Search Results (36)

Background: In psychiatry, gambling is classified as an addiction-related disorder and is characterized by a persistent, problematic pattern of behaviour that leads to significant distress and functional impairment. This study aims to explore the prevalence, underlying motivations, and potential academic impact of gambling behaviours among medical students in Poland. Methods: An anonymous online survey was conducted among students from multiple medical universities across Poland. Participants completed a sociodemographic questionnaire and the South Oaks Gambling Screen (SOGS). Respondents who reported any past or current gambling activity were additionally asked about their motivations and potential academic consequences. Results: The study included 281 participants. Active or past gambling was reported by 55% of respondents, with men significantly more likely to gamble currently. Women were predominantly non-problem gamblers, whereas men more often scored within the “some problems” range on the SOGS. Motivations also differed: women emphasised financial gain, while men cited fun, socializing, and competition. Lottery and scratch cards were most popular overall, though men preferred skill-based and casino activities. Conclusions: Although participants showed relatively low levels of gambling involvement, their risk of developing pathological gambling was comparable to that of the general population. Gender influenced involvement in different gambling patterns. Full article

Background and Objectives: Impulse control disorders (ICDs) are frequent non-motor complications of Parkinson’s disease (PD), usually related to dopaminergic therapy. Uric acid (UA) has been studied as a biomarker of PD severity and has been linked to impulsivity in non-PD populations. However, its association with ICDs in patients with PD (PwPs) has not been investigated. This study aimed to assess the relationship between serum UA levels, the uric acid to creatinine ratio (UA/Cr), and ICD prevalence in PwPs. Materials and Methods: We enrolled 172 PwPs hospitalized for follow-up or treatment modification. ICDs were screened with the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP). Clinical data included demographics, disease severity, motor and non-motor symptoms, and dopaminergic treatment. Fasting serum UA and UA/Cr were determined. Results: ICDs were present in 24.42% of patients, most commonly binge eating and compulsive buying. PwPs with ICDs had longer disease duration, more motor complications, higher dopaminergic doses, and more frequent dopamine agonist use. No relationship was found between absolute UA and overall ICD occurrence. However, lower UA/Cr was observed in patients with hypersexuality and pathological gambling, as well as in those with multiple ICD subtypes. Logistic regression confirmed that higher UA/Cr reduced the odds of hypersexuality (OR = 0.55; 95% CI 0.31–0.98) and multiple ICDs (OR = 0.33; 95% CI 0.13–0.84). As a secondary finding, lower absolute UA was observed in PwPs with more advanced motor symptoms, motor complications, depressive symptoms, and cognitive impairment. Conclusions: Lower UA/Cr was selectively associated with specific ICD subtypes and with the coexistence of multiple ICDs in patients with PD. UA/Cr may serve as a marker of ICD heterogeneity. Confirmation in larger, prospective cohorts is needed to establish clinical relevance. Full article

(1) Background: Elite sport can increase vulnerability to developing mental health pathologies. The purpose of the study is to determine the frequency at which these behavioural disorders appear in elite footballers and evaluate their relationship with other addictions. (2) Methods: A cross-sectional study was conducted between November 2020 and January 2022 on 306 participants. The variables of gambling and gaming were studied. The different groups were compared using Chi-squared tests. Probabilities exceeding 95% (p-values < 0.05) and residuals results greater than 2 or less than −2 were considered significant. (3) Results: There were significant differences between the two groups in terms of alcohol (p < 0.001), tobacco (p < 0.001), and cannabis (p = 0.016) consumption. We also found differences between those who had a history of a nervous disease (p = 0.015). 6.6% of the of football players had a probable diagnosis of a gambling disorder compared to 1% in the general population (p = 0.011). Among the pathological and non-pathological cases of gambling in the football population, significant differences were found between those with a salary of EUR 900–1500/month (p = 0.027) or a history of a nervous pathology (p = 0.021). (4) Conclusions: This study showed that professional football players were vulnerable to mental health pathologies related to gambling. Full article

Background: Pathological gambling (PG) is a significant non-motor complication in Parkinson’s disease (PD), often linked to dopaminergic therapies. PG impacts the quality of life of patients and their families, presenting unique challenges due to its interplay with motor symptoms and cognitive impairments in PD. This scoping review synthesized current evidence on rehabilitation strategies for PG in PD. Methods: A systematic review was conducted across the PubMed, Web of Science, Embase, and Scopus databases to identify studies addressing pharmacological, psychological, and neuromodulatory approaches. The scoping objective was to map the available evidence on treatment strategies and identify research gaps. Results: Of 537 studies, 5 met the inclusion criteria. Pharmacological strategies included dopamine agonist adjustments, naltrexone, and amantadine, which showed partial efficacy but were often limited by significant side effects. Neuromodulation via deep brain stimulation (DBS) demonstrated potential by modulating limbic circuits, though risks like apathy and transient symptom exacerbation were noted. Psychological interventions, particularly cognitive-behavioral therapy (CBT), were the most effective in modifying gambling behaviors, though adaptations are needed for PD-specific cognitive and psychiatric challenges. Conclusions: Effective rehabilitation for PG in PD requires a multidisciplinary approach to balance motor symptom management with impulse control disorders. While pharmacological, psychological, and neuromodulatory interventions show promise, gaps remain regarding their long-term efficacy, combined use, and tailoring to PD-specific needs. The lack of large-scale, comparative studies and limited exploration of novel therapeutic combinations underscore the need for further research to optimize patient outcomes and develop comprehensive treatment frameworks. Full article

Parkinson’s disease is neurodegenerative, and additionally, a percentage higher than 60% is represented by the patients with associated psychiatric symptoms, such as anxiety disorders and depression. Due to illness itself and to therapy secondary effects, there is a high risk for these patients to develop impulse control disorders like ICDs: compulsive shopping, pathological gambling binge eating disorder, and hypersexuality. There is high interest in therapy so as to diminish, as much as possible, the associated ICD symptoms. This article presents a study on pharmacological treatment of impulse control disorders in Parkinson disease carried on a sample of patients in hospitals where the authors have their clinical work. This study was carried on for a period of 6 years and is focused on research of different treatment plans. The patients were evaluated by the Hamilton Rating Scale. Statistical analysis of the obtained data (given by the HAM-A scores) is used for data processing. All patients showed a reduction in their impulse behavior. The directions of further research development are mentioned. Full article

In patients with Parkinson’s disease (PD), dopamine replacement therapy with dopamine D2/D3 receptor agonists induces impairments in decision-making, including pathological gambling. The neurobiological mechanisms underlying these adverse effects remain elusive. Here, in a mouse model of PD, we investigated the effects of the dopamine D3 receptor (D3R)-preferring agonist pramipexole (PPX) on decision-making. PD model mice were generated using a bilateral injection of the toxin 6-hydroxydopamine into the dorsolateral striatum. Subsequent treatment with PPX increased disadvantageous choices characterized by a high-risk/high-reward in the touchscreen-based Iowa Gambling Task. This effect was blocked by treatment with the selective D3R antagonist PG-01037. In model mice treated with PPX, the number of c-Fos-positive cells was increased in the external globus pallidus (GPe), indicating dysregulation of the indirect pathway in the corticothalamic-basal ganglia circuitry. In accordance, chemogenetic inhibition of the GPe restored normal c-Fos activation and rescued PPX-induced disadvantageous choices. These findings demonstrate that the hyperactivation of GPe neurons in the indirect pathway impairs decision-making in PD model mice. The results provide a candidate mechanism and therapeutic target for pathological gambling observed during D2/D3 receptor pharmacotherapy in PD patients. Full article

Online games have experienced significant growth in recent years, with gaming becoming a popular form of entertainment for people of all ages. However, their impact on cognition, especially among vulnerable groups such as students with disabilities, is a topic that requires deeper exploration. The objectives of this study are twofold: firstly, to understand the typology of risk players (non-risk players, players with problems, and pathological players); and secondly, to compare cognitive distortions among students with problematic profiles. Both objectives will be analyzed based on the presence or absence of disability. A total of 704 students from various Spanish universities (135 with disabilities and 569 without disabilities), aged between 18 and 38, participated in the study by completing the Gamblers Belief Questionnaire (GBQ), aimed at measuring cognitive distortions related to gambling problems, as well as the Massachusetts Gambling Screen questionnaire, aimed at measuring gambling addiction. The results indicate a higher percentage of students with disabilities showing a greater risk profile for addiction. Additionally, this group of students exhibits more cognitive distortions. These findings underscore the need for a comprehensive approach to addressing online gaming addiction and cognitive distortions among university students, with and without disabilities. Preventive measures are necessary, such as education on responsible technology use and the promotion of alternative activities. Moreover, specific intervention strategies need to be developed, including access to psychological health services for this student population. Full article

Over the last century, there has been a growing interest in researching pathological gambling, particularly in industrialized nations. Historically, gambling was widely perceived as morally questionable, condemned by religious groups. However, contemporary concerns have shifted towards the health repercussions of gambling disorders and broader societal impacts like increased crime and money laundering. Governments, aiming to mitigate social harm, often regulate or directly oversee gambling activities. The global surge in legal gambling has resulted in a substantial rise in its prevalence, popularity, and accessibility in the last two decades. This paper provides a comprehensive overview of global research on interventions for pathological gambling. Through a systematic search on platforms such as EBSCO, PubMed, and Web of Science, 13 relevant records were identified. The revised findings indicate a heightened occurrence of behavioral addictions, linking them to the early onset of gambling issues and their severe consequences. The research emphasizes the active role that clients play in the process of self-directed change and therapy. Therapists recognizing clients as both catalysts for change and potential obstacles can enhance their effectiveness. A common source of resistance arises when clients and therapists are in different stages of the change process, underlining the importance of therapists aligning with clients’ readiness for change. Recognizing the urgent need for a better understanding of this problem in adolescents, this study emphasizes the necessity to tailor prevention and treatment plans based on gender and age-specific requirements. Full article

Background and Objectives: Impulse control disorders (ICDs) are characterized by potentially harmful actions resulting from disturbances in the self-control of emotions and behavior. ICDs include disorders such as gambling, hypersexuality, binge eating, and compulsive buying. ICDs are known non-motor symptoms in Parkinson’s disease (PD) and are associated primarily with the use of dopaminergic treatment (DRT) and especially dopamine agonists (DA). However, in atypical parkinsonism (APS), such as progressive supranuclear palsy (PSP) or multiple system atrophy (MSA), there are only single case reports of ICDs without attempts to determine the risk factors for their occurrence. Moreover, numerous reports in the literature indicate increased impulsivity in PSP. Our study aimed to determine the frequency of individual ICDs in APS compared to PD and identify potential factors for developing ICDs in APS. Materials and Methods: Our prospective study included 185 patients with PD and 35 with APS (27 patients with PSP and 9 with MSA) hospitalized between 2020 and 2023 at the Neurological Department of University Central Hospital in Katowice. Each patient was examined using the Questionnaire for Impulsive–Compulsive Disorders in Parkinson’s Disease (QUIP) to assess ICDs. Additionally, other scales were used to assess the advancement of the disease, the severity of depression, and cognitive impairment. Information on age, gender, age of onset, disease duration, and treatment used were collected from medical records and patient interviews. Results: ICDs were detected in 23.39% of patients with PD (including binge eating in 11.54%, compulsive buying in 10.44%, hypersexuality in 8.79%, and pathological gambling in 4.40%), in one patient with MSA (hypersexuality and pathological gambling), and in 18.52% of patients with PSP (binge eating in 3.70%, compulsive buying in 7.41%, and hypersexuality in 11.11%). We found no differences in the frequency of ICDs between individual diseases (p = 0.4696). We confirmed that the use of higher doses of DA and L-dopa in patients with PD, as well as a longer disease duration and the presence of motor complications, were associated with a higher incidence of ICDs. However, we did not find any treatment effect on the incidence of ICDs in APS. Conclusions: ICDs are common and occur with a similar frequency in PD and APS. Well-described risk factors for ICDs in PD, such as the use of DRT or longer disease duration, are not fully reflected in the risk factors for ICDs in APS. This applies especially to PSP, which, unlike PD and MSA, is a tauopathy in which, in addition to the use of DRT, other mechanisms related to the disease, such as disorders in neuronal loops and neurotransmitter deficits, may influence the development of ICDs. Further prospective multicenter studies recruiting larger groups of patients are needed to fully determine the risk factors and mechanisms of ICD development in APS. Full article

Background and Objectives: Impulse Control Disorders (ICDs) including pathological gambling, hypersexuality, compulsive eating, compulsive buying, and other related behaviors are well-known distinct non-motor symptoms in Parkinson’s Disease (PD). Some large-scale studies present a prevalence of at least 10%, however, there are other reports providing much higher rates. The majority of the conducted studies investigating ICDs focus mainly on pharmacological factors, however, from a psychological perspective, there is yet enough room for investigation. In order to address the above issues, we designed a two-part study. Materials and Methods: First, we aimed to identify the incidence of ICD and related behaviors in a cohort of 892 Greek PD patients. Second, we administered a comprehensive battery of psychometric tools to assess psychological factors such as personality dimensions, quality of life, defenses, coherence, and resilience as well as to screen general cognitive capacity in PD patients with ICD manifestations. Results: With regard to the first part, we identified ICD manifestations in 12.4% of the patients. Preliminary findings from the second part indicate elevated activity, rather than impulsivity, as well as interrelations between several variables, including measures of activity, coping mechanisms, and quality of life. Conclusions: We present a working hypothesis for the contribution of high activity channeled to specific behavioral patterns through specific coping mechanisms, concerning the emergence of ICDs and related behaviors in PD, and further stress the importance of compulsivity rather than impulsivity in this process. Full article

Gaming Disorder (GD) is one of the latest additions in the psychiatric taxonomy, following its official inclusion in the latest revision of the International Classification of Diseases (ICD-11). This narrative review examines the rationale of an exclusion criterion for the diagnosis of GD, that of disordered gaming being limited exclusively during an episode of elevated mood in bipolar disorder. The history of the formulation of diagnostic criteria for the disorder and all relevant published studies are examined critically, and conclusions are drawn as to the potential validity and usability of the exclusion criterion. Suggestions are offered for future research to elucidate not only the relevance of the exclusion criterion but also the differential diagnosis of GD with pathological gambling (PG). Full article

Background: Gambling disorder is an emerging problem among young adults and must be researched to provide the necessary support. This study aims to characterise gambling disorders in Porto’s university students. Methods: A cross-sectional study distributed an online questionnaire to Porto’s university students. The authors developed a self-administered questionnaire that included the South Oaks Gambling Screen questionnaire—Portuguese Version (SOGS-PV). Results: A total of 1123 responses were included. The participants’ average age was 22.4 years (SD = 6.2), and 60.9% were women. Gambling activities were performed by 66.4% of the students, most commonly online or video games, “scratch card” games, skill games, lotteries, and sports bets. The final scores of the SOGS-PV suggested 19.7% (95% CI: 17.4–22.0) of students may have a gambling disorder, with 16.6% (95% CI: 14.4–18.8) being “probable pathological gamblers” and 3.1% (95% CI: 2.1–4.1) being “problem gamblers”. Gambling in the stocks/commodities market/virtual coins, sports bets, playing cards for money, and the numbers or betting on lotteries presents a higher risk of gambling disorder. The age (OR: 0.953; 95% CI: 0.922–0.986), being male (OR: 2.756; 95% CI: 1.899–4.000), the highest daily gambling amount (OR: 3.938; 95% CI: 2.580–6.012), the effects of the COVID-19 pandemic (OR: 0.129; 95% CI: 0.087–0.191), a mother with gambling disorder (OR: 5.284; 95% CI: 1.038–26.902), the personal services education area (OR: 2.858; 95% CI: 1.179–6.929), and the linguistics education area (OR: 2.984; 95% CI: 1.538–5.788) stand out as contributing factors to the development of this disorder. Conclusions: This study reveals a high level of possible gambling disorder among university students and emphasises the importance of this problem in the academic community. Physician awareness and prevention programmes are needed in this population. Full article

Background and Objectives: Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the world. It is characterized by the presence of not only typical motor symptoms but also several less known and aware non-motor symptoms (NMS). The group of disorders included in the NMS is Impulse Control Disorders (ICDs). ICDs are a group of disorders in which patients are unable to resist temptations and feel a strong, pressing desire for specific activities such as gambling, hypersexuality, binge eating, and compulsive buying. The occurrence of ICDs is believed to be associated primarily with dopaminergic treatment, with the use of dopamine agonists (DA), and to a lesser extent with high doses of L-dopa. The aim of our study was to develop a profile of Polish ICDs patients and assess the frequency of occurrence of ICDs, as well as determine the risk factors associated with these disorders against the background of the PD population from other countries. Materials and Methods: Our prospective study included 135 patients with idiopathic PD who were hospitalized between 2020 and 2022 at the Neurological Department of University Central Hospital in Katowice. In the assessment of ICDs, we used the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP). Other scales with which we assessed patients with PD were as follows: MDS-UPDRS part III and modified Hoehn–Yahr staging. Clinical data on age, gender, disease duration and onset, motor complications, and medications were collected from electronic records. Results: ICDs were detected in 27.41% of PD patients (binge eating in 12.59%, hypersexuality in 11.11%, compulsive buying in 10.37%, and pathological gambling occurred in only 5.19% of patients. In total, 8.89% had two or more ICDs). The major finding was that ICDs were more common in patients taking DA than in those who did not use medication from this group (83.78% vs. 54.07%, respectively; p = 0.0015). Patients with ICDs had longer disease duration, the presence of motor complications, and sleep disorders. An important finding was also a very low detection of ICDs in a routine medical examination; only 13.51% of all patients with ICDs had a positive medical history of this disorder. Conclusions: ICDs are relatively common in the population of Polish PD patients. The risk factors for developing ICDs include longer duration of the disease, presence of motor complications, sleep disorders, and use of DA and L-dopa. Due to the low detectability of ICDs in routine medical history, it is essential for physicians to pay more attention to the possibility of the occurrence of these symptoms, especially in patients with several risk factors. Further prospective studies on a larger group of PD patients are needed to establish a full profile of Polish PD patients with ICDs. Full article

Gambling among college students can start as a pastime activity. However, this pastime can lead to problem gambling and pathological gambling. This cross-sectional study aimed to identify and explain the initiation and sustenance of quitting gambling among university students who had participated in gambling during the past month and those who had not using a novel fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from a sample of 1474 university students at a large southwestern university in the U.S. between January 2023 and February 2023, utilizing a validated 39-item survey. The statistical analyses employed in this study encompassed descriptive statistics, independent samples t-tests, and hierarchical regression modeling. Among students who had engaged in gambling in the past month, the constructs of participatory dialogue (β = 0.052; p < 0.05), behavioral confidence (β = 0.073; p < 0.0001), changes in the physical environment (β = 0.040; p = 0.0137), and demographic variables accounted for 27.7% of the variance in the likelihood of initiating the behavior change. Furthermore, the constructs of emotional transformation (β = 0.104; p = 0.0003) and practice for change (β = 0.060; p = 0.0368), and demographic variables accounted for 22.6% of the variance in the likelihood of sustaining quitting gambling behavior. The Multi-Theory Model (MTM) can be employed to design interventions aimed at reducing problem gambling among college students. Full article

Although the prevalence of gambling disorder (GD) and problem gambling has remained stable in recent years, the expansion of legalized gambling is considered a public health problem leading to significant personal, familial, and social impacts. This study aims to assess the effectiveness of various physiotherapy interventions on the symptoms of patients with GD. A systematic review following PRISMA guidelines was conducted in December 2022, using descriptors related to physiotherapy and GD in ten databases. Inclusion criteria were designed to identify clinical trials published in the last decade. Eight studies were identified, with a total of 357 patients, and the main variables measured were anxiety and depression symptoms, gambling craving, and gambling desire. The interventions included aerobic exercise, relaxation techniques, and non-invasive brain stimulation. Results suggest that physiotherapy may help with GD symptoms, although more research is needed to strengthen these findings. These findings highlight the potential of physiotherapy in treating GD and provide a basis for future research to better understand the effectiveness of these interventions. Full article