Inpatient Treatment for Pathological Gamblers in Germany: Setting, Utilization, and Structure

Abstract

In Germany, there are two different approaches to inpatient treatment of pathological gambling (PG): Facilities focusing on addiction or on psychosomatic illness. However, little is known about how these differences influence utilization and structure of treatment. Therefore, in our study, we analyzed all known German gambling inpatient treatment centers concerning patients' sex, age and number of comorbid disorders and evaluated an expert assessment of the treatment system, access to treatment, and structure characteristics of inpatient treatment facilities. In 2011, 2,229 pathological gamblers were treated. This amounts to 1 % of all past-year pathological gamblers. 90 % of the patients were men, 93 % had at least one comorbid disorder. Access to treatment was mostly gained via psychosocial counseling centers, but was not readily available. Facilities with addiction departments treated less pathological gamblers per year (29.3 gamblers) than facilities with psychosomatic departments (53.3 gamblers) or with both departments (76.4 gamblers). Treatment duration was significantly longer in addiction departments treating PG as secondary diagnosis only, with a low rate of gamblers on all patients, or treating few gamblers. Some facilities specialized on PG and treated more gamblers, had a higher rate of gamblers on all patients, and offered specific treatment programs. The impact of this specialization on treatment outcome is still unclear. Although treatment numbers have risen steadily for the past years, only a small fraction of affected gamblers seek inpatient treatment. Therefore, awareness to the disease and access to treatment needs to be improved.

Differences in problem and pathological gambling: A narrative review considering sex and gender

“… Echeburúa et al (2011) , Harries, Redden, and Grant (2018) , and Kushnir, Godinho, Hodgins, Hendershot, and Cunningham (2016) found no differences between men and women with PrG and PG regarding dropout rates and general rate of treatment seeking. In contrast to these studies, a German study on the outpatient sector by Braun, Ludwig, Sleczka, Bühringer, and Kraus (2014) identified lower chances of being in treatment for women, which is consistent with another German study on inpatient treatment for gamblers ( Buchner et al, 2015 ). Furthermore, studies that dealt with the use of telephone gambling hotlines reported significantly more use of subsequent treatment services among men than among women, which was also apparent for adolescents ( Aster, Quack, Wejbera, & Beutel, 2018 ; Kim et al, 2016 ).…”

Toward a more nuanced understanding of the statistical properties of a median split

“…In still other arenas, median splits were used to study the effectiveness of inpatient treatments for pathological gamblers in Germany (Buchner et al, 2014), condom use among men being treated for sexually transmitted diseases (Crosby & Charnigo, 2013), the effect of friendships vs. isolation on patients' perceptions of lower back pain and quality of life (Hawthorne, de Morton, & Kent, 2013), gesture sequences in chimpanzees (McCarthy, Jensvold, & Fouts, 2013), effective measurement of ability and achievement in football, golf, hockey, and other sports (Robertson, Burnett, & Cochrane, 2014), the effect of time and previous injuries to concussion recoveries (Silverberg et al, 2013), cocaine‐induced motor responses in rats (Yamamoto et al, 2013), and the effects of visual stimuli on reaction times and electrophysiological brain activity (Wiebel, Valsecchi, & Gegenfurtner, 2014). In top finance journals, researchers have used median splits to study countries' debt levels and asset values (Kalteier & Posch, 2013), and the effect of venture capital on subsequent corporate financial performance (Hsu, 2013).…”

An Ecological Approach to Electronic Gambling Machines and Socioeconomic Deprivation in Germany

“…All of the above-mentioned measures have increased public awareness of gambling and produced a profound effect on treatment-seeking rates. In response, some federal states have started to finance specialized counseling centers for pathological gamblers (Buchner et al, 2015).…”