Prevalence of schizophrenia spectrum and other psychotic disorders in problem gambling: A systematic review and meta-analysis.

BACKGROUND: High rates of psychiatric comorbidities have been found in people with problem gambling (PBG), including substance use, anxiety, and mood disorders. Psychotic disorders have received less attention, although this comorbidity is expected to have a significant impact on the course, consequences, and treatment of PBG. This review aimed to estimate the prevalence of psychotic disorders in PBG. METHODS: Medline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of Science, and ProQuest were searched on November 1, 2023, without language restrictions. Studies involving people with PBG and reporting the prevalence of schizophrenia spectrum and other psychotic disorders were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for systematic reviews of prevalence data. The pooled prevalence of psychotic disorders was calculated using a random effects generalized linear mixed model and presented with forest plots. RESULTS: Of 1,271 records screened, 22 studies (n = 19,131) were included. The overall prevalence of psychotic disorders was 4.9% (95% CI, 3.6-6.5%, I2 = 88%). A lower prevalence was found in surveyed/recruited populations, compared with treatment-seeking individuals and register-based studies. No differences were found for factors such as treatment setting (inpatient/outpatient), diagnoses of psychotic disorders (schizophrenia only/other psychotic disorders), and assessment time frame (current/lifetime). The majority of included studies had a moderate risk of bias. CONCLUSIONS: These findings highlight the relevance of screening problem gamblers for schizophrenia spectrum and other psychotic disorders, as well as any other comorbid mental health conditions, given the significant impact such comorbidities can have on the recovery process.

Understanding mediated sports consumption by Irish children: a qualitative study exploring their exposure and understanding of gambling marketing, risks and harms.

BACKGROUND: Gambling marketing communications create a public health risk by increasing the normalisation of gambling in sports. In a context where broad level studies report significant underage gambling, currently no evidence exists on how these communications are received by children in the Republic of Ireland (hereafter Ireland) and Northern Ireland. To build this evidence base and provide granular detail below broad level data, this study explored the sport consumption habits and views of Irish children (aged 14-17 years) on their exposure, awareness and perceptions of the relationship between sport and gambling. METHODS: Drawing on a constructivist approach to data collection, 6 face-to-face focus groups were staged with a total of 51 youth sport consumers from both sides of the border region on the island of Ireland. RESULTS: Four main themes were established. First, mediated sport consumption was predominantly via mobile social media. Second, we found that their exposure to gambling marketing was high and while frequently seen through social media channels it was also prevalent in peer-to-peer conversations and on the main street. Third, we found mixed responses on their perceptions about gambling and sport. While many felt that sport and gambling were a good fit, they were aware of the financial risks involved. Few children understood the wider social risks with gambling harm. Fourth, children were sceptical of claims made in gambling communications. These findings highlight concerns about how exposure to gambling marketing is impacting children's views on sport and on gambling. These views need to be taken into consideration when broadcasters and sport organizations are entering into commercial associations. CONCLUSIONS: Gambling marketing is noticed by children watching mass and social media, and in the towns in the border regions of the island of Ireland. Our study provides children's viewpoints on this topic which complements the larger quantitative studies in Ireland and Northern Ireland that highlight the growing prevalence of children and gambling. This study not only extends the literature on the exposure, awareness and perceptions of children on the island of Ireland but provides crucial evidence to public health advocates in this region demonstrating the pervasiveness of gambling communications in and around children's spaces.

Depression, anxiety, and stress in young adult gamers and their relationship with addictive behaviors: A latent profile analysis.

BACKGROUND: There is limited research examining latent profiles of gamers based on emotional variables, which has implications for prevention efforts. The study sought to identify young adult gamer profiles based on depression, anxiety, and stress, and to examine differences between the latent profiles in other addictive behaviors (i.e., tobacco, alcohol, cannabis, illegal substance use, gaming, and gambling). METHODS: A total of 1209 young adults (Mage = 19.37, SD = 1.62; 55.3%males) reported past-year gaming. A latent profile analysis (LPA) was performed to identify distinct profiles, and a set of ANOVA and chi-square analyses characterized the profiles in terms of sociodemographic, addictive behaviors, and emotional variables. RESULTS: LPA suggested a three-profile solution: profile 1 (n = 660, 'low emotional distress'), profile 2 (n = 377, 'moderate emotional distress'), and profile 3 (n = 172, 'high emotional distress'). Participants with 'moderate' and 'high emotional distress' were mostly women, showed greater gaming severity, higher prevalence of past-month substance use (i.e., tobacco and illegal drugs), and greater consequences of alcohol use. LIMITATIONS: The cross-sectional nature of the study and sample being university students. CONCLUSION: Findings revealed three distinct profiles of gamers, which differed in emotional, gaming, and substance use severity. Transdiagnostic prevention programs have the potential to provide significant benefits to college students by addressing the core processes (e.g., emotion regulation) that underlie substance use and gaming.

The influence of age on gambling problems worldwide: A systematic review and meta-analysis of risk among younger, middle-aged, and older adults.

Background and Aims: Problem gambling (PG) represents a significant public health concern with widespread effects in various cultures and regions globally, with younger individuals and males at a particularly higher risk. This disparity is attributed to a mix of cultural, developmental, and biological influences. To date, there has not been a comprehensive examination to determine whether this risk pattern holds consistently across different jurisdictions. Methods: We performed a systematic review and meta-analysis using the PRISMA framework, identifying 21 eligible studies from 18 countries, encompassing 156,249 participants (47.6% male and 52.4% female). Results: The studies varied considerably by region (Asia: 19%, Europe: 52%, Oceania: 19%, North America: 10%), the diagnostic criteria for PG, and participation rates in gambling (ranging from 12% to 92%). Data on PG prevalence was categorised by gender and three age groups (young: 18-35, middle: 30-55, and older: 45-65). Using a random-effects meta-analysis, we found a global PG prevalence of 1.9%. Europe reported a significantly lower prevalence (1.3%) compared to North America (5.3%). Men were found to be 3.4 times more likely than women to engage in problem gambling, although the gap narrows in North America. The young demographic showed a 1.51 times higher likelihood of reporting PG compared to the middle-aged group, whereas older adults were 0.80 times less likely to report PG. Notably, age-related effects varied significantly across regions. Conclusions: Our findings confirm that age and gender significantly influence PG risk across cultures, with significant heterogeneity observed across jurisdictions.

Unemployment as a risk factor for gambling disorder: A longitudinal study based on national registry data.

Background and aims: Unemployment rates are elevated among individuals with disordered gambling, yet the directionality of the relationship remains unclear. The present study investigated paid and unpaid unemployment as risk factors for future gambling disorder (GD). Methods: The study employed a case-control design, including all adult Norwegians receiving a GD diagnosis within specialist health services from January 2008 to December 2018 (n = 5,131). These individuals were compared with age- and sex-matched controls from the general population (n = 30,164), as well as controls with somatic and psychiatric diagnoses (n = 30,476). Results: Logistic regressions showed that those in the highest quartile of unpaid unemployment days had more than double the odds (odds ratio [OR] 2.23 (95% CI [1.96, 2.52]) of developing GD compared to those with no unpaid unemployment days. Similarly, higher levels of paid unemployment were also found to increase the odds for GD, with those in the highest quartile having an OR of 1.86 (95% CI [1.50, 2.28]) compared to those with no paid unemployment days. Moreover, an interaction analysis indicated that the association between paid unemployment days and GD was significantly stronger among men compared to women. Conclusions: The present study suggests that both paid and unpaid unemployment constitute risk factors for GD. Programs aiming at obtaining and sustaining work have been found to improve health and future studies should examine if the risk for GD can be similarly mitigated.

Statistical predictors of the co-occurrence between gambling disorder and problematic pornography use.

Co-occurrence between gambling disorder (GD) and other mental disorders is common, but its association with problematic pornography use (PPU) remains unexplored. This study aimed to investigate relationships between sociodemographic variables, personality measures, psychopathology, emotional regulation, and impulsivity and the co-occurrence of GD and PPU using structural equation modeling (SEM). The sample consisted of 359 adults seeking treatment for GD. The short version of the Problematic Pornography Consumption Scale (PPCS-6) identified patients with GD + PPU. Psychopathology, impulsivity, emotional regulation, and personality were also assessed. Higher impulsivity levels statistically predicted co-occurrence between GD and PPU. Impulsivity mediated the relationship between younger age, maladaptive personality features, and emotional dysregulation and co-occurrence. Psychopathological distress did not directly associate with GD + PPU co-occurrence. Impulsivity relates importantly to the co-occurrence of GD and PPU. Younger age, maladaptive personality, and emotional dysregulation contribute to increased impulsivity levels and co-occurrence. The findings highlight the importance of addressing impulsivity in understanding and treating co-occurring GD and PPU.

Accessibility, neighborhood socioeconomic disadvantage and expenditures on electronic gambling machines: a spatial analysis based on player account data.

BACKGROUND: Gambling and its harmful effects on human health and well-being represent a significant public health concern in many countries, with electronic gambling machines (EGMs) recognized as one of the most detrimental forms of gambling. Previous research has established an association between EGM accessibility, expenditure, gambling harm, and the socioeconomic status (SES) of neighborhoods. However, there is limited understanding of the direct impact of SES and EGM accessibility on individual player expenditures. Prior estimations of expenditure often rely on self-reported data or venue-level revenue statistics. This study uses high spatial resolution socioeconomic data together with individual-level account-based location and expenditure (point of sales) data (71,669 players, 745 EGM venues) to explore the association between EGM accessibility and neighborhood SES and to examine whether the EGM expenditure of neighborhood residents is associated with EGM accessibility and neighborhood SES. DATA AND METHODS: Player account data include information on the home location and expenditure of the entire EGM gambling population across every EGM venue located in the Helsinki region, Finland. High-resolution (250 × 250 m) grid-level data on socioeconomic variables were used to obtain the local socioeconomic conditions of the players. EGM accessibility was estimated for every grid cell using a calibrated gravity model derived from the player account data. Statistical analyses included correlation analysis, spatial autocorrelation analysis, and regression models. RESULTS: First, significantly higher levels of EGM accessibility were found in areas with lower local SES. Second, regression analysis revealed that both higher EGM accessibility and lower local SES were associated with higher annual losses per adult. These results, in combination with visual and spatial autocorrelation analyses, revealed that accessibility to EGM gambling is highly concentrated, especially in lower socioeconomic neighborhoods with higher levels of EGM expenditure. CONCLUSIONS: The results lay the groundwork for future spatial research on gambling harm, expenditure, accessibility, and SES utilizing detailed account data on the interaction between players and venues. The results underscore the importance of spatial restrictions when regulating EGM accessibility, particularly in areas with vulnerable populations, as a crucial measure for public health and harm prevention. The results also enable targeted gambling harm prevention actions at the local level.

Gambling as a precipitating factor in deaths by suicide in the National Violent Death Reporting System.

OBJECTIVES: The public health burden of gambling remains difficult to estimate, given the lack of relevant, available data. Death by suicide, represents a substantial and quantifiable public health cost. The current study reviews data from the National Violent Death Reporting System to detect cases where gambling was identified as a meaningful contextual factor to a death by suicide. STUDY DESIGN: This study is an exploratory content analysis. METHODS: We analysed narrative data from cases of death by suicide, collected from 2003 to 2020 recorded in the Restricted Access Data of the National Violent Death Reporting System. Gambling-related cases identified in our analysis were compared against all other cases on demographic characteristics, case characteristics, US state, and incident year. Chi-square tests of independence and the Wilcoxon ranked sum tests were used in bivariate comparisons. RESULTS: Overall, 1306 of 296 317 cases were classified as gambling-related. This represented 0.44% of total cases. Gambling-related classification was over-represented among those identified as Asian (7.0% vs 2.2%) and under-represented among those identified as Black or African American (4.0% vs 6.4%) compared with all other deaths by suicide. Gambling-related cases were also over-represented in cases where alcohol use was suspected (28.0% vs 21.2%), where there were significant financial problems (50.3% vs 8.6%), where there were intimate partner problems (31.5% vs 25.6%), and under-represented in cases where there was a previous mental health diagnosis (35.1% vs 38.8%). The rate of gambling-related cases in Nevada was approximately nine times greater than the rate in the overall sample (4.0% vs 0.44%). CONCLUSIONS: Administrative data can be used to study the impacts of gambling on public health in the absence of quality representative survey data. However, these sources are still likely to underestimate the public health burden of gambling with current structures and procedures. Requiring intentional collection of gambling-related information in cases of suicide would be a significant step towards better quantifying the public health burden of gambling in the United States.

The Interest in Betting, Smoking, Alcohol, and Drugs in Malawi: Changing Trends between 2012-2022.

Background: In recent years, the online gambling market has rapidly developed, and betting has become one of the most popular forms of gambling. The aim of this study was to analyse the interest of the Malawian population in terms related to betting, sports betting, alcohol, cigarettes, and some psychoactive drugs through the relative search volumes of Google Trends. Methods: Internet search query data related to betting, sports betting, alcohol, cigarettes, and psychoactive drugs were obtained monthly from Google Trends for the period 2010-2022. Comparisons of interest levels in these topics were conducted in Malawi, and correlation coefficients were calculated. Results: In Malawi, relative search volumes for betting and sports betting terms were the highest (average RSVs: 66% and 30%). It was found that from 2019 onwards, the interest in betting and sports-related search topics and keywords increased significantly (p < 0.001). Strong positive correlations were found between betting-related keywords and alcohol and gross domestic product (r = 0.831 and r = 0.901, p < 0.001). A positive correlation was found between betting and psychoactive drug-related terms (minimum r = 0.417, p < 0.01). Conclusions: This study concludes that the interest of the Malawian population in betting has increased in recent years, while interest in psychoactive drugs and alcohol remains high. Gross domestic product is highly correlated with society's interest in betting. It was additionally found that Google Trends can be used as a tool to predict and monitor future risky behaviours, such as gambling disorder.

Substance use disorders among armed forces veterans with gambling disorder: Insights from an inpatient treatment sample.

Armed forces veterans are especially prone to experiencing a variety of addictive disorders, including gambling disorder. Even so, gambling disorder in veterans remains understudied generally, and there remain significant gaps in the research literature with regards to how gambling disorder relates to the experience and expression of comorbid substance use disorders. The present work examines the prevalence, presentation, and clinical associations of substance use disorders in U.S. Armed Forces veterans receiving inpatient treatment for gambling disorder. Participants (N = 664) were veterans from all branches of the U.S. Armed Forces receiving inpatient treatment for gambling disorder through the Department of Veteran Affairs Healthcare System. Clinical data from the time of intake was analyzed. A substantial portion of veterans (36.1%) met current criteria for an SUD, with another 16.5% reporting a history of SUD. Alcohol use disorder was the most commonly reported SUD (76.1% of those with a current SUD), with polysubstance use disorders and stimulant use disorders each occurring in at least 25% of those with SUDs. SUD status was related to greater levels of impulsivity, but there was no evidence that SUD status was related to gambling symptom severity, gambling preferences, or further psychiatric comorbidities.

Effect of pachinko parlour openings and closings on neighbourhood income-generating crimes in Japan: 6.5 years of observations.

BACKGROUND: Electronic gambling machines (EGMs) in gambling venues cause gambling-related harm and are a public health concern. This study focused on pachinko parlours as gambling venues and income-generating crimes as gambling-related harm. We aimed to verify whether income-generating crime rates increase in proximity to pachinko parlours and during the opening and post-closing periods of pachinko parlours relative to the pre-opening periods. METHODS: We used crime records spanning 6.5 years, including data on the opening and closing days of pachinko parlours for 6.5 years. We also sampled the addresses of convenience stores, bowling alleys, and households with official land prices all over Japan. The dependent variable was the daily income-generating crime incidence rate. Areas within 0.5 km, 0.5-1 km, 1-5 km, and 5-10 km radii of the pachinko parlours were the independent variables. The pre-, opening-, and post-closing periods of the pachinko parlours were also independent variables. The covariates included the number of convenience stores and always open pachinko parlours near pachinko parlours. Data were analysed using an analysis of variance (ANOVA) and covariance (ANCOVA). We also used differences-in-differences analysis (DD) to reveal the increase in income-generating crime rates in neighbourhoods exposed to the opening or closing of pachinko parlours. RESULTS: The daily income-generating crime incidence rate was significantly higher in areas within 0.5-1 km and 1-5 km radii of pachinko parlours than in those within 0.5 km and 5-10 km radii of them. The daily income-generating crime incidence rate was also significantly higher during the opening and post-closing periods than during the pre-opening period, even when controlling for the number of convenience stores and always open pachinko parlours. In particular, fraud crime rates increased with the opening and closing of pachinko parlours. CONCLUSIONS: The highest income-generating crime incidence rate was observed within a 0.5-1 km and 1-5 km radius of pachinko parlours. The opening of pachinko parlours also increased income-generating crime incidence rates, which increased after closing. Pachinko parlours are considered to be creating public harm because the corporate activities of these parlours make the youth in their neighbourhood perpetrators of fraud and older adults its victims. Future research should examine the current findings using official crime records.

Betting high, feeling low: a cross-sectional examination of gambling severity and psychological distress among Ghanaian youth.

BACKGROUND: Little is known about the nexus between online gambling and psychological distress among youth, especially in Ghana. This study aimed to investigate the effects of online sports betting on psychological distress, focusing on depression, anxiety, and stress among young individuals in the Volta region of Ghana. METHODS: A cross-sectional study was carried out at various betting centers in the Volta region of Ghana. Four hundred and three (403) participants were selected using a multi-stage sampling method. The study used a standardized questionnaire to assess psychological distress with the Depression, Anxiety, and Stress Scale (DASS 21) and problematic gambling with the Problem Gambling Severity Index (PGSI). The analysis included both descriptive and inferential methods. These include the implementation of the bootstrap technique within multiple regression models using the current versions of Jeffreys's Amazing Statistics Program (JASP) [0.18.2], Statistical Package for the Social Sciences (SPSS) [29.0.2], and Microsoft Excel (2019). RESULTS: The study found a prevalence of 40% for problematic gambling and 44% for moderate gambling problems among participants, resulting in an overall gambling prevalence of 84%. Regarding psychological distress, the estimated prevalence of depression among participants was 43.6%, with stress reported at 31.1% and anxiety at 68.8%. The overall prevalence of psychological distress was 48%. When analyzing the link between gambling and psychological distress, the study noted that males were more prone to gambling-related psychological distress than females (ß = 2.036, p = 0.025). Furthermore, individuals with problem gambling showed the highest probability of experiencing more significant psychological distress compared to other groups (ß = 9.228, p = 0.002), followed by those with moderate gambling levels (ß = 3.283, p = 0.002). CONCLUSION: We recommend that the mental health unit of the Ghana Health Service, in collaboration with the Gaming Commission of Ghana, should develop youth-friendly interventions to address the prevalence and onset of problematic gambling among the youth, especially males. This could, in turn, reduce the prevalence of psychological distress among youth engaged in online gambling in Ghana.

The prevalence of gambling and problematic gambling: a systematic review and meta-analysis.

BACKGROUND: Gambling behaviours have become of increased public health interest, but data on prevalence remain scarce. In this study, we aimed to estimate for adults and adolescents the prevalence of any gambling activity, the prevalence of engaging in specific gambling activities, the prevalence of any risk gambling and problematic gambling, and the prevalence of any risk and problematic gambling by gambling activity. METHODS: We performed a systematic review and meta-analysis. We systematically searched for peer-reviewed literature (on MEDLINE, Embase, and PsycInfo) and grey literature to identify papers published between Jan 1, 2010, and March 4, 2024. We searched for any gambling, including engagement with individual gambling activities, and problematic gambling data among adults and adolescents. We included papers that reported the prevalence or proportion of a gambling outcome of interest. We excluded papers of non-original data or based on a biased sample. Data were extracted into a bespoke Microsoft Access database, with the Joanna Briggs Institute Critical Appraisal Tool used to identify the risk of bias for each sample. Representative population survey estimates were firstly meta-analysed into country-level prevalence estimates, using metaprop, of any gambling, any risk gambling, problematic gambling, and by gambling activity. Secondly, population-weighted regional-level and global estimates were generated for any gambling, any risk gambling, problematic gambling, and specific gambling activity. This review is registered on PROSPERO (CRD42021251835). FINDINGS: We screened 3692 reports, with 380 representative unique samples, in 68 countries and territories. Overall, the included samples consisted of slightly more men or male individuals, with a mean age of 29·72 years, and most samples identified were from high-income countries. Of these samples, 366 were included in the meta-analysis. Globally, 46·2% (95% CI 41·7-50·8) of adults and 17·9% (14·8-21·2) of adolescents had gambled in the past 12 months. Rates of gambling were higher among men (49·1%; 45·5-52·6) than women (37·4%; 32·0-42·5). Among adults, 8·7% (6·6-11·3) were classified as engaging in any risk gambling, and 1·41% (1·06-1·84) were engaging in problematic gambling. Among adults, rates of problematic gambling were greatest among online casino or slots gambling (15·8%; 10·7-21·6). There were few data reported on any risk and problematic gambling among adolescent samples. INTERPRETATION: Existing evidence suggests that gambling is prevalent globally, that a substantial proportion of the population engage in problematic gambling, and that rates of problematic gambling are greatest among those gambling on online formats. Given the growth of the online gambling industry and the association between gambling and a range of public health harms, governments need to give greater attention to the strict regulation and monitoring of gambling globally. FUNDING: Australian National Health and Medical Research Council.

Cluster analysis based on gambling variables and mental health in a clinical population of gamblers.

BACKGROUND: Interest in characterizing individuals involved in addictive behaviors has been growing, which allows tailoring prevention and intervention strategies to the gambler's needs. The study aimed to 1) identify clusters of gamblers according to gambling-related characteristics and mental health; and 2) analyze differences in psychological variables between the clusters. METHODS: A total of 83 participants undergoing treatment for gambling disorder (Mage = 45.52, 51.8 % female) completed a set of questionnaires. Hierarchical cluster analysis was performed to classify gambling based on gambling variables (i.e., gambling severity and gambling motives) and mental health (i.e., depression, anxiety, and hostility). Several ANOVAs were conducted to illustrate the distinguishing features of each cluster, encompassing both the variables included in the cluster analysis and other relevant psychological variables. RESULTS: Findings suggest that gamblers can be classified into three clusters based on these variables: 1) "high gambling severity and good mental health," 2) "high gambling severity and poor mental health," and 3) "low gambling severity and good mental health." These clusters were differentiated as a function of psychological variables, such as emotional dependence, alexithymia, and stressful life events. CONCLUSIONS: Classifying gamblers according to their profile provides a better understanding of their needs and problems, allowing for a more tailored approach in terms of prevention and intervention strategies.

The Dual Burden of Emerging Adulthood: Assessing Gambling Severity, Gambling-Related Harm, and Mental Health Challenges.

Growing concerns over gambling problems across age groups have sparked research in public health and psychology. During emerging adulthood, individuals are more susceptible to mental health problems and more likely to develop gambling problems than in other age groups. This study explored the potential differences between emerging adults and adults aged 30+ in terms of problem gambling severity (PGS), gambling-related harm (GRH), depression and anxiety, and the mediating role of depression and anxiety in the association between age, PGS, and GRH. A representative online sample of 3244 Israelis aged 18 and over was divided into two groups: 740 emerging adults aged 18-29 and 2504 adults aged 30+. Gambling behaviors, the Problem Gambling Severity Index, the Short Gambling Harm Screen, and the Patient Health Questionnaire-4 assessing depression and anxiety were administered. Emerging adults had significantly higher levels of GRH, PGS, and depression-anxiety than their older counterparts, above and beyond gender and education. Depression-anxiety fully mediated the associations between age and gambling-related outcomes. These findings underscore the importance of considering psychological well-being in efforts to address problem gambling and gambling-related harms, especially in emerging adults.

National burden of gambling in Japan: an estimation from an online-based cross-sectional investigation and national epidemiological survey.

BACKGROUND: Gambling is a popular leisure activity in many countries, often expected to boost regional economies. Nevertheless, its negative impacts remain a significant concern. Gambling disorder is recognized as the most severe consequence; however, even non- or low-risk gamblers may also face negative impacts. This study aimed to estimate the number of Japanese gamblers experiencing gambling-related harm (GRH) and its distribution across six life domains, financial, relational, emotional, health, social and other aspects, based on the severity of their problem gambling risk. METHODS: This cross-sectional study relied on an online survey conducted between August 5 and 11, 2020. Participants aged 20 years and above, who engaged in gambling during 2019 were recruited via a market research company. The survey assessed the prevalence of GRH 72 items among four gambler risk groups (non-problem, low-, moderate-, and high-risk), as categorized by the Problem Gambling Severity Index. The data was adjusted for population weighting using representative national survey data: the 2017 Comprehensive Survey of Living Conditions and the 2017 Epidemiological Survey on Gambling Addictions. RESULTS: Out of the 28,016 individuals invited to the survey, 6,124 participated in the screening, 3,113 in the main survey, and 3,063 provided valid responses. After adjusting the survey data, it was estimated that 39.0 million (30.8%) of Japan's 126.8 million citizens gambled in 2019. Among them, 4.44 million (11.4%) experienced financial harm, 2.70 million (6.9%) health harm, 2.54 million (6.5%) emotional harm, 1.31 million (3.4%) work/study harm, 1.28 million (3.3%) relationship harm, and 0.46 million (1.2%) other harm. Although high-risk gamblers experienced severe harm at the individual level, over 60% of gamblers who experienced GRHs were non- and low-risk gamblers, with the exception of other harm, at the population level. CONCLUSIONS: The study highlighted the prevention paradox of gambling in Japan. While national gambling policies primarily focus on the prevention and intervention for high-risk gamblers, a more effective approach would involve minimizing GRH across the entire population.

Self-reported changes in engagement in offline and online gambling during temporary COVID-19 restrictions on access to land-based gambling venues in Poland and their relation to the gambling disorder. / Postrzegane zmiany w zaangazowaniu w hazard stacjonarny i online podczas czasowego ograniczenia dostepnosci punktów gry z powodu epidemii COVID-19 w Polsce a zaburzenie hazardowe.

OBJECTIVES: This study aimed to trace changes in the participation of Polish gamblers in online and offline (land-based) gambling caused by the temporary restrictions on access to land-based gambling venues imposed during the first national lockdown during the COVID-19 pandemic. METHODS: Data from 585 respondents were collected using an online questionnaire. Those who declared they had engaged in land-based gambling before 15 March 2020 were included in the sample. Respondents were asked about their online and offline gambling participation in the period before the first lockdown (before March 2020), during the first lockdown (15 March to 10 May 2020), and six months after the end of the lockdown. The analyses also considered the severity of the participants' gambling disorder symptoms measured with the CPGI and the reasons for reducing or increasing gambling involvement. RESULTS: The land-based gamblers most often maintained their gambling activity at the same level or reduced it during the lockdown (nearly 95% of gamblers). Motivations for less gambling included financial constraints and limited access to gambling. Increased offline gambling was explained by more free time, the need to relieve stress and to want to win money. Of the 394 people who had gambled only offline before the pandemic, 30 began to gamble online during the pandemic. The initiation of online gambling and increased online or offline gambling during the coronavirus outbreak was associated with greater severity of gambling disorder symptoms. CONCLUSIONS: In our sample, participation in gambling increased only marginally during the pandemic, and the increase was related to problematic gambling patterns.

Concussion history associated with adolescent psychological distress but not hazardous gambling: a cross-sectional study.

BACKGROUND: Sustaining multiple concussions over one's lifetime may be associated with behavioral and mood changes beyond the acute phase of injury. The present cross-sectional study examined the relationship between concussion history, the incidence of current moderate-severe psychological distress, and lifetime adolescent hazardous gambling in high school students. METHODS: Four-hundred fifty-nine high school students from southern Sweden (age: 16.81 ± 0.83, 58.2% male) completed a survey assessing concussion history (0,1,2…>8), psychological distress using the Kessler-6 scale, and lifetime hazardous gambling using the NODS-CLiP scale. RESULTS: Participants who self-reported three or more concussions were more likely to endorse moderate-severe symptoms of psychological distress than those with no concussion history while controlling for covariates, OR = 2.71, 95% CI [1.19, 6.18]. In contrast, concussion history was not associated with hazardous gambling after controlling for confounding variables. CONCLUSIONS: Self-reporting three or more concussions was associated with increased current psychological distress beyond the acute phase of injury among high school students. Adolescents who have sustained multiple concussions should undergo mental health evaluations beyond the acute phase of injury to identify and treat psychological distress, but probing for hazardous gambling may not be clinically relevant in this previously concussed adolescent population.

Gambling participation and risk after COVID-19: Analysis of a population representative longitudinal panel of Australians.

BACKGROUND AND AIMS: The impact of the COVID-19 pandemic on gambling participation and levels of gambling harm across populations during the pandemic is now addressed in a well-established body of empirical literature. This study aimed to measure the longer-term implications of COVID-19 on gambling participation and levels of gambling harm. DESIGN: Population-based cohort study using group-based trajectory modelling. SETTING: Australia, using gambling participation, problem gambling risk, sociodemographic and psychosocial data from 2019 (pre COVID-19), 2020, 2021 (during COVID-19) and 2023 (post COVID-19). PARTICIPANTS: A population representative survey of Australian adults, including four waves collected in April 2019 (n = 2054), November 2020 (n = 3029), October 2021 (n = 3474) and January 2023 (n = 3370), with a subset (n = 3160) of the sample having longitudinal data available. MEASUREMENTS: Participants were asked which gambling activities they participated in over the past 12 months for money. Problem gambling risk was measured by the nine-item Problem Gambling Severity Index (PGSI). FINDINGS: There was an overall reduction in gambling participation during COVID-19 and return to pre-pandemic levels for most gambling activities by 2023. The longitudinal analysis yielded four trajectories of gambling participation from 2019 to 2023, including individuals who (1) never gambled (25.0% of the longitudinal sample; n = 789); (2) engaged in non-problematic gambling (59.8%; n = 1888); (3) ceased gambling during COVID-19 and started again post pandemic (10.7%; n = 337); and (4) engaged in high risk gambling (4.6%; n = 146), with particular demographic and psychosocial profiles and patterns of participation in specific gambling activities related to these trajectories. CONCLUSIONS: Although overall gambling participation rates decreased at the population level in Australia during COVID-19, by 2023 participation in gambling appeared to have nearly returned to pre-pandemic levels. Patterns of gambling behavior before, during and after the pandemic appear to be heterogeneous.