Text Size
Decrease TextReset TextIncrease Text
Print
 

Addiction Medicine Research

Predictors of treatment outcome for pathological gamblers

Gambling is an exceptionally popular pastime in Singapore. However, for around 3% of the population, it can become problematic, or can lead to a pathological gambling disorder. To enhance treatment outcomes, we need to understand who is likely to respond to treatment. This study examines whether the baseline demographic and clinical characteristics of new pathological gambling cases can predict treatment outcomes over the course of one-year.

Gambling

The specific objectives of this study are:

  • To evaluate abstinence rates, symptom severity and quality of life at 3, 6 and twelve months after starting treatment.
  • To determine whether demographic characteristics, gambling behaviour, psychological functioning or motivation to change determines treatment outcome.
  • To examine whether treatment of the pathological gambler leads to improved relationships with other family members.

This study is funded by the local National Healthcare Group / Institutional-Block Grant / Woodbridge Hospital Endowment Fund (NHG/IBG /WHEF).

Principal Investigator:

  • Dr Guo Song, National Addictions Management Service

Study Team Members:

  • A/Prof Wong Kin Eng, National Addictions Management Service
  • Dr Victoria Manning, National Addictions Management Service

Neuropsychological functioning among Addiction Patients

It is well-established in Western addiction literature that misusers of drugs and alcohol frequently encounter impaired cognitive functioning. These impairments are associated with poor treatment outcomes, i.e. higher residential programme dropout rates, faster and higher relapse rates, and poorer long-term outcomes. The limited neuropsychological research on pathological gamblers to date also indicates the presence of some executive functioning deficits in this group.

Researchers from IMH’s National Addictions Management Service (NAMS) aim to examine the cognitive profile of Singaporean addiction patients, specifically in the areas of non-verbal learning and memory, planning and organisation ability, impulsivity and decision-making and mental flexibility. By extending the research to pathological gamblers, this team also hopes to examine potential vulnerability mechanisms of addiction in an addicted population that have not been exposed to misuse of neurotoxic substances. The team plans to validate a screening measure to detect mild cognitive impairment, so that patients can be appropriately assessed and managed to enhance treatment outcomes.

Ongoing and upcoming projects:

  1. Cognitive functioning during treatment of alcohol dependence: a predictor of outcome? (CogAlc)
  2. Cognitive functioning in patients with gambling disorder. (CogGam)
  3. Evaluating the MoCA as a screening tool to detect cognitive impairments in substance misusers.

Projects 1 and 2 are pilot projects, exploratory in nature and funded by the local National Healthcare Group Inter-block Grant (NHG IBG /WHEF). Project 3 is funded by the Lee Foundation. The research team is led by Dr Victoria Manning, who has previously undertaken research on neuropsychological functioning in addicted populations in the United Kingdom.

For a list of NAMS Research team members, please refer to this link.

Principal Investigator:

  • Dr Victoria Manning, National Addictions Management Service

Study Team Members:

  • A/Prof Wong Kim Eng, National Addictions Management Service
  • Dr Guo Song, National Addictions Management Service
  • Ms Teoh Hui Chin, National Addictions Management Service
  • Ms Brenda Gomez, National Addictions Management Service

Lofexdine Study: A double-blind randomised controlled clinical trial of Lofexidine versus Diazepam in the management of the opioid withdrawal syndrome during inpatient detoxification in Singapore

At NAMS IMH, many opiate patients undergoing inpatient detoxification leave prematurely because of the severity of unpleasant their withdrawal symptoms. Consequently, relapse rates are extremely high. The international evidence base indicates that better management of the withdrawal syndrome leads to improved treatment retention and completion rates, which are associated with better outcomes. In Singapore, the standard pharmacological treatment for opiate detoxification is diazepam, followed by a week of rehabilitation. Diazepam is highly addictive, widely abused among heroin users, and, pharmacologically, it does not reduce physical and psychological cravings that trigger relapse. The study’s objective is to establish whether an alternative medication is effective in the management of opioid withdrawal amongst opiate users in Singapore.

The research objectives are to:

  • To evaluate the clinical efficacy of Lofexidine versus Diazepam, by comparing Objective and Subjective Opiate Withdrawal Scale ratings on Days 3 and 4 of detoxification. 
  • To evaluate differences in time taken to drop-out (length of stay on the ward).
  • To evaluate the safety of Lofexidine with opiate-dependent patients undergoing inpatient detoxification in Singapore.

The Investigator Initiated Clinical Trial was granted by Woodbridge Hospital Endowment Fund (WHEF). 

Principal Investigator:

  • Dr Guo Song, National Addictions Management Service

Study Team Members:

  • A/Prof Wong Kim Eng, National Addictions Management Service
  • Dr Victoria Manning, National Addictions Management Service
  • Ms Yang Yi, National Addictions Management Service
  • Dr Kandasami Gomathinayagam, National Addictions Management Service
  • Dr G. Sathyadevan., National Addictions Management Service
  • Dr Melvin Wu, National Addictions Management Service

 

A member of National Healthcare GroupWork Life Activeness AwardTUVTUVTUVGold   Comm Chest Award 2012