Department of Psychiatry & Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK.
CNS Spectr. 2024 Feb;29(1):54-59. doi: 10.1017/S1092852923002444. Epub 2023 Sep 11.
Gambling disorder is common, affects 0.5-2% of the population, and is under-treated. Duration of untreated illness (DUI) has emerged as a clinically important concept in the context of other mental disorders, but DUI in gambling disorder, has received little research scrutiny.
Data were aggregated from previous clinical trials in gambling disorder with people who had never previously received any treatment. DUI was quantified, and clinical characteristics were compared as a function of DUI status.
A total of 298 individuals were included, and the mean DUI (standard deviation) was 8.9 (8.4) years, and the median DUI was 6 years. Longer DUI was significantly associated with male gender, older age, earlier age when the person first started to gamble, and family history of alcohol use disorder. Longer DUI was not significantly associated with racial-ethnic status, gambling symptom severity, current depressive or anxiety severity, comorbidities, or disability/functioning. The two groups did not differ in their propensity to drop out of the clinical trials, nor in overall symptom improvement associated with participation in those trials.
These data suggest that gambling disorder has a relatively long DUI and highlight the need to raise awareness and foster early intervention for affected and at-risk individuals. Because earlier age at first gambling in any form was strongly linked to longer DUI, this highlights the need for more rigorous legislation and education to reduce exposure of younger people to gambling.
赌博障碍较为常见,影响 0.5%-2%的人群,但治疗不足。在其他精神障碍的背景下,未治疗疾病持续时间(DUI)已成为一个重要的临床概念,但赌博障碍的 DUI 尚未得到充分研究。
从之前的赌博障碍临床试验中汇总了从未接受过任何治疗的患者的数据。量化 DUI,并根据 DUI 状况比较临床特征。
共纳入 298 人,平均 DUI(标准差)为 8.9(8.4)年,中位数 DUI 为 6 年。较长的 DUI 与男性、年龄较大、首次开始赌博的年龄较早以及酒精使用障碍家族史显著相关。较长的 DUI 与种族/民族地位、赌博症状严重程度、当前抑郁或焦虑严重程度、合并症或残疾/功能无关。两组在临床试验中退出的倾向或与参与这些试验相关的总体症状改善方面没有差异。
这些数据表明赌博障碍的 DUI 相对较长,强调需要提高认识并促进受影响和高危个体的早期干预。由于任何形式的首次赌博年龄较早与 DUI 较长有很强的关联,这突显了需要更严格的立法和教育,以减少年轻人接触赌博的机会。