Division of Health Research, Faculty of Health & Medicine, Lancaster University, United Kingdom; Centre for Gambling Research, ANU College of Arts and Social Sciences, School of Sociology, the Australian National University, Australia.
J Subst Abuse Treat. 2014 Feb;46(2):98-105. doi: 10.1016/j.jsat.2013.08.019. Epub 2013 Sep 24.
Pathological and problem gambling refer to a class of disorders, including those meeting criteria for a psychiatric diagnosis (i.e., pathological gambling), and others comprising a spectrum of severity defined by significant personal and social harm (i.e., problem gambling), that may be common in substance use treatment but are frequently unrecognized. This paper presents a systematic review and meta-analysis of available evidence indicating the prevalence of such gambling disorders in substance use treatment. It provides weighted mean estimates from across studies of clinical samples of substance users, and suggests around 14% of patients that demonstrate comorbid pathological gambling. Around 23% suffer conditions along the broader spectrum of problem gambling. The review also highlights important limitations of existing evidence, including scant data on current versus lifetime comorbidity, as well as reliance on convenience samples and self-administered measures of gambling problems. Notwithstanding a concomitant need for caution when applying these results, the findings suggest a strong need to identify and manage gambling comorbidity in substance use treatment. Strategies for identification of gambling disorders, and therapies that may provide useful adjunctive interventions in substance use treatment are discussed.
病理性赌博和问题赌博属于一类障碍，包括符合精神科诊断标准的障碍（即病理性赌博），以及由严重程度不同的个人和社会伤害定义的一系列障碍（即问题赌博），这些障碍在物质使用治疗中可能很常见，但通常未被识别。本文对现有证据进行了系统回顾和荟萃分析，这些证据表明物质使用治疗中存在此类赌博障碍。它提供了来自物质使用者临床样本研究的加权平均估计值，并表明约有 14%的患者同时存在病理性赌博。大约 23%的患者患有更广泛的问题赌博疾病。该综述还强调了现有证据的重要局限性，包括关于当前和终生共病的稀缺数据，以及对方便样本和自我报告赌博问题的依赖。尽管在应用这些结果时需要谨慎，但这些发现表明在物质使用治疗中识别和管理赌博共病的强烈需求。讨论了用于识别赌博障碍的策略，以及可能为物质使用治疗提供有用辅助干预的疗法。
