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Objective: Gambling disorder is the new term for “pathological gambling” in the DSM-5. It is an emerging mental health concern with easier access and increasing opportunities via internet lately. However, treatment seeking is low and data the in Turkish population are limited to a single study. Therefore, we assessed sociodemographic and clinical features in a treatment-seeking male population.
Methods: Charts of patients presenting with gambling disorder to the addiction unit of Istanbul University between 2000 and 2014 were reviewed. Manic or psychotic patients were excluded.
Results: Forty-one patients had presented primarily due to compulsive gambling. 70% (n=29) of the sample were married, 85% (n=35) were employed. Mean age at admission was 38.9±9.11 (min=18, max=61). Mean duration of compulsive gambling was 8 years. Sixtythree percent of the patients were self-motivated for therapy while others came due to family pressure. 58.5 % (n=24) of the sample had histories of unsuccessful attempts to quit gambling. The gambling types were as follows: 48% horse races, 48% football bet, 4.9% stock exchange, 34.1% card games, 24.4% dice games, 19.7% online bet sites. Frequency of gambling behaviors were as follows: 61% every day, 34% three times a week, 2.4% once a week, 2.4% less than four times in a month in the last month before admission. Mean followup duration in our unit was 3.9 months (min=one visit, max=48 months). 51% (n=21) had major depressive disorder at admission. 43.9% (n=18) had thoughts about death. 9.8% (n=4) reported a history of suicide attempt. 5% (n=2) were hospitalized at first admission due to active suicidal ideation. 27% of the sample had reported alcohol, 12% had cannabis, 7% had designer drugs, 2.4% had cocaine, and 2.4% had heroine abuse. During follow-up 28.9% of the sample stopped gambling and 10.5% had reduced gambling frequency. Patients that were hospitalized had higher follow-up duration. Self-motivated patients had higher depression rates, ideation of dying rates and higher follow-up duration.
Conclusion: The main finding is the high early drop-out rate of the patients with gambling disorder despite treatment seeking behavior. Another finding was the long interval of compulsive gambling without treatment seeking. Notably, none of the efforts to quit gambling was made during psychiatric follow-up. Stigma and lack of knowledge may explain these situations. Besides, depression and suicidality seems to be an important factor for treatment seeking. Gambling should be assessed and targeted specifically in depressive patients. To conclude, new treatment models are urgently needed to increase admission and attendance to treatment and studies to be conducted in the general population or risky populations are required.