These findings suggest that health care professionals can acquire skills in trauma inquiry and response from short trainings, which may enhance systematic assessment of traumatic events. (PsycINFO Database Record

Background: The risk of developing a problem gambling behavior is distributed unequally among the population. For example, individuals who report stressful life events, show impairments of mental health or belong to a socio-economically deprived group are affected more frequently by gambling problems. The aim of our study is to investigate whether these risk factors are equally relevant for all gambling groups (social = 0 DSM-5 criteria, at risk = 1 DSM-5 criterion, problem = 2–3 DSM-5 criteria, disordered = 4–9 DSM-5 criteria).Methods: Of a total of 10,000 participants in the representative gambling survey in Austria in 2015, 4,082 individuals reported gambling during the last 12 months and were allocated to the four gambling groups according to DSM-5. With social gamblers as the reference group, relevant risk factors for the other three groups were identified by means of bi- and multivariate multinomial logistic regression.Results: Significant risk factors for gambling disorder are at-risk alcohol use (OR = 4.9), poor mental health (OR = 5.9), young age (≤26 years, OR = 2.1), a low level of formal education (OR = 2.4), having grown up with a single parent (OR = 2.5), parents with addiction problems (OR = 2.3) and belonging to the working class (OR = 2.9). Risk factors for problem gambling are parents with addiction problems (OR = 3.8), poor mental health (OR = 2.6) and a young age (OR = 2.2). With regard to at-risk gambling, only growing up with a single parent was relevant (OR = 2.4).Conclusion: Overall, the results of this study suggest, that the number and the influence of the included risk factors differ between gambling problem groups. Apparently, the development of severe gambling problems is to a lesser extent facilitated by specific risk factors than by their cumulative presence. Therefore, future prevention and treatment measures should place a particular focus on individuals who have experienced growing up in a difficult family situation, have poor mental health, suffer from substance-related problems or have a low level of formal education.

Schl ü sselw ö rter᭹ ᭤ Gl ü cksspiel ᭹ ᭤ Gl ü cksspielprobleme ᭹ ᭤ pathologisches Gl ü cksspielverhalten Fragestellung: Es werden die Ergebnisse einer repr ä sentativen Befragung zum Gl ü cksspielverhalten der in Deutschland lebenden Bev ö lkerung dargestellt. Methodik: Die Datenerhebung fand vom 17.11. bis zum 5.12.2006 statt und erfolgte mittels einer Telefon-und Onlinebefragung. Die ungewichtete Stichprobe umfasst 7.980 zuf ä llig ausgew ä hlte Personen (Telefonsample: N = 3.999; Onlinesample: N = 3.981) im Alter von 18 bis 65 Jahren. Ergebnisse: Im Laufe des zur ü ckliegenden Jahres hatten 39,2 % aller Befragten mindestens einmal an einem Gl ü cksspiel teilgenommen. Lotto spielte genau ein Drittel der Gesamtstichprobe. Es folgen Rubbellose (11,6 % ), Gl ü cksspirale (6,4 % ), Klassenlotterie und Sportwetten (jeweils 4,5 % ), Gl ü cksspiel-und Geldautomaten (3,4 % ) und Casinospiele (2,7 % ). Bezogen auf die gesamte Stichprobe sind 0,64 % von einem problematischen und 0,56 % von einem pathologischen Spielverhalten betroffen. Besonders hohe Anteile pathologischer Spieler weisen die Gruppen der Automatenspieler (8,7 % ), Pferdewetter (6,7 % ) und Casinospieler (5,2 % ) auf. Des Weiteren sind insbesondere Befragte mit multipler Gl ü cksspielteilnahme, m ä nnliche und junge Gl ü cksspieler sowie Personen, deren Angeh ö rige selbst ein Spielproblem aufweisen, ü berdurchschnittlich h ä ufi g von einem pathologischen Gl ü cksspielverhalten betroffen. Schlussfolgerungen: Pr ä vention-und Hilfema ß nahmen im Gl ü cksspielbereich sollten sich insbesondere an die oben genannten Risikogruppen richten. Der Zugang zu Gl ü cksspielen mit hohem Suchtpotenzial, insbesondere den Geld-und Gl ü cksspielautomaten, sollte erschwert werden. Abstract & Objective: This article presents the results of a nationwide representative survey on gambling in Germany. Methods: Data collection took place in November and December 2006 and was carried out via telephone or online questionnaire. 7.980 randomized selected persons (telephone sample: N = 3.999; online sample: N = 3.981) between 18 to 65 years completed the questionnaire. Problematic and pathological gambling was assessed according to DSM-IV.Results: 39 % of all respondents gambled at least once within the last year. Lotto was played by exactly one third of the sample. One out of eight respondents bought scratch cards (11.6 % ). Lower percentages were found for other lotteries such as " Gl ü cksspirale " (6.4 % ) or " Klassenlotterie " (4.5 % ), sports betting (4.5 % ), slot machines (3.4 % ) und casino games (2.7 % ). Among all respondents this survey found 0.64 % with signs of problematic gambling and another 0.56 % with pathological gambling. High proportions of pathological gamblers were found among respondents using slot machines (8.7 % ), horse races (6.7 % ) and casino games (5.2 % ). Moreover we found greater gambling problems especially for men, young adults, respondents with gambling problems within their family and for persons with multiple gambling activities. Conclusions: P...

The analytical method used in this study is an innovative epidemiological approach to evaluate person-related register data over the course of several years. Establishing a monitoring system of prescription drugs with potential for dependence may allow for a quicker identification of trends and initiation of appropriate measures.

esides their intended effects, medicines often have unwanted side effects, including the development of prescription drug misuse, potentially leading to dependence. In Germany, an estimated 1.4 to 2.6 million people are dependent on prescription drugs (1-3), primarily sleeping drugs and tranquilizers (benzodiazepines [BZD] or Z-drugs [ZD]) or opioid analgesics (OA). According to a study by Buth et al. (4), 5.1% of the German population were taking BZD (including tetrazepam) and a further 1.1% one of the socalled Z-drugs in 2010. These rates were significantly higher among female patients and especially the elderly. Based on a 3-year period (2006 to 2008), 16.7% of patients who were prescribed BZD and/or ZD were found to show a problematic pattern of use (5). The majority were elderly patients taking the drugs in low doses over very long periods of time. This so-called low-dose dependence can have significant adverse effects on the health of these patients; for instance, it often leads to fractures (6, 7), pneumonia (8), or dementia (9). OA are indispensable for the treatment of severe pain and in palliative care. However, there is a risk of patients developing opioid dependence (10). In the United States and Canada, physicians have prescribed OA in large quantities over prolonged periods of time for less severe or temporary pain. Many patients developed OA dependence and later switched to more potent analgesics or to heroin (11). Similarly, the amounts of OA prescribed in Germany increased by 21% between 2007 and 2016 (12). According to a study by Schubert et al. (13), 4.5% of all patients covered by statutory health insurance (Gesetzliche Krankenversicherung, GKV) received an OA (excluding codeine-containing preparations) in 2010. Ten years earlier, the prevalence had been only 3.3% (13). Even though, apart from cancer care, there are few indications for the longterm prescription of OA (14, 15), prolonged treatment with these drugs is common (13, 16). The aim of this paper is to describe trends in the prescription of BZD, ZD, and OA among the GKVinsured population during the years 2006 to 2016-by sex and age-and to investigate how frequently whole-year prescriptions for these medications were issued.