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Repetitive Transcranial Magnetic Stimulation (rTMS) in The Treatment of Gambling Disorder in Indonesia

Not Applicable
Recruiting
Conditions
Gambling Disorder
Interventions
Device: Repetitive Transcranial Magnetic Stimulation (rTMS)
Registration Number
NCT06182137
Lead Sponsor
Indonesia University
Brief Summary

Research has shown that cognitive-behavioral therapy (CBT) is an effective treatment for gambling disorder. Several studies had also been done to evaluate the effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) in addiction management, particularly in alleviating craving. A randomised controlled trial (RCT) of 60 subjects would be conducted to evaluate the effectiveness of transmodalistic therapy with a combination of rTMS and CBT for online gambling disorder.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Subjects with pathological gambling (SOGS score ≥ 5)
  • Subjects aged 18-70 years old
  • Subjects who understand Bahasa Indonesia
  • Subjects who agree to participate and receive treatment
Exclusion Criteria
  • Subjects with history of psychotic disorder, personality disorder, or sleep disorder according to ICD-11
  • Subjects with history of neurostimulation
  • Subjects with history of medical implant
  • Subjects with history of severe neurological disorder, which causes seizure or loss of consciousness
  • Subjects with intellectual disability
  • Subjects with endocrinological disorders
  • Subjects with contraindication during prior MR or other related procedures
  • Subjects who are currently or expecting pregnancy
  • Subjects with history of substance use in the last 6 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
rTMS and CBTRepetitive Transcranial Magnetic Stimulation (rTMS)During 5 weeks of therapy, the subjects will undergo 12 CBT sessions combined with 15 rTMS procedures lasting about 30-60 minutes.
Sham and CBTRepetitive Transcranial Magnetic Stimulation (rTMS)During 5 weeks of therapy, the subjects will undergo 12 CBT sessions combined with 15 rTMS procedures (coil replaced with sham) lasting about 30-60 minutes.
Primary Outcome Measures
NameTimeMethod
Improvement in pathological gambling scoreBaseline (week 0), interim assessment (week 3), post-intervention (week 6), follow up at 3 months and 6 months after intervention

South Oaks Gambling Screen (SOGS), Indonesian version, with minimum score of 0 and maximum score of 20. A score of 0-2 indicates no pathological gambling; a score of 3-4 indicates problems with gambling, and a score of 5 or more indicates that the subject is a probable pathological gambler. Lower score indicates a better outcome.

Improvement in gambling symptoms severityBaseline (week 0), interim assessment (week 3), post-intervention (week 6), follow up at 3 months and 6 months after intervention

Gambling Symptoms Assessment Scale (G-SAS), Indonesian version, with minimum score of 0 and maximum score of 48. Interpretations: Mild (8-20), Moderate (21-30), Severe (31-40), and Extreme (41-48). Lower score indicates a better outcome.

Improvement in gambling urgeBaseline (week 0), interim assessment (week 3), post-intervention (week 6), follow up at 3 months and 6 months after intervention

Gambling Urge Scale (GUS), Indonesian version, with minimum score of 0 and maximum score of 42. Lower score indicates a better outcome.

Improvement in gambling related cognitive distortionsBaseline (week 0), interim assessment (week 3), post-intervention (week 6), follow up at 3 months and 6 months after intervention

Gambling Related Cognitions Scale (GRCS), Indonesian version, with 5 cognitive distortion domains. Lower score indicates a better outcome.

Secondary Outcome Measures
NameTimeMethod
Improvement in gambling-related cognitive functionsBaseline (week 0), interim assessment (week 3), post-intervention (week 6), follow up at 3 months and 6 months after intervention

Creyos (formerly Cambridge Brain Sciences, CBS), measures 12 domains of cognitive function with the subject results compared with their respective average age results in percentile. A higher percentile is a better outcome.

Improvement in depression symptomsBaseline (week 0), post-intervention (week 6), follow up at 3 months and 6 months after intervention

Beck Depression Inventory-II (BDI II), measures severity of depression symptoms, with minimum score of 0 and maximum score of 63. Interpretation: (1) minimal (0-13), (2) mild (14-19), (3) moderate (20-28), and (4) severe (29-63). Lower score indicates a better outcome.

Improvement in self-reported psychological distressBaseline (week 0), post-intervention (week 6), follow up at 3 months and 6 months after intervention

20-item Self-Reporting Questionnaire (SRQ-20), Indonesian version, measures non-specific psychological distress. Score range 0-20, with scores \>10 classified as mental distress. Lower score indicates a better outcome.

Improvement of overall severity of illnessBaseline (week 0), interim assessment (week 3), post-intervention (week 6), follow up at 3 months and 6 months after intervention

Clinical Global Impression (CGI), measure overall severity of illness and improvement observed by the clinician. Lower score indicates a better outcome.

Trial Locations

Locations (1)

Universitas Indonesia

🇮🇩

Jakarta Pusat, Jakarta, Indonesia

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