Gambling disorder and problematic pornography use: Does co-occurrence influence treatment outcome?

Background and aims: Gambling disorder (GD) is a behavioral addiction often co-occurring with various mental health concerns, such as problematic pornography use (PPU). The specific impact of the co-occurrence of GD and PPU on treatment outcome remains underexplored. This study aimed to compare the treatment outcomes of individuals actively receiving treatment for GD (n = 172; 3.49% females), distinguishing between those without PPU (n = 146) and those with co-occurring GD and PPU (n = 26). Methods: Cognitive-behavioral therapy (CBT) was administered in 16 weekly sessions, with assessments of GD severity, impulsivity, emotion regulation, psychopathology, and personality. Dropout, relapses, number of sessions attended, number of relapses, and amount of money spent during relapses were assessed as the main treatment outcomes. Results: Patients with co-occurring GD and PPU showed greater GD severity, psychopathology, impulsivity, and difficulties in emotional regulation compared to those with GD and without PPU. Moreover, the presence of PPU appeared to be mainly associated with higher likelihood of treatment dropout, and, consequently, fewer CBT sessions attended. Discussion and Conclusions: It is important to evaluate GD/PPU co-occurrence and strengthen the CBT approach for GD patients with PPU by using supplementary strategies to improve treatment adherence.