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The Placebo Effect and Its Clinical Associations in Gambling Disorder

Accepted version
Peer-reviewed

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Type

Article

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Authors

Grant, JE 
Chamberlain, SR 

Abstract

Background: Gambling disorder is prevalent and functionally impairing, yet no FDA approved medications exist for its treatment. The ability of clinical trials to discriminate active treatment benefits has been hindered by the unusually high placebo response. Virtually nothing is known about baseline clinical characteristics that might be predictive of placebo response in gamblers. Methods: 152 participants assigned to placebo were pooled from multiple double-blind trials in gambling disorder. Participants were classified as placebo responders or non-responders based on a cut-off of 35% reduction in symptom severity on the Gambling Severity Scale (GSAS). Baseline group differences were characterized using t-tests and equivalent non-parametric tests as appropriate. Results: Fifty-one percent of individuals assigned to placebo treatment showed a significant clinical response to placebo. Placebo responders stayed in treatment for significantly longer, were more likely to endorse ‘enjoyment’ as a trigger for gambling, and were less likely to endorse ‘boredom’ or ‘loneliness’ as triggers for gambling. Placebo responders and non-responders did not differ significantly on age, gender, age at symptom onset, baseline symptom severity, comorbidities, or likelihood of having received a previous treatment. Conclusions: Predictors of placebo response for gambling disorder appear markedly different from those reported for other mental health disorders.

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Keywords

Adult, Female, Gambling, Humans, Male, Outcome Assessment, Health Care, Placebo Effect

Journal Title

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists

Conference Name

Journal ISSN

1040-1237
1547-3325

Volume Title

29

Publisher

Frontline Medical Communications

Publisher DOI

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Sponsorship
Wellcome Trust (110049/Z/15/Z)
Wellcome Trust Clinical Fellowship (110049/Z/15/Z)