Early Detection of Pathological Gambling: Betting on GPs’ Beliefs and Attitudes

Abstract

Pathological gambling (PG) is an addictive disorder with harm related to the high psychiatric comorbidity and increased suicidal risk. Prevalence rates in general population range from 0.2% to 2.1%. Problem gamblers are hard to attract to treatment programs for several proper reasons and for obstacles (e.g., accessibility). To address these obstacles, primary care (where the problem gambling (PrG) prevalence seems to be 6.2%) has a crucial role to play (i.e., identifying and referring patients to specialized treatment programs and treating at first line when needed and possible) in the era of online gambling offer expansion. The present work aimed to collect data on resources in the field from GPs themselves, using a 24-item online questionnaire. Swiss French-speaking participants were asked about their screening practice and knowledge. The results state that the vast majority of them are aware of the existence and the potential impact of PrG on their patients. However, PrG screening is not systematic and their knowledge of adequate treatments or referral methods is scarce. GPs being central to health screening in general, targeted advice and training on short screening tools and better knowledge of referral pathways should be promoted and continued to empower the GP's management skills in a public health approach.

Gambling and problem gambling in Switzerland

“…This explains partly why the number of peer-reviewed published papers authored by Swiss investigators to date is limited. Among studies published in the last 5 years, some have focused on the prevention, assessment and prevalence of problem offline and online gambling in the community [18,[38][39][40][41][42], while others were interested in risk factors associated with harmful gambling [43,44].…”

“Talk with me”: perspectives on services for men with problem gambling and housing instability

“…Specifically, the review found that 75 % of persons who seek treatment for problem gambling have co-morbid Axis I disorders, with the most common conditions being nicotine dependence, major depression, alcohol abuse and dependence, social phobia, generalized anxiety disorder, and post-traumatic stress disorder. Therefore, providing more education and training to service providers on the importance of screening for problem gambling, and availability of services would be helpful in optimizing referral pathways and the uptake of needed services [ 25 , 60 ].…”

Glücksspielsucht über das Internet – eine Übersicht der Situation in der Schweiz

“…Patienten mit einer Spielstörung nehmen in Studien lieber die Hilfe ihres Hausarztes an als die eines Spezialisten [49]. Viele Hausärzte wissen jedoch oft nicht, wie man eine Spielsucht diagnostiziert, welche Therapien dem Patienten angeboten werden können oder wohin sie ihn überweisen müssen [49,50]. Ein kurzer effizienter Screening-Fragebogen zur Früherkennung einer beginnenden oder etablierten Spielstörung muss für die Hausärzte noch hergestellt werden.…”

“…Diese Kurzinterventionen haben sich in Studien als hilfreich erwiesen [51]. Das Bereitstellen von E-Learning-Materialien oder "Helplines" für Hausärzte muss noch gewährleistet werden zur Unterstützung der eigenen Weiterbildung zu diesem Thema [50]. Stationäre Aufenthalte in therapeutischen Anstalten zählen zur Tertiärprävention und dienen als Rückfallprophylaxe mit transitorischem Unterbruch des Problemverhaltens [52].…”

“…Studien zeigen, dass gestörte Spieler erst ca. fünf Jahre nach dem Auftreten von Problemen eine erste professionelle Hilfe suchen [50]. Die Gründe dafür sind vielfältig und reichen von Antriebslosigkeit, Verleugnung, Glaube an Selbstheilung und Scham bis zur fehlenden Kenntnis über das Beratungsangebot.…”