Schizophrenia symptom severity and motivations for gambling in individuals with schizophrenia or schizoaffective disorder

Disordered gambling among people with psychotic disorders: a systematic review

Disorders of gambling are more common among the mentally ill, including in people with psychotic disorders. The aim of this study was to conduct a systematic review of the literature regarding the prevalence and correlates of gambling disorders in people with psychotic disorders. We systematically reviewed English-language literature through searches of six bibliographic databases, all run on 11 November 2022: Medline ALL, Embase, Emcare, APA PsycINFO, CINAHL and the Cochrane Library. Observational studies that reported the prevalence of gambling in psychotic disorders or psychosis among gamblers were included. Studies were critically appraised using the Joanna Briggs Institute Critical Appraisal Tools. Sixteen studies, including 1,116,103 participants, from across a range of settings, were included. Most studies were done on males and recruited participants with a mean age of 40 years. Most of the studies (n = 12) were cross-sectional, and the remaining were case control in design. Most of the studies rated fair in quality. The prevalence of gambling among psychotic population ranged from 0.32 to 19.3%, with the majority of the studies reporting rates between 6.4 and 17%. The rates were 5-25 times higher than in the general population. While there were no consistent associations found with socio-demographic indices, several studies reported an association between gambling behaviours and substance use disorder among those with psychotic illnesses. Our research suggests that clinicians should assess for comorbid gambling among those with psychotic illness, particularly in those with mood symptoms, impulsivity, and substance use disorders. Gambling can negatively impact on their financial and social situations. Future research should study specific strategies or therapies among those with comorbid gambling and psychotic disorders.

Chronically homeless veterans with gambling disorder: Epidemiology, clinical correlates, and traumatic experiences

BACKGROUND

Gambling disorder (GD) is often a concern for people living in poverty. Although GD has been correlated with homelessness, there has been no study of factors related to chronic homelessness among veterans with GD.

METHOD

This study used data from specialized homeless programs from the U.S. Department of Veterans Affairs Homeless Operations Management System to explore prevalence and correlates of chronic homelessness among veterans with GD in this program and to describe initial descriptive epidemiology. Chi-square tests, analyses of variance, and logistic regressions were conducted to examine differences in sociodemographic, military, clinical, and behavioral characteristics between veterans with versus without chronic homelessness.

RESULT

Of 6053 veterans with GD, 1733 (28.6%) had chronic homelessness. Veterans with versus without chronic homelessness were more likely to be older, male, unemployed, and of low educational attainment and report having spent fewer years in the military. Chronic homelessness was associated with elevated odds of mental health and medical diagnoses, traumatic experiences, incarceration, and suicidal thoughts. Veterans with versus without chronic homelessness more frequently reported needing substance use, medical and psychiatric treatments but expressed low interest in participation in psychiatric treatment.

CONCLUSION

Veterans with GD and chronic homelessness have more clinical and behavioral concerns and needs for treatment, but participate in treatment at lower rates. It may be important to address both chronic homelessness and GD concurrently in order to effectively support veterans facing these challenges.

Changes in Quality of Life in Treatment-Resistant Schizophrenia Patients Undergoing Avatar Therapy: A Content Analysis

Avatar Therapy has a significant impact on symptoms, beliefs, and quality of life of patients with treatment-resistant schizophrenia. However, little is known about how these changes are implemented into their lives and to which aspects of their lives these improvements relate. Ten consecutive patients enrolled in an ongoing clinical trial were assessed using semi-guided interviews before as well as three months after Avatar Therapy. These encounters have been recorded and transcribed so that the discourse could be thoroughly analyzed, leading to the generation of an extensive theme grid. As the cases were analyzed, the grid was adapted in a back-and-forth manner until data saturation occurred. The content analysis allowed the identification of nine main themes representing different aspects of the patients’ lives, each of which was subdivided into more specific codes. By analyzing the evolution of their frequency, it was observed that, following therapy, patients presented with fewer psychotic symptoms, better self-esteem, more hobbies and projects, and an overall improved lifestyle and mood. Finally, investigating the impact of Avatar Therapy on quality of life allows for a deeper understanding of how people with treatment-resistant schizophrenia can achieve meaningful changes and move towards a certain recovery process.

Network Analysis of the Structure of the Core Symptoms and Clinical Correlates in Comorbid Schizophrenia and Gambling Disorder

Few studies have analyzed the clinical profile of treatment-seeking patients with the comorbid presence of schizophrenia (SCZ) and gambling disorder (GD), which warrants new research to assess the network structure of this complex mental condition. The aim of this study was to explore the organization of the symptoms and other clinical correlates of SCZ with GD. Network analysis was applied to a sample of N = 179 SCZ patients (age range: 19-70 years, mean=39.5, SD=9.9) who met clinical criteria for gambling disorder-related problems. Variables included in the network were the core GD symptoms according to the DSM-5, psychotic and paranoid ideation levels, global psychological distress, GD severity measures (debts and illegal behavior related with gambling), substances (tobacco, alcohol, and illegal drugs), and personality profile. The nodes with the highest authority in the network (variables of highest relevance) were personality traits and psychological distress. Four empirical modules/clusters were identified, and linkage analysis identified the nodes with the highest closeness (bridge nodes) to be novelty seeking and reward dependence (these traits facilitate the transition between the modules). Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat SCZ with GD.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-022-00983-y.

Description the Importance of Developing a Self-Reliance Instrument for Schizophrenic Patients in the Hospital Setting

Abstract Background: The level of independence among schizophrenia patients is still a problem that must be resolved. The development of appropriate relevant instruments is needed. This study aims to develop a nursing rehabilitation therapy instrument to increase the independence of schizophrenia patients in the hospital setting. Methods: This study used a research and development study design. The study was conducted in a Psychiatric Hospital in Surabaya, Indonesia from August to December 2020. The total sample in this study consisted of 100 nurses determined by a simple random sampling technique. In addition, 50 medical records were observed. The inclusion criteria were nurses who cared for patients with schizophrenia with a minimum work experience of 1 year. Respondents were excluded from the study if they did not follow the study through to completion. The data collection process was done online by filling in a Google form. The data was analysed using descriptive statistics and a FGD followed with 10 nurses to discuss the new instrument. Results: The data found that a rehabilitation therapy instrument is not currently available (53%). The FGD results show that it is necessary to develop the nurse’s knowledge and to provide adequate facilities and rooms, as well as to develop instruments to use as measuring tools in order to evaluate the rehabilitation therapy given. Conclusion: Rehabilitation therapy instruments are important to develop for schizophrenia patients. It is hoped that the development of the instrument in this study will optimise the rehabilitation of schizophrenia patients.

The prevalence and features of schizophrenia among individuals with gambling disorder

BACKGROUND-OBJECTIVES

Few studies have analyzed the comorbid presence of gambling disorder (GD) with schizophrenia, its sociodemographic correlates and clinical implications. This study estimated the prevalence of the dual diagnosis (GD with schizophrenia) and the differences in the profiles of patients with and without the dual condition.

METHOD

The sample included n = 3,754 patients consecutively accepted for treatment for GD. Sociodemographics, gambling-related variables, psychopathological state and personality traits were assessed and compared between the groups.

RESULTS

The prevalence of schizophrenia within patients who met clinical criteria for GD was 4.4% (95% confidence interval: 3.8%-5.1%). Variables related to the dual presence of GD with schizophrenia were single marital status, lower education level, inactive working status, socioeconomic disadvantage, younger age, earlier onset of gambling problems, worse global psychopathological state and more dysfunctional personality profile (higher level in harm avoidance and lower level in cooperativeness, reward dependence, persistence and self-directedness).

CONCLUSION

The presence of schizophrenia among patients with GD was around 4 times higher than the prevalence rate estimated in the reference general population. The differences in the profiles of GD patients with and without schizophrenia suggest that individuals with the dual diagnosis condition require unique assessment considerations and tailored treatment interventions specifically designed for the clinical and functioning higher risk.