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病理性赌博:与肥胖、自我报告的慢性疾病、不良生活方式选择和生活质量受损的关系。

Pathological gambling: relationship to obesity, self-reported chronic medical conditions, poor lifestyle choices, and impaired quality of life.

机构信息

Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA 52242, USA.

出版信息

Compr Psychiatry. 2013 Feb;54(2):97-104. doi: 10.1016/j.comppsych.2012.07.001. Epub 2012 Aug 28.

Abstract

BACKGROUND

Pathological gambling (PG) is an important public health problem that is prevalent, costly to society, and associated with substance misuse, depression, domestic violence, crime, and suicide. Despite these challenges, little is known about the physical health and medical correlates of PG. The goal of this project was to assess self-reported chronic medical conditions, medication usage, lifestyle choices, health care utilization, quality of life variables, and body mass index (BMI) in persons with and without PG.

METHODS

Subjects with PG and community controls were systematically assessed for their medical health, lifestyle choices, medication usage, and health care utilization. We administered the Medical Outcome Study Short-Form 36 Health Survey to assess perceived health and quality of life. BMI was calculated for all subjects. Obesity was defined as having a BMI≥30kg/m(2).

RESULTS

We compared 95 subjects with DSM-IV PG (South Oaks Gambling Screen [SOGS] score≥5) and 91 control subjects without PG (SOGS≤2) selected through random digit dialing from the general community. PG subjects and controls were similar in age and gender. Persons with PG had more medical and mental health conditions than controls, and were more likely to avoid regular exercise, smoke≥1 pack/day, drink≥5 servings of caffeine daily, and watch television≥20hours/week. They had more emergency department visits for physical and mental health conditions, were more likely to have been psychiatrically hospitalized in the past year, and were more likely to take psychotropic medication. They were less likely to have had regular dental visits and were more likely to put off medical care due to financial problems. Severity of gambling was positively correlated with number of medical conditions. Persons with PG had poorer self-reported health perceptions on all but one SF-36 subscale. Importantly, persons with PG had a higher BMI than controls and were more likely to be obese.

CONCLUSIONS

PG is associated with obesity, chronic medical conditions, poor lifestyle choices, worse quality of life, and the use of costly forms of medical care. Pathological gamblers are less likely to receive regular dental care and are more likely to be unable to pay for medical care. The implications of the findings are discussed.

摘要

背景

病理性赌博(PG)是一个重要的公共卫生问题,它普遍存在、给社会带来沉重负担,并与物质滥用、抑郁、家庭暴力、犯罪和自杀有关。尽管存在这些挑战,但人们对 PG 的身体健康和医学相关性知之甚少。本项目的目标是评估有和没有 PG 的人群的自我报告的慢性疾病、药物使用、生活方式选择、医疗保健利用、生活质量变量和体重指数(BMI)。

方法

对有 PG 和社区对照的受试者进行系统评估,评估其身体健康、生活方式选择、药物使用和医疗保健利用情况。我们使用医疗结局研究短式 36 健康调查(Medical Outcome Study Short-Form 36 Health Survey)评估感知健康和生活质量。对所有受试者计算 BMI。肥胖定义为 BMI≥30kg/m2。

结果

我们比较了 95 名符合 DSM-IV PG(South Oaks Gambling Screen [SOGS] 得分≥5)标准的受试者和 91 名没有 PG(SOGS≤2)的社区对照者,这些对照者是通过随机数字拨号从普通社区中选择的。PG 受试者和对照者在年龄和性别上相似。PG 患者比对照组有更多的医疗和心理健康状况,并且更有可能避免定期锻炼、每天吸烟≥1 包、每天饮用≥5 份咖啡因、每周看电视≥20 小时。他们因身体和心理健康状况而到急诊室就诊的次数更多,过去一年更有可能因精神疾病住院,并且更有可能服用精神药物。他们定期看牙医的次数较少,更有可能因经济问题而推迟医疗保健。赌博的严重程度与医疗条件的数量呈正相关。PG 患者在除一项 SF-36 子量表外的所有子量表上的自我报告健康感知都较差。重要的是,PG 患者的 BMI 高于对照组,并且更有可能肥胖。

结论

PG 与肥胖、慢性疾病、不良生活方式选择、较差的生活质量以及昂贵的医疗保健形式有关。病理性赌徒更有可能无法定期接受牙科护理,并且更有可能无力支付医疗费用。讨论了研究结果的意义。

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