{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:57:25Z","timestamp":1785326245658,"version":"3.55.0"},"reference-count":92,"publisher":"Akademiai Kiado Zrt.","issue":"3","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Bavarian State Ministry of Public Health and Care Services"},{"DOI":"10.13039\/501100006636","name":"Swedish Research Council for Health, Working Life and Welfare","doi-asserted-by":"crossref","award":["2016-07091"],"award-info":[{"award-number":["2016-07091"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["JBA"],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aim<\/jats:title><jats:p>Evidence on the course of gambling disorder (GD) in clients seeking help from outpatient addiction care facilities is sparse. To close this knowledge gap, this longitudinal one-armed cohort study portrays the development of GD in help-seeking clients over a 3-year timeframe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated changes in severity of GD as well as in gambling frequency and intensity in 145 gamblers in outpatient treatment in Bavaria using generalized estimation equations (GEEs). To investigate potentially different trajectories between study participants with and without migration background (MB), additional analyses were applied with time*migration interaction. All analyses were adjusted for age, gender, education, electronic gambling machine (EGM) gambling, MB, GD, related help sought before and treatment status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within the entire study population, improvements in severity of GD (reduction of 39.2%), gambling intensity (reduction of 75.6%) and gambling frequency (reduction of 77.0%) were observed between baseline and 36 months of follow-up. The declines were most pronounced between baseline and follow-up 1 and stabilized thereafter. Participants with MB improved consistently less than participants without MB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and conclusion<\/jats:title><jats:p>Our study suggests that severity of GD and gambling patterns improve in the context of outpatient treatment. The beneficial results furthermore persist for 36 months after treatment termination. As clients with MB seem to profit less than clients without MB, improvements in outpatient gambling services to the specific needs of this clientele are required.<\/jats:p><\/jats:sec>","DOI":"10.1556\/2006.2021.00043","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T12:15:41Z","timestamp":1627474541000},"page":"690-700","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":3,"title":["Changes in gambling behaviour and related problems in clients seeking help in outpatient addiction care: Results from a 36-month follow-up study in Bavaria"],"prefix":"10.1556","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2333-9846","authenticated-orcid":true,"given":"Andreas M.","family":"Bickl","sequence":"first","affiliation":[{"name":"IFT Institut f\u00fcr Therapieforschung, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Schwarzkopf","sequence":"additional","affiliation":[{"name":"IFT Institut f\u00fcr Therapieforschung, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna K.","family":"Loy","sequence":"additional","affiliation":[{"name":"IFT Institut f\u00fcr Therapieforschung, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Gr\u00fcne","sequence":"additional","affiliation":[{"name":"German Youth Institute (DJI), Department of Youth and Youth Services, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Braun-Michl","sequence":"additional","affiliation":[{"name":"IFT Institut f\u00fcr Therapieforschung, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Sleczka","sequence":"additional","affiliation":[{"name":"German University of Health and Sport, Ismaning, Germany"},{"name":"Seeburg Castle University, Seekirchen am Wallersee, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny Cisneros","family":"\u00d6rnberg","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludwig","family":"Kraus","sequence":"additional","affiliation":[{"name":"IFT Institut f\u00fcr Therapieforschung, M\u00fcnchen, Germany"},{"name":"Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden"},{"name":"Institute of Psychology, ELTE, E\u00f6tv\u00f6s Lor\u00e1nd University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"ref91","first-page":"CD008937","article-title":"Psychological therapies for pathological and problem gambling","volume":"11","author":"Cowlishaw","year":"2012","journal-title":"Cochrane Database Systematic Review"},{"key":"ref721","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.cpr.2003.09.005","article-title":"Role of culture in gambling and problem gambling","volume":"23","author":"Raylu","year":"2004","journal-title":"Clinical Psychology Review"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1024\/2008.03.03","article-title":"Komorbidit\u00e4t bei Pathologischem Gl\u00fccksspiel","volume":"54","author":"Premper","year":"2008","journal-title":"Sucht"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1360-0443.2005.00962.x","article-title":"Electronic gaming machines: Are they the \u201ccrack\u2010cocaine\u201dof gambling?","volume":"100","author":"Dowling","year":"2005","journal-title":"Addiction"},{"key":"ref671","volume-title":"Pathologisches Gl\u00fccksspielen und Epidemiologie (PAGE): Entstehung, Komorbidit\u00e4t, Remission und Behandlung. 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