Medeiros Gustavo C, Redden Sarah A, Chamberlain Samuel R, Grant Jon E
1 Department of Psychiatry and Behavioral Neuroscience, The University of Chicago , Chicago, IL, USA.
2 Department of Psychiatry, University of Cambridge , Cambridge, UK.
J Behav Addict. 2017 Jun 1;6(2):194-202. doi: 10.1556/2006.6.2017.029. Epub 2017 May 31.
Background and aims Gambling disorder (GD) may have its onset in a wide range of ages, from adolescents to old adults. In addition, individuals with GD tend to seek treatment at different moments in their lives. As a result of these characteristics (variable age at onset and variable age at treatment seeking), we find subjects with diverse duration of illness (DOI) in clinical practice. DOI is an important but relatively understudied factor in GD. Our objective was to investigate clinical and neurocognitive characteristics associated with different DOI. Methods This study evaluated 448 adults diagnosed with GD. All assessments were completed prior to treatments being commenced. Results Our main results were: (a) there is a negative correlation between DOI and lag between first gambling and onset of GD; (b) lifetime history of alcohol use disorder (AUD) is associated with a longer duration of GD; (c) the presence of a first-degree relative with history of AUD is associated with a more extended course of GD; and (d) there is a negative correlation between DOI and quality of life. Discussion This study suggests that some important variables are associated with different DOI. Increasing treatment-seeking behavior, providing customized psychological interventions, and effectively managing AUD may decrease the high levels of chronicity in GD. Furthermore, research on GD such as phenomenological studies and clinical trials may consider the duration of GD in their methodology. DOI might be an important variable when analyzing treatment outcome and avoiding confounders.
背景与目的
赌博障碍(GD)可能在从青少年到老年人的广泛年龄范围内发病。此外,患有GD的个体倾向于在其生命中的不同时刻寻求治疗。由于这些特征(发病年龄可变以及寻求治疗的年龄可变),我们在临床实践中发现了病程长短各异的患者。病程是GD中一个重要但相对研究不足的因素。我们的目的是研究与不同病程相关的临床和神经认知特征。
方法
本研究评估了448名被诊断为GD的成年人。所有评估均在开始治疗前完成。
结果
(a)病程与首次赌博和GD发病之间的间隔呈负相关;(b)酒精使用障碍(AUD)的终生史与GD的较长病程相关;(c)有AUD病史的一级亲属与GD的更长病程相关;(d)病程与生活质量呈负相关。
讨论
本研究表明,一些重要变量与不同的病程相关。增加寻求治疗行为、提供定制化心理干预以及有效管理AUD可能会降低GD的高慢性程度。此外,诸如现象学研究和临床试验等关于GD的研究可能在其方法中考虑GD的病程。在分析治疗结果和避免混杂因素时,病程可能是一个重要变量。