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Mei B, Tao Q, Dang J, Niu X, Sun J, Zhang M, Wang W, Han S, Zhang Y, Cheng J. Meta-analysis of structural and functional abnormalities in behavioral addictions. Addict Behav 2024; 157:108088. [PMID: 38924904 DOI: 10.1016/j.addbeh.2024.108088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The incidence of behavioral addictions (BAs) associated with scientific and technological advances has been increasing steadily. Unfortunately, a large number of studies on the structural and functional abnormalities have shown poor reproducibility, and it remains unclear whether different addictive behaviors share common underlying abnormalities. Therefore, our objective was to conduct a quantitative meta-analysis of different behavioral addictions to provide evidence-based evidence of common structural and functional changes. METHODS We conducted systematic searches in PubMed, Web of Science and Scopus from January 2010 to December 2023, supplementing reference lists of high-quality relevant meta-analyses and reviews, to identify eligible voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies. Using anisotropic seed-based D-Mapping (AES-SDM) meta-analysis methods, we compared brain abnormalities between BAs and healthy controls (HCs). RESULTS There were 11 GMV studies (287 BAs and 292 HCs) and 26 fMRI studies (577 BAs and 545 HCs) that met inclusion criteria. Compared with HCs, BAs demonstrated significant reductions in gray matter volume (GMV) in (1) right anterior cingulate gyri extending into the adjacent superior frontal gyrus, as well as in the left inferior frontal gyrus and right striatum. (2) the bilateral precuneus, right supramarginal gyrus, and right fusiform gyrus were hyperfunction; (3) the left medial cingulate gyrus extended to the superior frontal gyrus, the left inferior frontal gyrus, and right middle temporal gyrus had hypofunction. CONCLUSIONS Our study identified structural and functional impairments in brain regions involved in executive control, cognitive function, visual memory, and reward-driven behavior in BAs. Notably, fronto-cingulate regions may serve as common biomarkers of BAs.
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Affiliation(s)
- Bohui Mei
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Qiuying Tao
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Jinghan Dang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Xiaoyu Niu
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Jieping Sun
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Mengzhe Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Weijian Wang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China.
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, China; Henan Engineering Technology Research Center for detection and application of brain function, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, China; Henan key laboratory of imaging intelligence research, China; Henan Engineering Research Center of Brain Function Development and Application, China.
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Gee MJ, Johnson K, Leonhard C. Brief Virtual Workshop on Gambling Disorder to Raise Knowledge and Awareness Among Health Service Providers. J Gambl Stud 2024; 40:1-20. [PMID: 36538203 PMCID: PMC9765357 DOI: 10.1007/s10899-022-10176-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 12/24/2022]
Abstract
Gambling disorder is a "hidden disease" due to the lack of visible markers. It often negatively affects multiple domains of a person's life and predicts adverse physical, mental, social, and financial outcomes. Health service settings are suited for early detection of gambling disorder because of its comorbid medical conditions and due to the trust patients have in their health service providers (HSPs). However, HSPs often lack the knowledge needed to screen for this disorder and to make appropriate referrals. This paper reports a quasi-experimental wait-list control study (experimental group n = 18; wait-list control group n = 14), with cross-over and a twelve-week follow-up which assessed whether a brief virtual gambling disorder training entitled Gambling Know More could improve gambling disorder knowledge among HSPs. Results showed workshop participation caused a significant increase in gambling disorder knowledge immediately after the workshop and twelve weeks later. Participation in Gambling Know More bodes well for increasing early detection of gambling disorder and appropriate treatment referrals among HSPs. Findings have important policy implications for the training of HSPs.
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Affiliation(s)
- Michael J Gee
- The Chicago School of Professional Psychology at Xavier University of Louisiana, 1 Drexel Dr, P.O. Box 200, New Orleans, LA, 70125, USA
| | - Kelli Johnson
- The Chicago School of Professional Psychology at Xavier University of Louisiana, 1 Drexel Dr, P.O. Box 200, New Orleans, LA, 70125, USA
| | - Christoph Leonhard
- The Chicago School of Professional Psychology at Xavier University of Louisiana, 1 Drexel Dr, P.O. Box 200, New Orleans, LA, 70125, USA.
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3
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Korvuo T, Palomäki J, Castrén S. Dissociative experiences reduce online problem gambling treatment effectiveness. Compr Psychiatry 2023; 127:152414. [PMID: 37688936 DOI: 10.1016/j.comppsych.2023.152414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/08/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
AIMS To determine whether dissociative experiences moderate online problem gambling treatment effectiveness, and to characterize the temporal persistence of the relationship between dissociation and problem gambling. DESIGN Repeatedly measured self-report data on a guided online cognitive behavioral therapy for problem gambling collected on four occasions: before treatment, after treatment, and at 6- and 12-month follow-ups. SETTING AND PARTICIPANTS The data (N = 1243, 59.2% males) were collected in Finland between 2019 and 2021. MEASUREMENTS The primary outcome variable was the self-reported level of problem gambling. The predictors were the treatment phase and dissociative experiences, their interaction, and the demographic covariates of age, education, income, and gender. FINDINGS Problem gambling scores and dissociative experiences declined significantly following treatment and remained low through the follow-ups (retention rates: 52.6% [post-treatment], 26.3% [at the 6-month follow-up], and 16.1% [at the 12-month follow-up]). However, the treatment was significantly less effective in reducing problem gambling for individuals who kept experiencing dissociation after the treatment. CONCLUSIONS Dissociation is an integral sign of problem gambling severity and sustained dissociative experiences may significantly reduce the long-term effectiveness of online problem gambling treatments. Treatment efforts should be customized to account for individual differences in dissociative tendencies, and future research should broaden the study of dissociative experiences to other behavioral addictions.
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Affiliation(s)
- Tuire Korvuo
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Palomäki
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland; Gambling Clinic, Helsinki University Hospital, Finland.
| | - Sari Castrén
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland; University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland; University of Helsinki, Department of Medicine, Helsinki, Finland
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Miles M, Rothschild J, Åkesson G, Håkansson A. Nationwide, Multioperator Self-Exclusion and Psychiatric Comorbidity in Patients with Gambling Disorder: A Retrospective Chart Review Study from a Regional Treatment Unit. JOURNAL OF ADDICTION 2023; 2023:5532259. [PMID: 37808466 PMCID: PMC10555495 DOI: 10.1155/2023/5532259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/28/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023]
Abstract
Gambling disorder is an addictive disorder that has been shown to have a detrimental effect on an individual's health, social, and financial situations. Voluntary self-exclusion is one way for patients to reduce harm in gambling disorder, but breaching one's self-exclusion appears to be common. In January 2019, Sweden launched a nationwide, multioperator self-exclusion instrument called Spelpaus (literally "game break"). Spelpaus is unique to Sweden, and there is limited research on the use of this type of nationwide, multioperator self-exclusion services, also in relation to gambling disorder and mental health. There is a reason to follow the clinical picture of treatment seeking for gambling disorder over time, and this study aims to explore clinical characteristics of patients seeking clinical gambling disorder treatment, including sex distribution and mental health comorbidity, as well as the use of Spelpaus amongst patients with gambling disorder and how frequently users gambled despite ongoing self-exclusion, in relation to sex and psychiatric comorbidities. A retrospective chart study was carried out on patients presenting to a regional gambling disorder treatment unit. Information regarding self-exclusions using Spelpaus, gambling despite self-exclusion, and the method of gambling despite self-exclusion as well as psychiatric comorbidities were extracted from medical records. Females were markedly more likely to report overall psychiatric comorbidities (48% vs. 25% among males, p < 0.001), affective, neurotic/anxiety-related (p < 0.001), and behavioral/emotional (p = 0.028) diagnoses and more likely to have two or more diagnoses excluding gambling disorder (p = 0.001). From 120 patients from whom information regarding self-exclusion was present, 114 (95%) had chosen to self-exclude. From the 114 self-excluders, 67 reported to have gambled despite self-exclusion, with unregistered websites being the most common method. Self-exclusion was not significantly related to sex (p = 0.146) or to psychiatric comorbidities (p = 0.178). In conclusion, psychiatric comorbidity was particularly common in female gambling disorder patients and gambling despite self-exclusion was common. Gambling regulations should be improved to help self-excluders avoid being able to gamble on unlicensed gambling operators. Further research should focus on sex differences and the association with psychiatric comorbidities.
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Affiliation(s)
- M. Miles
- Lund University, Faculty of Medicine, Lund, Sweden
| | | | | | - A. Håkansson
- Lund University, Department of Clinical Sciences Lund, Division of Psychiatry, Lund, Sweden
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de Sá RRC, Coelho S, Parmar PK, Johnstone S, Kim HS, Tavares H. A Systematic Review of Pharmacological Treatments for Internet Gaming Disorder. Psychiatry Investig 2023; 20:696-706. [PMID: 37559452 PMCID: PMC10460977 DOI: 10.30773/pi.2022.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Internet gaming disorder (IGD) is an increasingly common behavioral addiction, with an estimated global prevalence of 3%. A variety of pharmacological treatments have been used to treat IGD, yet no review to date has synthesized clinical trials evaluating their efficacy. This systematic review therefore synthesized the literature reporting on clinical trials of pharmacological treatments for IGD. METHODS We reviewed articles from MEDLINE, Embase, PubMed Central, CINAHL, and PsycINFO that were published as of March of 2022. A total of 828 articles were retrieved for review and 12 articles were included, reporting on a total of 724 participants. RESULTS Most participants were male (98.6%), and all were currently living in South Korea. The most common drugs used to treat IGD were bupropion, methylphenidate, and a range of selective serotonin reuptake inhibitors. The Young Internet Addiction Scale was the most frequently used to measure gaming-related outcomes. All studies reported reduced symptoms of IGD from pre- to post-treatment. Across all clinical trials, IGD symptom reductions following the administration of pharmacological treatments ranged from 15.4% to 51.4%. A risk of bias assessment indicated that only four studies had a low risk of bias. CONCLUSION Preliminary results suggest that a wide array of pharmacological interventions may be efficacious in the treatment of IGD. Future studies using double-blind randomized controlled trial designs, recruiting larger and more representative samples, and controlling for psychiatric comorbidities are needed to better inform understanding of pharmacological treatments for IGD.
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Affiliation(s)
| | - Sophie Coelho
- Department of Psychology, York University, Toronto, ON, Canada
| | - Puneet Kaur Parmar
- Department of Psychology, Toronto Metropolitan University Toronto, ON, Canada
| | - Samantha Johnstone
- Department of Psychology, Toronto Metropolitan University Toronto, ON, Canada
| | - Hyoun Soo Kim
- Department of Psychology, Toronto Metropolitan University Toronto, ON, Canada
| | - Hermano Tavares
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Farkouh R, Audette-Chapdelaine S, Brodeur M. Pharmacotherapy and gambling disorder: a narrative review. J Addict Dis 2023:1-15. [PMID: 37423770 DOI: 10.1080/10550887.2023.2229725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Gambling disorder (GD) is a psychiatric disorder classified in the DSM-5 as a non-substance-related and addictive disorder with extensive health and socioeconomic impacts. Its chronic and high-relapsing nature makes it essential to find treatment strategies that improve functioning and reduce impairment associated with it. The purpose of this narrative review is to evaluate and summarize the available evidence on the effectiveness and safety of pharmacotherapy in GD. METHODS An electronic literature search of Medline, Embase, and Cochrane Central was conducted to identify systematic reviews, meta-analyses, and reviews on pharmacological interventions in patients with gambling disorder. A similar search of these databases and of Prospero, Clinicaltrials.gov, and Epistemonikos was conducted to identify clinical trials that were published since 2019. RESULTS The initial search identified 1925 articles. After screening and duplicate removal, 18 articles were included in the review (11 studies were systematic reviews and meta-analyses, 6 were reviews, and 1 was an open-label trial). Eight pharmacological agents (naltrexone, nalmefene, paroxetine, fluvoxamine, citalopram, escitalopram, lithium, and topiramate) that were studied in randomized controlled trials and open-label trials showed small to moderate effect sizes in reducing GD symptoms in some studies during post-hoc analyses. CONCLUSION The overall sum of evidence in the literature on the use of pharmacotherapy in GD is conflicting and inconclusive. Some studies have shown that pharmacotherapy's role in GD is promising, especially when the choice of the agent is guided by comorbid psychiatric disorders. However, significant limitations exist in the study designs, which need to be addressed in future research on the topic. Conducting future and more rigorous trials that address the limitations in the existing literature is necessary to establish more accurate efficacy data on the use of pharmacotherapy in this population.
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Affiliation(s)
- Rezkalla Farkouh
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sophie Audette-Chapdelaine
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Magaly Brodeur
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Bai M, Huang E, Du H, Yang L, Zhang X, Yang Y, Yan Z, Wang W. Fluoxetine combined with risperidone in treatment of online gambling disorder-case report. Heliyon 2023; 9:e13772. [PMID: 36895358 PMCID: PMC9989641 DOI: 10.1016/j.heliyon.2023.e13772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/11/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Pathological gambling leaves seriously negative impacts on individuals, families, and society. With the universal use of internet, online gambling disorder is also increasing worldwide. However, there is currently a lack of effective treatments, especially medical treatments, for online gambling disorder. This study shared 3 cases of online gambling disorder that was treated with combined fluoxetine and risperidone to provide an option for the treatment of online gambling.
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Affiliation(s)
- Mei Bai
- The First People's Hospital of Guiyang, Guiyang, Guizhou, 550001, China
| | - Erjia Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Cardiovascular Surgery, The Second Xiangya Hospital Central South University, Changsha, China
| | - Huijie Du
- The First People's Hospital of Guiyang, Guiyang, Guizhou, 550001, China
| | - Lu Yang
- The First People's Hospital of Guiyang, Guiyang, Guizhou, 550001, China
| | - Xin Zhang
- The First People's Hospital of Guiyang, Guiyang, Guizhou, 550001, China
| | - Yang Yang
- The First People's Hospital of Guiyang, Guiyang, Guizhou, 550001, China
| | - Zhe Yan
- The First People's Hospital of Guiyang, Guiyang, Guizhou, 550001, China
| | - Wei Wang
- The First People's Hospital of Guiyang, Guiyang, Guizhou, 550001, China
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Pettorruso M, Di Carlo F, Romeo VM, Jimenez-Murcia S, Grant JE, Martinotti G, Di Giannantonio M. The pharmacological management of gambling disorder: if, when, and how. Expert Opin Pharmacother 2023; 24:419-423. [PMID: 36690348 DOI: 10.1080/14656566.2023.2172329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Gambling disorder (GD) consists of a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The etiology is multifactorial. GD frequently co-occurs with other psychiatric disorders and is often untreated. Different psychosocial interventions, particularly cognitive-behavioral therapy, are useful in the treatment of GD. Pharmacological therapy may also be helpful . No formal guidelines exist, and the management of the disease is often guided by few clinical elements. AREAS COVERED A literature search was performed using PubMed, Scopus, and Web of Science databases about treatment options for GD, considering both psychosocial treatments and available pharmacological ones. EXPERT OPINION The authors address whether and when it is appropriate to initiate pharmacological treatment for GD. They focus on providing clinicians with guidance on how to approach patients with GD in those situations where pharmacological therapy may be necessary. The reasons for the clinician to start thinking about a medication are examined. As specific traits in the psychopathology of GD may be managed with a strategic choice of the pharmacologic agent, the different available options are analyzed on the basis of their potential usefulness in GD. Issues that remain open about the pharmacological management of GD are summarized.
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Affiliation(s)
- Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Vincenzo Maria Romeo
- Faculty of Psychological Sciences and Techniques, Dante Alighieri University, Reggio Calabria, Italy
| | - Susana Jimenez-Murcia
- Gambling Unit, Department of Psychiatry, University Hospital Bellvitge, Barcelona, Spain
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.,Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, UK
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
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Wolfschlag M, Håkansson A. Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management. Pharmaceut Med 2023; 37:37-52. [PMID: 36611111 PMCID: PMC9825131 DOI: 10.1007/s40290-022-00453-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Abstract
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. Patients with Parkinson's disease, restless legs syndrome and other conditions potentially treated with dopamine agonists, as well as patients treated for psychotic disorders, are vulnerable patient groups with theoretically increased risk of developing gambling disorder (GD), for example due to higher rates of mental ill-health in these groups. The aim of the present paper is to review the epidemiological, clinical, and neurobiological evidence of the association between dopaminergic medications and GD, and to describe risk groups and treatment options. The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. Since reward-related learning is mediated by dopamine, it can be altered by dopaminergic medications, possibly leading to increased gambling behavior and a decreased impulse control. A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. More research is needed in order to fully outline the clinical picture of GD developing in patient groups with dopaminergic medications, and data are needed on the differentiation of risk in different compounds. In addition, very few interventional studies are available on the management of GD induced by dopaminergic medications. While GD overall can be treated, there is need for treatment studies testing the effectiveness of tapering of the medication or other gambling-specific treatment modalities in these patient groups.
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Affiliation(s)
- Mirjam Wolfschlag
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02 Malmö, Sweden ,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden
| | - Anders Håkansson
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02, Malmö, Sweden. .,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden.
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Dowling N, Merkouris S, Lubman D, Thomas S, Bowden-Jones H, Cowlishaw S. Pharmacological interventions for the treatment of disordered and problem gambling. Cochrane Database Syst Rev 2022; 9:CD008936. [PMID: 36130734 PMCID: PMC9492444 DOI: 10.1002/14651858.cd008936.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Pharmacological interventions for disordered and problem gambling have been employed in clinical practice. Despite the availability of several reviews of the efficacy of pharmacological interventions for disordered or problem gambling, few have employed systematic search strategies or compared different categories of pharmacological interventions. Systematic reviews of high-quality evidence are therefore essential to provide guidance regarding the efficacy of different pharmacological interventions for disordered or problem gambling. OBJECTIVES The primary aims of the review were to: (1) examine the efficacy of major categories of pharmacological-only interventions (antidepressants, opioid antagonists, mood stabilisers, atypical antipsychotics) for disordered or problem gambling, relative to placebo control conditions; and (2) examine the efficacy of these major categories relative to each other. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Embase, and PsycINFO (all years to 11 January 2022). SELECTION CRITERIA We included randomised trials evaluating a pharmacological intervention for the treatment of disordered or problem gambling. Eligible control conditions included placebo control groups or comparisons with another category of pharmacological intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures, including systematic extraction of included study characteristics and results and risk of bias assessment. Our primary outcome was reduction in gambling symptom severity. Our secondary outcomes were reduction in gambling expenditure, gambling frequency, time spent gambling, depressive symptoms, anxiety symptoms, and functional impairment; and responder status. We evaluated treatment effects for continuous and dichotomous outcomes using standardised mean difference (SMD) and risk ratios (RR), respectively, employing random-effects meta-analyses. A minimum of two independent treatment effects were required for a meta-analysis to be conducted (with only meta-analytic findings reported in this abstract). MAIN RESULTS We included 17 studies in the review (n = 1193 randomised) that reported outcome data scheduled for end of treatment. Length of treatment ranged from 7 to 96 weeks. Antidepressants: Six studies (n = 268) evaluated antidepressants, with very low to low certainty evidence suggesting that antidepressants were no more effective than placebo at post-treatment: gambling symptom severity (SMD -0.32, 95% CI -0.74 to 0.09, n = 225), gambling expenditure (SMD -0.27, 95% CI -0.60 to 0.06, n = 144), depressive symptoms (SMD -0.19, 95% CI -0.60 to 0.23, n = 90), functional impairment (SMD -0.15, 95% CI -0.53 to 0.22, n = 110), and responder status (RR 1.24, 95% CI 0.93 to 1.66, n = 268). Opioid antagonists: Four studies (n = 562) evaluated opioid antagonists, with very low to low certainty evidence showing a medium beneficial effect of treatment on gambling symptom severity relative to placebo at post-treatment (SMD -0.46, 95% CI -0.74 to -0.19, n = 259), but no difference between groups in responder status (RR 1.65, 95% CI 0.86 to 3.14, n = 562). Mood stabilisers: Two studies (n = 71) evaluated mood stabilisers (including anticonvulsants), with very low certainty evidence suggesting that mood stabilisers were no more effective than placebo at post-treatment: gambling symptom severity (SMD -0.92, 95% CI -2.24 to 0.39, n = 71), depressive symptoms (SMD -0.15, 95% CI -1.14 to 0.83, n = 71), and anxiety symptoms (SMD -0.17, 95% CI -0.64 to 0.30, n = 71). Atypical antipsychotics:Two studies (n = 63) evaluated the atypical antipsychotic olanzapine, with very low certainty evidence showing a medium beneficial effect of treatment on gambling symptom severity relative to placebo at post-treatment (SMD -0.59, 95% CI -1.10 to -0.08, n = 63). Comparative effectiveness: Two studies (n = 62) compared antidepressants with opioid antagonists, with very low certainty evidence indicating that antidepressants were no more effective than opioid antagonists on depressive symptoms (SMD 0.22, 95% CI -0.29 to 0.72, n = 62) or anxiety symptoms (SMD 0.21, 95% CI -0.29 to 0.72, n = 62) at post-treatment. Two studies (n = 58) compared antidepressants with mood stabilisers (including anticonvulsants), with very low certainty evidence indicating that antidepressants were no more effective than mood stabilisers on depressive symptoms (SMD 0.02, 95% CI -0.53 to 0.56, n = 58) or anxiety symptoms (SMD 0.16, 95% CI -0.39 to 0.70, n = 58) at post-treatment. Tolerability and adverse events: Several common adverse effects were reported by participants receiving antidepressants (e.g. headaches, nausea, diarrhoea/gastrointestinal issues) and opioid antagonists (e.g. nausea, dry mouth, constipation). There was little consistency in the types of adverse effects experienced by participants receiving mood stabilisers (e.g. tiredness, headaches, concentration difficulties) or atypical antipsychotics (e.g. pneumonia, sedation, increased hypomania). Discontinuation of treatment due to these adverse events was highest for opioid antagonists (10% to 32%), followed by antidepressants (4% to 31%), atypical antipsychotics (14%), and mood stabilisers (13%). AUTHORS' CONCLUSIONS This review provides preliminary support for the use of opioid antagonists (naltrexone, nalmefene) and atypical antipsychotics (olanzapine) to produce short-term improvements in gambling symptom severity, although a lack of available evidence precludes a conclusion regarding the degree to which these pharmacological agents can improve other gambling or psychological functioning indices. In contrast, the findings are inconclusive with regard to the effects of mood stabilisers (including anticonvulsants) in the treatment of disordered or problem gambling, and there is limited evidence to support the efficacy of antidepressants. However, these conclusions are based on very low to low certainty evidence characterised by a small number of included studies, high risk of bias, modest pooled sample sizes, imprecise estimates, moderate between-study heterogeneity, and exclusion of participants with psychiatric comorbidities. Moreover, there were insufficient studies to conduct meta-analyses on many outcome measures; to compare efficacy across and within major categories of interventions; to explore dosage effects; or to examine effects beyond post-treatment. These limitations suggest that, despite recommendations related to the administration of opioid antagonists in the treatment of disordered or problem gambling, pharmacological interventions should be administered with caution and with careful consideration of patient needs. A larger and more methodologically rigorous evidence base with longer-term evaluation periods is required before definitive conclusions can be drawn about the effectiveness and durability of pharmacological treatments for disordered or problem gambling.
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Affiliation(s)
- Nicki Dowling
- School of Psychology, Deakin University, Geelong, Australia
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | | | - Dan Lubman
- Turning Point, Eastern Health, Melbourne, Australia
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Shane Thomas
- School of Health, Federation University, Melbourne, Australia
- Research School of Population Health, Australian National University, Melbourne, Australia
- Peking University, Beijing, China
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic UK, Faculty of Brain Sciences, UCL, London, UK
- Department of Psychiatry, Cambridge University, Cambridge, UK
| | - Sean Cowlishaw
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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11
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Salerno L, Grassi E, Makris N, Pallanti S. "A Theta Burst Stimulation on Pre-SMA: Proof-of-Concept of Transcranial Magnetic Stimulation in Gambling Disorder". J Gambl Stud 2022; 38:1529-1537. [PMID: 35596900 PMCID: PMC9123619 DOI: 10.1007/s10899-022-10129-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/18/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
Gambling Disorder (GD) is a condition constituting a public health concern, with a burden of harm which is much greater than that of drug addiction. Patients with GD are generally reluctant to pharmacologic treatment and seem to prefer nonpharmacological interventions. Therefore, this proof-of-concept study aimed to investigate the feasibility of continuous Theta Burst Stimulation (cTBS) on the pre-SMA in six patients (5 males, 1 female), aged 30–64 years, with a DSM-5 diagnosis of Gambling Disorder and no comorbid mood disorders. Participants received over 10 sessions of Continuous TBS (cTBS) over pre-SMA bilaterally and have been evaluated using rating scales, including the PG-YBOCS and the CGI, before treatment (T0), at day 10 of treatment (T1) and at day 30 after treatment (T2); cTBS intervention was safe and without side effects. Since the design of our study does not allow us to draw conclusions on the effectiveness of the intervention with respect to the improvement of the functioning of the subject with GD, a more in-depth study, including a sham condition, neurocognitive measures of disinhibition and decision making, and collecting follow-up data on the sustained effect of TBS over a longer period is ongoing.
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Affiliation(s)
| | | | - Nikos Makris
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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12
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Kisch M, Håkansson A. Associations Between Addictive Behaviors, Individual Characteristics, and the Use of Gambling Services Within the World of Gaming: Cross-sectional Survey Study. JMIR Serious Games 2022; 10:e29077. [PMID: 35451974 PMCID: PMC9077510 DOI: 10.2196/29077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/12/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background Gambling within the world of gaming is an emerging phenomenon that may share common conceptual characteristics with traditional forms of gambling. The current literature suggests a higher degree of problematic behaviors in this gambling pattern, but studies are few, prompting for further research regarding individual characteristics and comorbid conditions associated with this activity. Objective The aim of the study is to investigate correlations between the use of gambling services within the world of gaming and individual characteristics and addictive behaviors including problem gambling. Methods A cross-sectional web survey was distributed to an existing panel of online respondents in Sweden. A total of 2001 respondents were included. Chi-square and Mann-Whitney U tests, followed by a logistic regression, were used in order to determine independent variables associated with gambling in the context of gaming. Results A total of 2.9% (58/1984) of respondents reported past-year gambling within gaming. Significant associations were found with male sex, younger age, history of treatment-seeking for alcohol problems, and higher Gaming Addiction Scale scores. Conclusions The demonstrated findings strengthen previously found associations between gambling in gaming and younger age, male sex, and problematic gaming behaviors. Additionally, the association with a history of treatment needs for alcohol problems adds to the previous impression of increased problem severity and comorbidity in within-gaming gamblers.
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Affiliation(s)
- Mark Kisch
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden.,Malmö Addiction Center, Region Skåne, Malmö, Sweden
| | - Anders Håkansson
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden.,Clinical Research Unit/Clinical Gambling Disorder Unit, Malmö Addiction Center, Region Skåne, Malmö, Sweden
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13
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Widinghoff C, Berge J, Hakansson A. Psychiatric Drug Prescription and Temporal Associations with a First Diagnosis of Gambling Disorder—Results from a National Register Study. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AbstractPsychiatric comorbidity is common in gambling disorder (GD), but there are few studies on larger nationwide samples of treatment-seeking patients. Also, temporal associations between GD and other psychiatric disorders are often difficult to study. To address the prevalence and the temporal associations of prescriptions for psychiatric disorders — both in specialized care and primary care — in patients with a GD diagnosis (ICD-10 F63.0). Data was derived from national health registers in Sweden. All patients who were diagnosed with GD in specialized health care in 2005–2016 were included and run against the nationwide database on prescription of pharmaceuticals aimed for psychiatric disorders (n = 2018). Prevalence of psychiatric drug prescription was used as a proxy for psychiatric comorbidity and studied for two 2-year periods (period 1 and 2) prior to GD and one 2-year period (period 3) after the diagnosis. Controlling for gender, age, and time periods, for eight drug categories (anti- epileptics, anti-psychotics, benzodiazepine derivatives, anxiolytics, hypnotics, anti- depressants and drugs used in addictive disorders), significant increases in drug prescription were seen. For central stimulants, a significant increase was seen upon receiving the GD diagnosis (from period 2 to 3), and for benzodiazepines, an increase was seen prior to the GD diagnosis (from period 1 to 2), but not upon diagnosis (from period 2 to 3). Psychiatric comorbidity in GD is common. Drug prescription for psychiatric problems increased markedly in the years temporarily associated with a first diagnosis of GD. The findings may call for early screening for problem gambling in patients with treatment contacts for increasingly poor mental health.
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14
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Pharmacological and Psychosocial Treatment of Adults With Gambling Disorder: A Meta-Review. J Addict Med 2021; 14:e15-e23. [PMID: 31651561 DOI: 10.1097/adm.0000000000000574] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Gambling disorder (GD) leads to impaired socioeconomical functioning and increased social costs. Although the research on GD has been rising over the years, approved treatment guidelines are currently not available. The aim of this study was to systematically review the literature on the pharmacological and psychosocial treatment of adults with GD, and to identify possible agreed-upon standards of care. METHODS MEDLINE, PubMed, Cochrane, Web of Science, Embase, and CINAHL electronic databases were searched up to April 2019 for systematic reviews on pharmacological, psychosocial, and combined treatment of adults with GD. Twenty-six studies were eventually included in this meta-review. RESULTS Studies reported promising results of opioid antagonists and mood stabilizers in reducing GD-related symptomatology. Lithium was particularly effective in subjects with comorbid bipolar disorders. Cognitive behavioral therapy (CBT) was the most commonly used psychological intervention and reduced global severity, gambling frequency, and financial loss. Motivational interviewing (MI) seemed to improve several GD domains, alone or in combination with CBT. Self-help interventions (SHIs) showed some efficacy in promoting treatment-seeking, and in combination with other treatments. CONCLUSIONS We found moderate evidence of effect for CBT, but weaker evidence for pharmacotherapy and SHIs. Results suggested some efficacy for MI in the short but not in the long term. It is likely that certain interventions might be more effective than others on specific features of GD. Further studies are needed to compare the efficacy and acceptability of individual and combined psychosocial and pharmacological interventions, to deliver patient-tailored treatments.
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15
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Shiina A, Hasegawa T, Iyo M. Possible effect of blonanserin on gambling disorder: A clinical study protocol and a case report. World J Clin Cases 2021; 9:2469-2477. [PMID: 33889612 PMCID: PMC8040182 DOI: 10.12998/wjcc.v9.i11.2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gambling disorder is characterized by excessive and recurrent gambling and can have serious negative social consequences. Although several psychotherapeutic and pharmacological approaches have been used to treat gambling disorder, new treatment strategies are needed. Growing evidence suggests that dopamine D3 receptor plays a specific role in the brain reward system.
AIM To investigate if blonanserin, a dopamine D3 receptor antagonist, would be effective in reducing gambling impulses in patients with gambling disorder.
METHODS We developed a study protocol to measure the efficacy and safety of blonanserin as a potential drug for gambling disorder, in which up to 12 mg/d of blonanserin was prescribed for 8 wk.
RESULTS A 37-year-old female patient with gambling disorder, intellectual disability, and other physical diseases participated in the pilot study. The case showed improvement of gambling symptoms without any psychotherapy. However, blonanserin was discontinued owing to excessive saliva production.
CONCLUSION This case suggests that blonanserin is potentially an effective treatment for patients with gambling disorder who resist standard therapies, but it also carries a risk of adverse effects. Further studies are needed to confirm the findings.
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Affiliation(s)
- Akihiro Shiina
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba 260-8670, Japan
| | - Tadashi Hasegawa
- Department of Psychiatry, Chiba University Hospital, Chiba 260-8670, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
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16
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Grall-Bronnec M, Guillou-Landreat M, Caillon J, Dubertret C, Romo L, Codina I, Chereau-Boudet I, Lancon C, Auriacombe M, Hardouin JB, Challet-Bouju G. Five-year follow-up on a sample of gamblers: predictive factors of relapse. J Behav Addict 2021; 10:42-54. [PMID: 33793415 PMCID: PMC8969856 DOI: 10.1556/2006.2021.00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/12/2021] [Accepted: 02/06/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND AIMS Few studies have been conducted on the long-term evolution of gambling disorder (GD). The aim of this study was to identify factors that could predict GD relapse. METHODS Data were part of a dataset from a large 5-year cohort of gamblers who were assessed at inclusion and each year thereafter. Participants were recruited from an outpatient addiction treatment center, from various gambling places and through the press. For this specific study, inclusion criteria included (i) transitioning from GD to recovery at a follow-up time and (ii) undergoing at least one follow-up visit afterwards. Participants were evaluated using a structured clinical interview and self-report questionnaires assessing sociodemographic, gambling and clinical characteristics. "Relapse" was defined as the presence of GD (according to the DSM-5) at the N+1th visit following the absence of GD at the Nth visit. A Markov model-based approach was employed to examine predictive factors associated with relapse at a subsequent follow-up visit. RESULTS The sample consisted of 87 participants, aged 47.6 years (sd = 12.6), who were predominantly male (65%). Among the participants, 49 remained in recovery, whereas 38 relapsed. Participants who reported not having experienced at least one month of abstinence and those with a low level of self-directedness at the previous follow-up visit were more likely to relapse. CONCLUSIONS Our findings suggest the existence of factors that are predictive of relapse in individuals with GD who had previously achieved recovery. These results can inspire the development of measures to promote long-term recovery.
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Affiliation(s)
- Marie Grall-Bronnec
- Department of Addictology and Psychiatry, CHU Nantes, Nantes, France,Université de Nantes, Université de Tours, Inserm U1246, Nantes, France,Corresponding author. E-mail:
| | - Morgane Guillou-Landreat
- Department of Addictology, CHU Brest, Brest, France,Université de Bretagne Occidentale, ERCR SPURBO, Brest, France
| | - Julie Caillon
- Department of Addictology and Psychiatry, CHU Nantes, Nantes, France,Université de Nantes, Université de Tours, Inserm U1246, Nantes, France
| | - Caroline Dubertret
- Institute of Psychiatry and Neurosciences, INSERM UMR1266, Université de Paris, Team 1, Paris, France,Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Lucia Romo
- Department of Psychology, Université Paris Nanterre, EA 4430 CLIPSYD, Nanterre, France,CMME, GHU Paris Psychiatrie et Neurosciences, INSERM U1266, Paris, France
| | - Irène Codina
- Marmottan Medical Center, GPS Perray-Vaucluse, Paris, France
| | | | - Christophe Lancon
- Centre d'études et de recherches sur les services de santé et la qualité de vie, Université de la Méditerranée, Marseille, France
| | - Marc Auriacombe
- University of Bordeaux, Bordeaux, France,Addiction Team, Sleep Addiction and Neuropsychiatry Laboratory (SANPSY), CNRS USR 3413, Bordeaux, France,Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | | | - Jean-Benoit Hardouin
- Université de Nantes, Université de Tours, Inserm U1246, Nantes, France,Methodology and Biostatistic Department, CHU Nantes, Nantes, France
| | - Gaëlle Challet-Bouju
- Department of Addictology and Psychiatry, CHU Nantes, Nantes, France,Université de Nantes, Université de Tours, Inserm U1246, Nantes, France
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17
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Bjørseth B, Simensen JO, Bjørnethun A, Griffiths MD, Erevik EK, Leino T, Pallesen S. The Effects of Responsible Gambling Pop-Up Messages on Gambling Behaviors and Cognitions: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 11:601800. [PMID: 33569015 PMCID: PMC7868407 DOI: 10.3389/fpsyt.2020.601800] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/31/2020] [Indexed: 12/12/2022] Open
Abstract
Pop-up messages utilized by gambling operators are normally presented to gamblers during gambling sessions in order to prevent excessive gambling and/or to help in the appraisal of maladaptive gambling cognitions. However, the effect of such messages on gambling behavior and gambling cognitions has not previously been synthesized quantitatively. Consequently, a meta-analysis estimating the efficacy of pop-up messages on gambling behavior and cognitions was conducted. A systematic literature search with no time constraints was performed on Web of Science, PsychInfo, Medline, PsychNET, and the Cochrane Library. Search terms included "gambling," "pop-up," "reminder," "warning message," and "dynamic message." Studies based on randomized controlled trials, quasi-experimental designs and pre-post studies reporting both pre- and post-pop-up data were included. Two authors independently extracted data using pre-defined fields including quality assessment. A total of 18 studies were included and data were synthesized using a random effects model estimating Hedges' g. The effects of pop-ups were g = 0.413 for cognitive measures (95% CI = 0.115-0.707) and g = 0.505 for behavioral measures (95% CI = 0.256-0.746). For both outcomes there was significant between-study heterogeneity which could not be explained by setting (laboratory vs. naturalistic) or sample (gambler vs. non-gamblers). It is concluded that pop-up messages provide moderate effects on gambling behavior and cognitions in the short-term and that such messages play an important role in the gambling operators' portfolio of responsible gambling tools.
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Affiliation(s)
- Benjamin Bjørseth
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | - Aina Bjørnethun
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Eilin K. Erevik
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway
| | - Tony Leino
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway
- Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
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18
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Blank L, Baxter S, Woods HB, Goyder E. Interventions to reduce the public health burden of gambling-related harms: a mapping review. LANCET PUBLIC HEALTH 2021; 6:e50-e63. [PMID: 33417847 DOI: 10.1016/s2468-2667(20)30230-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/09/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
Abstract
Recognition is growing that gambling, although highly profitable for corporations and governments, is a source of serious and unevenly distributed harm. This recognition has led to demands for public health strategies at the local, national, and international levels. We aimed to identify review-level evidence for interventions to address or prevent gambling-related harms and explore policy implications, using stakeholder consultation to assess the evidence base, identify gaps, and suggest key research questions. We opted for a systematic mapping review and narrative synthesis for all forms of gambling in any setting. We included participants from the whole population, identified gamblers including self-defined, and specific populations at risk (eg, children and young people). We included all outcome measures relating to prevention or treatment of gambling-related harms that were reported by review authors. After duplication, the searches generated 1080 records. Of 43 potential papers, 13 were excluded at the full paper stage and 30 papers were included in the Review. We identified whole-population preventive interventions, such as demand reduction (n=3) and supply reduction (n=4) interventions, and targeted treatment interventions for individuals addicted to gambling, such as therapeutic (n=12), pharmacological (n=5), and self-help or mutual support (n=4) interventions. We also reviewed studies (n=2) comparing these approaches. Interventions to screen, identify, and support individuals at risk of gambling-related harms and interventions to support ongoing recovery and prevent relapse for individuals with a gambling addiction were not represented in the review-level evidence. A public health approach suggests that there are opportunities to reduce gambling-related harms by intervening across the whole gambling pathway, from regulation of access to gambling to screening for individuals at risk and services for individuals with an identified gambling problem. The dearth of evidence for some interventions means that implementation must be accompanied by robust evaluation.
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Affiliation(s)
- Lindsay Blank
- School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Susan Baxter
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Helen Buckley Woods
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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19
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Håkansson A, Widinghoff C. Gender Differences in Problem Gamblers in an Online Gambling Setting. Psychol Res Behav Manag 2020; 13:681-691. [PMID: 32884371 PMCID: PMC7443450 DOI: 10.2147/prbm.s248540] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/18/2020] [Indexed: 12/19/2022] Open
Abstract
Background Problem gambling traditionally is markedly more common in men than in women. However, recent data in online gamblers have indicated at least a comparable risk of problem gambling in women in this sub-group. The present study aimed to compare the characteristics of male and female moderate-risk and problem gamblers in online gamblers in Sweden. Methods In a web survey addressing online gamblers (past-year online gambling on 10 or more occasions), women and men with moderate-risk or problem gambling (n=327) were compared with respect to gambling severity, financial consequences, comorbidity, socio-demographic characteristics, and fulfilled screening items. Results Female gender was associated with psychological distress, over-indebtedness, higher problem gambling severity and with screening items indicating financial consequences and guilt, with no gender difference for the self-reported need to seek treatment for substance use problems. In the sub-group of problem gamblers, female gender remained associated with psychological distress. Conclusion In a setting displaying high rates of online gambling and novel findings of a higher risk of problem gambling in women than previously seen, psychological distress appears to separate female and male problem gamblers. Given the higher level of severity and financial consequence, these findings call for screening and early intervention in female at-risk gamblers.
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Affiliation(s)
- Anders Håkansson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden.,Malmö Addiction Center, Region Skåne, Malmö, Sweden
| | - Carolina Widinghoff
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden.,Malmö Addiction Center, Region Skåne, Malmö, Sweden
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20
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de Abreu MS, C V V Giacomini A, Genario R, Fontana BD, Parker MO, Marcon L, Scolari N, Bueno B, Demin KA, Galstyan D, Kolesnikova TO, Amstislavskaya TG, Zabegalov KN, Strekalova T, Kalueff AV. Zebrafish models of impulsivity and impulse control disorders. Eur J Neurosci 2020; 52:4233-4248. [PMID: 32619029 DOI: 10.1111/ejn.14893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/25/2020] [Accepted: 06/18/2020] [Indexed: 12/22/2022]
Abstract
Impulse control disorders (ICDs) are characterized by generalized difficulty controlling emotions and behaviors. ICDs are a broad group of the central nervous system (CNS) disorders including conduct disorder, intermittent explosive, oppositional-defiant disorder, antisocial personality disorder, kleptomania, pyromania and other illnesses. Although they all share a common feature (aberrant impulsivity), their pathobiology is complex and poorly understood. There are also currently no ICD-specific therapies to treat these illnesses. Animal models are a valuable tool for studying ICD pathobiology and potential therapies. The zebrafish (Danio rerio) has become a useful model organism to study CNS disorders due to high genetic and physiological homology to mammals, and sensitivity to various pharmacological and genetic manipulations. Here, we summarize experimental models of impulsivity and ICD in zebrafish and highlight their growing translational significance. We also emphasize the need for further development of zebrafish ICD models to improve our understanding of their pathogenesis and to search for novel therapeutic treatments.
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Affiliation(s)
- Murilo S de Abreu
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil.,The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA
| | - Ana C V V Giacomini
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil.,Postgraduate Program in Environmental Sciences, University of Passo Fundo, Passo Fundo, Brazil
| | - Rafael Genario
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Barbara D Fontana
- Brain and Behaviour Laboratory, School of Pharmacy and Biomedical Sciences, University of Portsmouth, UK
| | - Matthew O Parker
- Brain and Behaviour Laboratory, School of Pharmacy and Biomedical Sciences, University of Portsmouth, UK
| | - Leticia Marcon
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Naiara Scolari
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Barbara Bueno
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Konstantin A Demin
- Institute of Experimental Medicine, Almazov National Medical Research Center, Ministry of Healthcare of Russian Federation, St. Petersburg, Russia.,Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - David Galstyan
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Tatyana O Kolesnikova
- Institute of Experimental Medicine, Almazov National Medical Research Center, Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
| | | | | | - Tatyana Strekalova
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.,Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany.,Institute of General Pathology and Pathophysiology, University of Würzburg, Moscow, Russia
| | - Allan V Kalueff
- School of Pharmacy, Southwest University, Chongqing, China.,Laboratory of Petrochemistry, Ural Federal University, Ekaterinburg, Russia
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21
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Grant JE, Chamberlain SR. Gambling and substance use: Comorbidity and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109852. [PMID: 31881248 DOI: 10.1016/j.pnpbp.2019.109852] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/12/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
Gambling disorder is a common condition that was previously listed as an impulse control disorder, but is now considered a substance-related and addictive disorder. Gambling disorder has been associated with various untoward long-term outcomes including impaired quality of life, relationship break-ups, debt and mortgage foreclosure, and elevated risk of suicidality. This paper provides a concise primer on gambling disorder, with a special focus on its parallels with substance use disorders. We consider clinical presentations, comorbid expression, heritability, and treatment approaches (psychological and pharmacological). Lastly, we highlight new treatment directions suggested by the literature.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge; & Cambridge and Peterborough NHS Foundation Trust (CPFT), UK
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22
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Effect of a web-based relapse prevention program on abstinence among Japanese drug users: A pilot randomized controlled trial. J Subst Abuse Treat 2020; 111:37-46. [DOI: 10.1016/j.jsat.2019.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/08/2019] [Accepted: 12/03/2019] [Indexed: 12/22/2022]
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23
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Abstract
Neuropharmacological interventions in preclinical translational models of impulsivity have tremendously contributed to a better understanding of the neurochemistry and neural basis of impulsive behaviour. In this regard, much progress has been made over the last years, also due to the introduction of novel techniques in behavioural neuroscience such as optogenetics and chemogenetics. In this chapter, we will provide an update of how the behavioural pharmacology field has progressed and built upon existing data since an earlier review we wrote in 2008. To this aim, we will first give a brief background on preclinical translational models of impulsivity. Next, recent interesting evidence of monoaminergic modulation of impulsivity will be highlighted with a focus on the neurotransmitters dopamine and noradrenaline. Finally, we will close the chapter by discussing some novel directions and drug leads in the neuropharmacological modulation of impulsivity.
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Affiliation(s)
- Tommy Pattij
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam University Medical Centers, VU University Medical Center, Amsterdam, The Netherlands.
| | - Louk J M J Vanderschuren
- Division of Behavioural Neuroscience, Department of Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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