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Gambling addiction

Gambling in primary care patients: why should we care and what can we do about it?

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Gambling addiction dental group

Postby Tojam В» 30.06.2019

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Disordered gambling has been associated with a host of serious health and social consequences. A limited body of research suggested that problem and pathologic gamblers experience higher rates of several types of physical symptoms, including fatigue, insomnia, minor respiratory ailments, intestinal distress, migraine headaches, high blood pressure and cardiovascular disease [ 1 — 3 ]. The social costs of problem and pathologic gambling include work and educational disruptions, criminal arrests, severe financial difficulties and familial problems including domestic violence and child maltreatment [ 4 — 6 ].

Problematic gambling is also associated with higher rates of comorbid psychiatric conditions, including concomitant substance use, eating disorders, depression and anxiety disorders [ 4 , 7 — 9 ]. Individuals with problematic gambling also have higher rates of attempted and completed suicides as compared with the general population [ 10 , 11 ].

In contrast to the harm associated with problem and pathologic gambling, recreational gambling has been argued to have significant societal benefits, including the creation of jobs and generation of revenues for state and local governments that are used for public benefit [ 12 ].

Some research has also suggested that nonpathologic recreational gambling may be related to improvements in social and health functioning, at least for a subset of the population [ 13 ]. The study by Morasco, vom Eigen and Petry featured in this issue pages 94— provides further evidence that problem and pathologic gambling can have a significant negative impact on both the physical and mental domains of functioning and calls into question prior research suggesting that recreational gambling may confer health benefits.

Morasco et al. First, the study uses a well-established measure of gambling pathology, the South Oaks Gambling Screen SOGS , to evaluate rates of problem and pathologic gambling in a general adult primary care setting [ 14 ].

The SOGS is the most widely used measure of adult gambling behavior, rendering results easily comparable with prevalence rates in the general population outside primary care. In addition, Morasco et al. This is a significant improvement over prior research and allows Morasco et al. Finally, Morasco et al. Rates were highest among males, ethnic minority patients and individuals receiving disability payments.

Contrary to a previous finding of beneficial health effects for recreational gambling, Morasco et al. Recreational gamblers did not fare better than non-gamblers on any dimension of functioning.

Although the study results are an important addition to the literature, there are limitations that must be considered and questions remaining. First, the contrasting findings between the work of Morasco et al.

Further research is needed to evaluate the extent to which demography moderates the relationship between level of gambling involvement and negative or positive health and mental health outcomes. A second limitation of Morasco et al. In future research, we might be better served by examining different types of gambling behavior in relation to health and mental health outcomes rather than assuming a one-size-fits-all relationship. The potential for sampling bias is another possible limitation of Morasco et al.

To the extent that sampling bias exists, prevalence rates of problem and pathologic gambling reported in this sample could be an overestimate or underestimate of the actual rates, although the relation between gambling and health outcomes would not be expected to be markedly affected by any such bias. Finally, questions remain regarding why and how gambling is related to poorer health and mental health functioning.

It is possible that decreased health functioning may not be related to gambling per se but rather to the environment in which gambling occurs—for example, smoking, free or reduced-price alcohol and all-you-can-eat buffets at many casinos may contribute to negative health outcomes.

Further research is needed to begin to answer these questions. Despite limitations, the research reported by Morasco et al. First, although evidence suggests that problem and pathologic gambling are associated with negative psychological and physical health consequences, the magnitude of the problem in terms of health care use and associated costs has yet to be determined.

Documentation of greater use and higher costs of health care among problem and pathologic gamblers would provide additional and stronger justification for aggressively pursuing treatment among these patients as part of regular primary care visits. In addition, although screening for other behavioral disorders, including substance use disorders, is becoming more common in primary care, screening for problem and pathologic gambling is considerably less common.

The addition of a short screening instrument such as the two-item Lie—Bet Questionnaire on existing intake assessments seems feasible and could identify a relatively large number of patients at risk for a disorder that might not otherwise be uncovered [ 19 ]. Of course, assuming we can do a better job of identifying problem and pathologic gamblers begs the question of what we do with them once identified.

More research is needed to determine whether and what kinds of services these patients might be willing to pursue in addressing their gambling problems. At the very least, these patients might be offered referral information from their primary care provider. Unfortunately, at present, few referral options are available for problem and pathologic gambling. Gamblers Anonymous GA meetings are available in many areas, but typically only at a fraction of the frequency of other step groups such as Alcoholics Anonymous i.

Although the success rates of GA have not been well documented, the availability of GA, free services and lack of available alternatives may make GA a good referral in many locations. The development and evaluation of brief advice interventions, similar to those available for smoking and substance use disorders e.

Longer, but still brief e. Finally, some evidence suggests that traditional cognitive—behavioral therapy for treating problem and pathologic gambling is also effective [ 22 ]. Nonetheless, further evaluation of gambling treatments is sorely needed, as is additional training in interventions for gambling disorders among medical and mental health practitioners.

The findings reported by Morasco et al. Mary E. National Center for Biotechnology Information , U. Gen Hosp Psychiatry.

Author manuscript; available in PMC Feb Larimer , Ph. Lostutter , B. Author information Copyright and License information Disclaimer. E-mail address: ude. Copyright notice. The publisher's final edited version of this article is available at Gen Hosp Psychiatry. See other articles in PMC that cite the published article. Contributor Information Mary E. References 1. Pathological gambling: psychosomatic, emotional, and marital difficulties as reported by the gambler.

J Gambl Behav. Bergh C, Kuhlhorm E. Social, psychological, and physical consequences of pathological gambling in Sweden. J Gambl Stud. Leisure HR. Cost and treatment of pathological gambling. Epidemiological study of pathological gambling in Edmonton.

Can J Psychiatry. Criminal offenses in Gamblers Anonymous and hospital treated pathological gamblers. Social costs of pathological gambling. Gupta R, Derevensky JL.

Adolescents with gambling problems: from research to treatment. Suicide behavior among members of Gamblers Anonymous. Lester D. Legal gambling and crime. Psychol Rep. Taking chances: problem gambles and mental health disorders: results from the St. Louis Epidemiological Catchment Area Study. Am J Public Health. Elevated suicide levels associated with legalized gambling. Suicide Life Threat Behav. Gambling and the health of the public: adopting a public health perspective.

Health correlates of recreational gambling in older adults. Am J Psychiatry. Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis. A item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. Prevalence of gambling disorders in a primary care setting. Arch Fam Med. Disordered gambling among university-based medical and dental patients: a focus on internet gambling.

Psychol Addict Behav. Indicated prevention of problem gambling among college students. Motivational enhancement and self-help treatments for problem gambling. J Consult Clin Psychol. Petry NM. Pathological gambling: etiology, comorbidity, and treatment. Support Center Support Center. External link. Please review our privacy policy.

Gambling on Addiction : How Governments Rely on Problem Gamblers - The Fifth Estate, time: 24:18
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Re: gambling addiction dental group

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Postby Niktilar В» 30.06.2019

Support Center Support Center. Longer, but still brief e. The addition of a short screening instrument such as the two-item Lie—Bet Questionnaire on existing intake assessments seems feasible and could identify a relatively large number of patients at risk for a disorder that might not gamblinb be uncovered [ 19 ].

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Postby Taular В» 30.06.2019

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Postby Golticage В» 30.06.2019

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Postby Taulmaran В» 30.06.2019

External link. Ears Hearing aids 5 ways to prevent hearing loss. The SOGS is the most widely used measure of adult gambling behavior, rendering results easily comparable with prevalence rates in the general population outside primary care.

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Postby Zurn В» 30.06.2019

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Postby Grojar В» 30.06.2019

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