intervention, called by responsible gambling officers trained in motivational interviewing, and who call gamblers who are screened for suspected high-risk gambling practices either through the operator's own records, or because they have voluntarily taken a self-test indicating a hazardous gambling pattern. The present projects evaluates the effectiveness, user satisfaction and acceptability of the intervention, in two parts: 1) A retrospective, register-based follow-up of gamblers reached by the telephone intervention, in comparison to control individuals for whom attempts were made to carry out the same intervention, but who were never successfully reached on telephone. The effectiveness measures include potential changes in gambling level (frequency, level of wagering) post-intervention compared to pre-intervention, as well as occurrence of deposit limits, or voluntary self-exclusion. 2) A prospective web survey study involving individuals reached with the intervention from November, 2020, who - after receiving electronic written information and after providing informed consent - will answer a web survey around 10 days after the intervention, about their attitudes to the telephone intervention, and their self-reported gambling (on the same operator and on other gambling operators), self-limiting interventions and treatment seeking after the intervention. The study will provide important data on the effectiveness of this intervention aiming to reduce high-risk gambling practices, and will be able to study also the risk of gamblers transferring their gambling practices to other operators after a motivational intervention as the present one. Also, as acceptability and user satisfaction of the intervention are crucial for its success over time, these measures are also included in order to improve the understanding or how effective responsible gambling interventions can be implemented by gambling operators with a harm-reducing mission.
Gambling disorder (GD) is recognized as an addictive disorder in the DSM-5. Craving is a core phenomenon in addiction that can lead to relapse in problem gambling for pathological gamblers. Exposure Therapy (ET) focuses on craving in addiction treatment. ET in Cognitive-Behavioral Therapy (CBT) is based on classical conditioning that addresses the association between contextual cues and the craving response. ET helps the patient to reduce craving when faced with cues triggering craving. ET includes in vivo exposure and imaginal exposure. The literature recommends being as close as possible to the context of addiction to facilitate the extinction of craving but in vivo ET is complicated to perform. For GD, in outpatient consultation, bringing a patient to a casino presents obstacles (e.g., time, human and financial cost, agreement with casino for therapy). The study will be to assess the effectiveness of Virtual Reality Exposure Therapy (VRET) in a virtual gambling environment. Various trials show that VRET is no more or less effective than classical ET in CBT but has other advantages for motivation to treatment. This research aims to compare efficacy between CBT with VRET and CBT with imaginal exposure for treatment of GD in a multicenter, randomized, controlled, non-inferiority clinical trial.
The goal of this project is to develop and to test the efficacy of a novel mHealth app for gambling disorder. The app capitalizes on smartphones' global positioning software (GPS) that recognizes a user's location to within 15 feet. Users will receive an alert of this go near a gambling venue. The project will conduct a 12-week pilot randomized clinical trial to test the short-term efficacy of the app with gambling disorder individuals.
Problem gambling (PG) is a major public health concern worldwide. As awareness of PG has risen, treatment demand is increasing, and internet interventions is a promising alternative for providing fast, evidence-based treatment at scale, to a low cost. This article presents the protocol of an open label, uncontrolled pilot and feasibility trial of a novel internet-delivered cognitive behavioral treatment, conducted in regular addiction care with adult treatment-seeking patients (max N=25) with problematic gambling. Weekly measures of gambling symptoms and gambling will serve as outcome measures. Study results will further guide the development of the intervention and its implementation into regular addiction care.
Gambling disorder (GD), currently considered a behavioral addiction, show substantial similarities with substance use disorders (SUDs) in terms of neurobiology and symptomatology. In particular, alterations in prefrontal control circuit may underlie vulnerability to gambling- and drug-related cues and diminished cognitive control over craving, and negative emotions. Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) could represent a novel approach to remodel these brain circuits. The aim of this study is to evaluate High frequency (HF) rTMS over the left DLPFC as an efficacious treatment for reduction of gambling urges and behavior in a randomized double-blind placebo-controlled design in which 36 GD patients will receive active or sham rTMS for 12 weeks.
Group cognitive behavioral therapy for Gambling Disorder (GD) with a focus on emotion regulation - A pilot study This pilot study will evaluate the feasibility and possible effectiveness of a novel treatment protocol developed within the research group including emotion regulation techniques for the treatment of GD.
In this project the investigators propose a randomized double-blind placebo-controlled design in which 40 patients with GD will receive active or sham cTBS to the pre-SMA for 2 weeks. The investigators will combine TMS, multimodal structural and functional MRI and behavioral measures in order to identify circuit-level mechanisms of action and therapeutic targets (connectivity changes that explain clinical improvement) and assess the efficacy of TMS in modulating inhibitory control and symptom severity in this population.