Tavares Hermano
Gambling Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil.
Addiction. 2014 Dec;109(12):1972-6. doi: 10.1111/add.12560. Epub 2014 May 23.
To provide an overview of gambling in Brazil, including historical background, past and current legislation, gamblers' profile, treatment and research initiatives.
Review of the published literature and research reports.
Gambling is deeply rooted in Brazilian history and culture, but gambling regulation historically alternates between legalization and banning. Currently, only state lotteries, horse betting and poker-playing are allowed. There is pressure to widen the games repertoire, but efforts at full legalization and commercial exploration of gambling have receded. Despite the barriers to gambling access, Brazil has prevalence rates similar to other countries: 1.0 and 1.3% life-time prevalence for pathological and problem gambling. A faster progression from regular to problem gambling was found among middle-aged women in clinical samples and for adolescent male gamblers in a population-based sample. Youth gambling is associated with severe forms of gambling and other risk-taking behaviours. Treatment options are scarce, and the public health system is unprepared to support gambling patients. Ongoing incipient efforts are being made to establish a treatment model combining psychotherapy and psychiatric comorbidity treatment with promotion of quality of life.
Life-time incidence of pathological gambling in Brazil appears similar to many other countries, at approximately 1%. Arguably, there is a need to develop a more coherent regulatory and treatment response to this societal problem.
概述巴西的赌博情况，包括历史背景、过去和当前的立法、赌徒概况、治疗及研究举措。
查阅已发表的文献和研究报告。
赌博在巴西历史和文化中根深蒂固，但赌博监管在历史上在合法化和禁令之间交替。目前，仅允许州彩票、赛马博彩和扑克游戏。存在扩大博彩种类的压力，但全面合法化和商业性开发赌博的努力已减弱。尽管存在赌博获取方面的障碍，但巴西的患病率与其他国家相似：病态赌博和问题赌博的终身患病率分别为1.0%和1.3%。在临床样本中的中年女性以及基于人群样本中的青少年男性赌徒中，发现从常规赌博到问题赌博的进展更快。青少年赌博与严重形式的赌博及其他冒险行为相关。治疗选择稀缺，公共卫生系统未准备好支持赌博患者。目前正在初步努力建立一种将心理治疗和精神共病治疗与促进生活质量相结合的治疗模式。
巴西病态赌博的终身发病率与许多其他国家相似，约为1%。可以说，有必要针对这一社会问题制定更连贯的监管和治疗应对措施。
