Who Are the Subjects with Gambling-Related Problems Requiring Treatment? A Study in Northern Italy
Abstract
:1. Introduction
2. Methods
Statistical Analysis
3. Results
3.1. Characteristics of PG
3.2. Mental Disorders, Substance Dependence, and Alcohol Dependence before or after PG
3.3. Multivariate Analysis
4. Discussion
5. Conclusions
Author Contributions
Conflicts of Interest
References
- Hodgins, D.C.; Stea, J.N.; Grant, J.E. Gambling disorders. Lancet 2011, 378, 1874–1884. [Google Scholar] [CrossRef]
- Stucki, S.; Rihs-Middel, M. Prevalence of adult problem and pathological gambling between 2000 and 2005: An update. J. Gambl. Stud. 2007, 23, 245–257. [Google Scholar] [CrossRef] [PubMed]
- Griffiths, M.D. Problem gambling in Europe: What do we know? Casino Gaming Int. 2010, 6, 81–84. [Google Scholar]
- Calado, F.; Griffiths, M.D. Problem gambling worldwide: An update and systematic review of empirical research (2000–2015). J. Behav. Addict. 2016, 5, 592–613. [Google Scholar] [CrossRef] [PubMed]
- Calado, F.; Griffiths, M.D. Il gioco problematico in Europa: Una rassegna della letteratura empirica (2000–2016). PRISMA Econ. 2016, 3, 41–81. [Google Scholar] [CrossRef]
- Barbaranelli, C.; Vecchione, M.; Fida, R.; Podio-Guidugli, S. Estimating the prevalence of adult problem gambling in Italy with SOGS and PGSI. J. Gambl. Issues 2013, 28, 1–24. [Google Scholar] [CrossRef]
- Bastiani, L.; Gori, M.; Colasante, E.; Siciliano, V.; Capitanucci, D.; Jarre, P.; Molinaro, S. Complex factors and behaviors in the gambling population of Italy. J. Gambl. Stud. 2013, 29, 1–13. [Google Scholar] [CrossRef] [PubMed]
- Littler, A. The regulation of gambling at European level. The balance to be found. ERA Forum 2007, 8, 357–371. [Google Scholar] [CrossRef]
- Agenzia delle Dogane e dei Monopoli—AAMS. Organizzazione, Attività e Statistica; Agenzia delle Dogane e dei Monopoli: Roma, Italy, 2016. [Google Scholar]
- Ronzitti, S.; Lutri, V.; Smith, N.; Clerici, M.; Bowden-Jones, H. Gender differences in treatment-seeking British pathological gamblers. J. Behav. Addict. 2016, 5, 231–238. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Suurvali, H.; Cordingley, J.; Hodgins, D.C.; Cunningham, J. Barriers to seeking help for gambling problems: A review of the empirical literature. J. Gambl. Stud. 2009, 25, 407–424. [Google Scholar] [CrossRef] [PubMed]
- Slutske, W.S. Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. Am. J. Psychiatry 2006, 163, 297–302. [Google Scholar] [CrossRef] [PubMed]
- Meyer, G.; Hayer, T.; Griffiths, M. Problem Gambling in Europe: Challenges, Prevention, and Interventions; Springer: New York, NY, USA, 2009. [Google Scholar]
- Sassen, M.; Kraus, L.; Bühringer, G.; Pabst, A.; Piontek, D.; Taqi, Z. Gambling among adults in Germany: Prevalence, disorder and risk factors. SUCHT 2011, 57, 249–257. [Google Scholar] [CrossRef]
- Wardle, H.; Moody, A.; Spence, S.; Orford, J.; Volberg, R.; Jotangia, D.; Griffiths, M.; Hussey, D.; Dobbie, F. The British Gambling Prevalence Survey 2010; Gambling Commission: Birmingham, UK, 2011. [Google Scholar]
- Peters, E.N.; Nordeck, C.; Zanetti, G.; O’grady, K.E.; Serpelloni, G.; Rimondo, C.; Blanco, C.; Welsh, C.; Schwartz, R.P. Relationship of gambling with tobacco, alcohol, and illicit drug use among adolescents in the USA: Review of the literature 2000–2014. Am. J. Addict. 2015, 24, 206–216. [Google Scholar] [CrossRef] [PubMed]
- Crockford, D.N.; el-Guebaly, N. Psychiatric comorbidity in pathological gambling: A critical review. Can. J. Psychiatry 1998, 43, 43–50. [Google Scholar] [CrossRef] [PubMed]
- Ibáñez, A.; Blanco, C.; Donahue, E.; Lesieur, H.R.; Pérez de Castro, I.; Fernández-Piqueras, J.; Sáiz-Ruiz, J. Psychiatric comorbidity in pathological gamblers seeking treatment. Am. J. Psychiatry 2001, 158, 1733–1735. [Google Scholar] [CrossRef] [PubMed]
- Black, D.W.; Moyer, T. Clinical features and psychiatric comorbidity of subjects with pathological gambling behavior. Psychiatr. Serv. 1998, 49, 1434–1439. [Google Scholar] [CrossRef] [PubMed]
- Dowling, N.A.; Cowlishaw, S.; Jackson, A.C.; Merkouris, S.S.; Francis, K.L.; Christensen, D.R. Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis. Aust. N. Z. J. Psychiatry 2015, 49, 519–539. [Google Scholar] [CrossRef] [PubMed]
- Barnes, G.M.; Welte, J.W.; Tidwell, M.C.O.; Hoffman, J.H. Gambling and substance use: Co-occurrence among adults in a recent general population study in the United States. Int. Gambl. Stud. 2015, 15, 55–71. [Google Scholar] [CrossRef] [PubMed]
- Grant, J.E.; Chamberlain, S.R. Gambling disorder and its relationship with substance use disorders: Implications for nosological revisions and treatment. Am. J. Addict. 2015, 24, 126–131. [Google Scholar] [CrossRef] [PubMed]
- Petry, N.M.; Stinson, F.S.; Grant, B.F. Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. J. Clin. Psychiatry 2005, 66, 564–574. [Google Scholar] [CrossRef] [PubMed]
- Lorains, F.K.; Cowlishaw, S.; Thomas, S.A. Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction 2011, 106, 490–498. [Google Scholar] [CrossRef] [PubMed]
- Aragay, N.; Roca, A.; Garcia, B.; Marqueta, C.; Guijarro, S.; Delgado, L.; Garolera, M.; Alberni, J.; Vallès, V. Pathological gambling in a psychiatric sample. Compr. Psychiatry 2012, 53, 9–14. [Google Scholar] [CrossRef] [PubMed]
- Haydock, M.; Cowlishaw, S.; Harvey, C.; Castle, D. Prevalence and correlates of problem gambling in people with psychotic disorders. Compr. Psychiatry 2015, 58, 122–129. [Google Scholar] [CrossRef] [PubMed]
- DPA, Dipartimento Nazionale Politiche Antidroga. Relazione Annuale al Parlamento sullo stato delle Dipendenze; DPA: Roma, Italy, 2015. [Google Scholar]
- Istituto Superiore di Sanità (ISS). Indagine sulle Caratteristiche e Sull’operatività dei Servizi e delle Strutture per il Trattamento del Disturbo da Gioco di Azzardo; Istituto Superiore di Sanità: Roma, Italy, 2015. [Google Scholar]
- Clayton, D.; Hills, M. Statistical Models in Epidemiology; Oxford University Press: Oxford, UK, 1993. [Google Scholar]
- Lubman, D.; Manning, V.; Dowling, N.; Rodda, S.; Lee, S.; Garde, E.; Merkouris, S.; Volberg, R. Problem Gambling in People Seeking Treatment for Mental Illness; Victorian Responsible Gambling Foundation: Melbourne, Australia, 2017. [Google Scholar]
- Williams, R.J.; Volberg, R.A.; Stevens, R.M.G. The Population Prevalence of Problem Gambling: Methodological Influences, Standardized Rates, Jurisdictional Differences, and Worldwide Trends: Report Prepared for the Ontario Problem Gambling Research Centre and the Ontario Ministry of Health and Long Term Care; University of Lethbridge: Lethbridge, AB, Canada, 2012. [Google Scholar]
- Westphal, J.R.; Johnson, L.J. Multiple co-occurring behaviours among gamblers in treatment: Implications and assessment. Int. Gambl. Stud. 2007, 7, 73–99. [Google Scholar] [CrossRef]
- Manning, V.; Dowling, N.A.; Lee, S.; Rodda, S.; Garfield, J.B.B.; Volberg, R.; Kulkami, J.; Lubman, D.I. Problem gambling and substance use in patients attending community mental health services. J. Behav. Addict. 2017, 6, 678–688. [Google Scholar] [CrossRef] [PubMed]
Total | % | 2000–2012 | % | 2013–2016 | % | p | |
---|---|---|---|---|---|---|---|
Subjects | 680 | 100.0 | 216 | 31.8 | 464 | 68.2 | - |
CMHC | 77 | 11.3 | 60 | 27.8 | 17 | 3.7 | <0.0001 |
SERD | 579 | 85.2 | 141 | 65.3 | 438 | 94.4 | - |
HOS | 24 | 3.5 | 15 | 6.9 | 9 | 1.9 | - |
Mean age | 47.4 | - | 48.8 | - | 46.7 | 0.068 | |
18–30 years | 72 | 10.6 | 12 | 5.6 | 60 | 12.9 | 0.039 |
31–40 years | 140 | 20.6 | 50 | 23.3 | 90 | 19.4 | - |
41–50 years | 195 | 28.7 | 59 | 27.4 | 136 | 29.3 | - |
51–60 years | 145 | 21.4 | 48 | 22.3 | 97 | 20.9 | - |
>60 years | 127 | 18.7 | 46 | 21.4 | 81 | 17.5 | - |
Female | 135 | 19.9 | 50 | 23.2 | 85 | 18.3 | 0.142 |
Non-natives | 88 | 12.9 | 20 | 9.3 | 68 | 14.7 | 0.053 |
Substance dependence in the entire period | 73 | 10.7 | 22 | 10.2 | 51 | 11.0 | 0.752 |
Cocaine | 27 | 4.0 | 10 | 4.6 | 17 | 3.7 | 0.548 |
Heroin | 17 | 2.5 | 6 | 2.8 | 11 | 2.4 | 0.752 |
Cannabis | 5 | 0.7 | 2 | 0.9 | 3 | 0.7 | 0.691 |
Benzodiazepines | 5 | 0.7 | 2 | 0.9 | 3 | 0.7 | 0.691 |
Alcohol dependence syndrome in the entire period | 60 | 8.8 | 22 | 10.2 | 38 | 8.2 | 0.393 |
Mental disorders in the entire period | 210 | 30.9 | 71 | 32.9 | 139 | 30.0 | 0.444 |
Schizophrenia and other functional psychoses | 30 | 4.4 | 11 | 5.1 | 19 | 4.1 | 0.555 |
Mania and bipolar affective disorders | 28 | 4.1 | 11 | 5.1 | 17 | 3.7 | 0.383 |
Depression | 100 | 14.7 | 34 | 15.7 | 66 | 14.2 | 0.603 |
Neurotic and somatoform syndromes | 72 | 10.6 | 25 | 11.6 | 47 | 10.1 | 0.569 |
Personality and behavioral disorders | 58 | 8.5 | 28 | 13.0 | 30 | 6.5 | 0.005 |
Other psychic disorders | 33 | 4.9 | 11 | 5.1 | 22 | 4.7 | 0.843 |
Subjects (680) | Before/After PG Univariate Analysis | |||||
---|---|---|---|---|---|---|
Before PG | % | After PG | % | OR | 95% CI | |
Substance dependence | 54 | 7.9 | 19 | 2.8 | 2.84 | 1.68–4.79 |
Alcohol dependence syndrome | 50 | 7.4 | 10 | 1.5 | 5.0 | 2.54–9.86 |
Mental disorders | 167 | 24.6 | 43 | 6.3 | 3.88 | 2.78–5.43 |
Schizophrenia and other functional psychoses | 29 | 4.3 | 1 | 0.2 | 29.0 | 3.95–212.89 |
Mania and bipolar affective disorders | 24 | 3.5 | 4 | 0.6 | 6.0 | 2.08–17.29 |
Depression | 83 | 12.2 | 17 | 2.5 | 4.88 | 2.90–8.23 |
Neurotic and somatoform syndromes | 63 | 9.3 | 9 | 1.3 | 7.0 | 3.48–14.07 |
Personality and behavioral disorders | 43 | 6.3 | 15 | 2.2 | 2.87 | 1.59–5.16 |
Other psychic disorders | 29 | 4.3 | 4 | 0.6 | 7.25 | 2.55–20.62 |
Mental Disorders | Drug Dependence | Alcohol Dependence | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | ||
Sex | Male | 1 | Referent | - | 1 | Referent | - | 1 | Referent | - |
Female | 2.08 | 1.32–3.29 | 0.02 | 0.25 | 0.07–0.87 | 0.029 | 0.72 | 0.28–1.87 | 0.503 | |
Age at first admission | 18–30 years | 1 | Referent | - | 1 | Referent | - | 1 | Referent | - |
31–40 years | 2.06 | 0.85–4.99 | 1.07 | 1.37 | 0.35–5.40 | 0.655 | 3.75 | 0.45–30.99 | 0.220 | |
41–50 years | 1.76 | 0.76–4.11 | 1.89 | 2.84 | 0.80–10.03 | 0.105 | 6.62 | 0.86–51.01 | 0.069 | |
51–60 years | 3.10 | 1.33–7.25 | 0.009 | 1.01 | 0.25–4.15 | 0.990 | 5.44 | 0.68–43.72 | 0.111 | |
>60 years | 2.12 | 0.88–5.09 | 0.093 | 0.37 | 0.06–2.38 | 0.297 | 0.56 | 0.03–9.22 | 0.683 | |
Nationality | Natives | 1 | Referent | - | 1 | Referent | - | 1 | Referent | - |
Non-natives | 0.17 | 0.06–0.44 | <0.0001 | 0.97 | 0.65–1.45 | 0.880 | 0.99 | 0.89–1.10 | 0.885 | |
Period of first admission | 2000–2012 | 1 | Referent | 1 | Referent | 1 | Referent | |||
2013–2016 | 1.39 | 0.88–2.18 | 0.154 | 1.20 | 0.56–2.56 | 0.642 | 0.51 | 0.26–1.02 | 0.059 | |
First admission for PG | CMHC | 1 | Referent | - | 1 | Referent | - | 1 | Referent | - |
SERD | 1.00 | 0.51–1.98 | 0.996 | 5.50 | 0.70–43.43 | 0.106 | 3.21 | 0.71–14.61 | 0.131 | |
HOS | 7.64 | 2.55–22.93 | <0.0001 | 2.99 | 0.23–38.13 | 0.400 | 4.14 | 0.59–29.04 | 0.153 | |
Alcohol dependence syndrome before PG | No | 1 | Referent | - | 1 | Referent | - | 1 | Referent | - |
Yes | 1.84 | 0.87–3.87 | 0.110 | 2.78 | 1.15–6.69 | 0.023 | - | - | - | |
Drug dependence before PG | No | 1 | Referent | - | 1 | Referent | - | 1 | Referent | - |
Yes | 3.69 | 1.90–7.18 | <0.0001 | - | - | - | 2.76 | 1.15–6.61 | 0.023 | |
Mental disorders before PG | No | 1 | Referent | - | 1 | Referent | - | 1 | Referent | - |
Yes | - | - | - | 3.96 | 2.04–7.68 | <0.0001 | 3.96 | 2.04–7.68 | <0.0001 |
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Pavarin, R.M.; Fioritti, A.; Marani, S.; Gambini, D.; Turino, E.; Piazza, A. Who Are the Subjects with Gambling-Related Problems Requiring Treatment? A Study in Northern Italy. J. Clin. Med. 2018, 7, 80. https://doi.org/10.3390/jcm7040080
Pavarin RM, Fioritti A, Marani S, Gambini D, Turino E, Piazza A. Who Are the Subjects with Gambling-Related Problems Requiring Treatment? A Study in Northern Italy. Journal of Clinical Medicine. 2018; 7(4):80. https://doi.org/10.3390/jcm7040080
Chicago/Turabian StylePavarin, Raimondo Maria, Angelo Fioritti, Silvia Marani, Daniele Gambini, Elsa Turino, and Antonella Piazza. 2018. "Who Are the Subjects with Gambling-Related Problems Requiring Treatment? A Study in Northern Italy" Journal of Clinical Medicine 7, no. 4: 80. https://doi.org/10.3390/jcm7040080