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We assess how video lottery terminal (VLT) operators' self-perceive their ability to recognize a problem gambler, to what extent they are approached by problem gamblers seeking for assistance, how many detections and interventions they report, and the reasons they give for not intervening with clients who show signs of problem gambling. We also examine how these variables are related to the operators' gender and status in the establishment. 177 VLT operators anonymously completed a structured questionnaire at the beginning of a responsible gambling training class held in different French-speaking Swiss towns. The operators felt confident in their ability to detect problem gambling behaviors, were rarely approached by problem gamblers seeking assistance, and reported fewer interventions compared to the number of detections. This reluctance to intervene was mainly attributed to the fear of potential negative reactions from the client. Female staff were the most reluctant to intervene and the most fearful of potential negative reactions from the client. Responsible gambling training programs should include coping strategies for dealing with potential negative reactions from clients. Our findings suggest that staff gender and status are two individual characteristics that should be taken into account when planning responsible gambling trainings.

The aim of this study is to test the hypothesis that coadjuvant treatment with SSRI and topiramate would improve the outcome of patients with comorbid OCD and impulsive behaviour disorders. Methods: We will describe two clinical cases admitted to our Psychiatric Hospitalization Unit. Case 1 is a 39 years old female diagnosed with OCD, borderline personality disorder and alcohol dependence and case 2 is a 38 years old male with OCD, mixed personality disorder and cocaine abuse. Results: Treatment with topiramate (range dosage: 250-400 mg/ daily) as well as SSRI (paroxetine 40 mg/daily-case 1; sertraline 200 mg/daily-case 2) improved affective instability and impulsive symptoms in both patients. Topiramate was well tolerated without important side effects. Conclusions: Topiramate could be an interesting alternative in the coadjuvant treatment of OCD with impulsive features.

Background and Aims:Gender differences have been reported among pathological gamblers populations. These differences concern variables such as type of gambling (men are more likely engaged in “strategic gambling” whereas women prefer “non-strategic” gambling), evolution of the gambling problem (faster progression for women) and suicidal behaviours (more attempted suicide by women).The aim of the present study is to investigate the relationship between gender and clinical status in a Swiss sample of treatment seeking pathological gamblers.Method:Prospective descriptive study of 260 new outpatients entering treatment between October 1999 and October 2007 at the Center for Excessive Gambling Studies, Lausanne, Switzerland. Data are issued from standardised medical records. Gender differences were examined (Chi-squares and ANOVAs) on interval between first gambling behaviours and first specialized treatment, interval between pathological gambling onset and first specialized treatment, purpose of consulting, type of gambling (« strategic gambling » vs « nonstrategic gambling ») and suicidality.Results and Discussion:In line with international findings, gender differences were observed on type of gambling, suicidality and interval between pathological gambling onset and first specialized treatment. A tendency emerged on interval between first gambling behaviours and first specialized treatment. As a new finding, we observed a difference on the purpose of consulting, with emotional crisis more reported by women whereas men are more likely to report familial crisis. Gender seems to be relevant in the context of pathological gambling and should be integrated in prevention and clinical strategies.

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