RESUMO
OBJECTIVES: To analyze the comorbidity of pathological gamblers, mainly in disorders with loss of impulse-control as addictions and personality disorders (PD). Also, to discuss addictive and impulsive characteristics of pathological gambling (PG), and their implications in prognosis and treatment. MATERIAL AND METHOD: Cross-sectional study on 162 patients with PG admitted for treatment in a specific residential unit. The SCID-I and II were used for the addiction and the PD diagnosis. For the diagnosis and evaluation of PG the SOGS, AGQ III and the Gambling Severity Index were also used. RESULTS: The 61.1 % of the patients presented some PD, where the cluster B ones (impulsive group) were more frequent, followed by C and A ones. 63.3% of patients had had in their lives substance dependence criteria, where alcohol dependence was the most prevalent. The presence of PD is related to the gravity of the addiction by the dependence to more than one substance (chi2=7.15; p<0.008). DISCUSSION: TP and substance-related disorders (SRD) are frequent comorbidities of the PG. Their co-presentation could mean worse prognosis of this patients. The PG as impulsive disorder could help to the understanding of the etiopathogenia of this disorder, but also of the prognosis. This hypothesis will add to the addictive one other treatment approaches that should be included in future studies of PG.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Jogo de Azar/psicologia , Transtornos da Personalidade/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Comorbidade , Estudos Transversais , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Prevalência , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Inquéritos e QuestionáriosRESUMO
A cognitive explanation for pathological gambling (PG) posits that problem gambling behaviors are maintained by irrational beliefs and attitudes about gambling. However, it has never been shown that beliefs and attitudes about gambling are affected by treatment. This exploratory study examined the effect of a 28-day inpatient treatment program on beliefs and attitudes in pathological gamblers (PGs). The participants were 66 consecutive admissions to a Veterans Affairs inpatient program for PG. Participants completed a self-report measure of gambling-specific attitudes and beliefs at admission and again before discharge. Discharge scores indicated significant change (p < .001). The results of this study are preliminary but suggest that treatment may affect attitudes and beliefs about gambling. Controlled treatment outcome studies should include a measure of gambling attitudes and beliefs.
