AVENTURA, FLA. – People with unrecognized gambling disorders may present with depression, anxiety, substance abuse, or other psychiatric symptoms, and screening patients with these symptoms can help make this connection, Dr. Timothy Fong said during a workshop at the annual meeting of the American Academy of Addiction Psychiatry.
Screening tools are essential in helping identify patients with a gambling disorder or subthreshold disorder, who typically do not bring up these problems with their physicians and often suffer in private, said Dr. Fong, a psychiatrist at the University of California, Los Angeles, and codirector of the UCLA Gambling Studies Program.
©fergregory/thinkstockphotos.com
“By the time I see them, the screening has already happened; they have self-identified as having a problem,” he pointed out. “But when they’re coming to see the general psychiatrist,” problems like depression, difficulty sleeping, or problems with a spouse or family, “are the chief complaints, it’s not ‘I have a gambling problem.’ ”
Screening can help identify patients before they develop a full-blown gambling disorder, at an earlier stage, when it is simpler to treat and interventions are more effective “and you can prevent the progression to a more severe disorder,” he noted.
Another sign someone might have a gambling problem is failure to respond to medication, an indication that problem gambling “may be a hidden addiction that is driving the stress [or] depression,” Dr. Fong said, citing a patient with depression who does not respond to courses of selective serotonin reuptake inhibitors or other categories of antidepressants as an example.
During a workshop on gambling disorders held during the meeting, Dr. Fong and Dr. Iman Parhami, who is affiliated with the Delaware Division of Substance Abuse and Mental Health, New Castle, Del., referred to one such resource, a brief three-question screening tool available on the National Center for Responsible Gaming website.