Study protocol: seeking treatment for gambling - a 10-year retrospective clinical and register study of gambling patterns and physical and psychiatric comorbidity in patients with gambling disorder.

Abstract

Background: Gambling disorder, the first non-substance-related addictive disorder to be recognized, can have a severe impact on health and psycho-social well-being, but treatment seeking is often low, and the documentation of clinical needs and medical comorbidities is sparser than for substance use disorders. The present study protocol describes a large clinical and register study which aims to describe physical and psychiatric comorbidities in patients seeking treatment at a regional gambling disorder treatment unit within addiction health care, and how comorbidity, routes of referral, and psychiatric medications are associated with problem gambling patterns, self-exclusion from gambling, gambling despite self-exclusion, gender, age, psycho-social living conditions, and over-indebtedness. In addition, the study aims to map out prior contacts of care in treatment-seeking patients, aiming to lay the ground for improved and earlier detection of gambling problems in diverse clinical settings.

Methods: Health care documentation will be studied for all patients seeking treatment for gambling-related problems (estimated N around 1,200) for the entire 10-year period since the opening of a specialized treatment unit in the Skåne region, Sweden, in December, 2015, through November, 2025. In addition to data from health care records, treatment episode data will be run against a regional health care register describing all other primary care and specialized care contacts in the region, including out-patient and in-patient episodes and diagnoses, for both physical and mental health disorders.

Discussion: The present project can describe - over time - the full range of socio-demographic conditions and comorbidities, not only regarding mental health but also physical disorders, in clinical patients with gambling disorder. Results can therefore guide efforts for detection of gambling problems in other types of social service or health care settings. User perspectives are ensured through the collaboration with a patient and peer support organization, and public implementation is ensured through continuous collaboration with political decision makers and coordinating leading stakeholders in social services and health care in the region and elsewhere.

Trial registration: ClinicalTrials.gov, Clinical Trials identifier number NCT07488871, date of registration March 9, 2026.