A Case of Gambling Addiction Applying to the Emergency Department with a Suicide Attempt

Abstract

Gambling addiction (GA) is a disorder characterized by repetitive gaming that persists despite negative consequences and leads to a decrease in functionality.Suicidal thoughts and suicide attempts are higher in people with GA than in society. In this study, a case of GA applying with suicide attempt is presented and treatment modalities are discussed.A 29-year-old male patient, married, high school graduate and working as a worker, was brought to the emergency room after a suicide attempt. He had been experiencing symptoms of depression for the past three months due to increased debt.After his family learned about his gambling debt, the patient attempted suicide by drinking medicine.In her mental state examination, her memory and attention decreased, her speech was slow, her mood was depressed. The patient had no symptoms of mania.According to DSM-5 diagnostic classification, it was determined that there was a diagnosis of “Gambling Addiction”. In addition to this diagnosis, he had depression. For his depression, sertraline 50 mg/day and risperidone 1 mg/day were started.In addition, cognitive and behavioral therapy was initiated for GA. The patient, who was on follow-up for about five months, stated that he did not gamble especially after the start of psychotherapy.His depressive symptoms improved significantly after the first month. Financial problems, problematic family relationships and added psychiatric diseases caused by the GA increase the risk of suicide attempt.Applications for GA treatment are very few. Psychiatric comorbidity and suicidal ideation should be questioned in the applicants.

Keywords

• pathological gambling,depression,cognitive behavioral therapy,suicide,addiction,treatment

İntihar Girişimi ile Acil Servise Başvuran Kumar Bağımlılığı Olgusu

Öz

Kumar bağımlılığı (KB), olumsuz sonuçlara rağmen devam eden ve işlevselliğin azalmasına neden olan tekrarlayan kumar oynamalarla karakterize bir bozukluktur.İntihar düşünceleri ve intihar girişimleri KB'li kişilerde toplumdan daha yüksektir. Bu çalışmada intihar girişimi ile başvuran bir kumar bağımlılığı olgusu sunulmuştur ve tedavi yöntemleri tartışılmıştır.Evli, lise mezunu ve işçi olarak çalışan 29 yaşında erkek hasta intihar girişiminden sonra acil servise getirildi. Borç artışı nedeniyle son üç aydır depresyon belirtileri yaşıyordu.Ailesi kumar borcunu öğrendikten sonra, hasta ilaç içerek intihar girişiminde bulundu. Ruhsal durum muayenesinde hafızası ve dikkati azalmış, konuşması yavaş, duygu durumu çökkündü. Hastanın mani belirtisi yoktu. DSM-5 tanı sınıflandırmasına göre “Kumar Bağımlılığı” tanısı olduğu belirlendi. Bu tanıya ek olarak depresyonu vardı. Depresyonu için günde 50 mg sertralin ve günde 1 mg risperidon başlandı. Ayrıca KB için bilişsel ve davranışçı terapi başlatılmıştır. Yaklaşık beş aydır takipte olan hasta, özellikle psikoterapinin başlamasından sonra kumar oynamadığını belirtti. Depresif belirtileri ilk aydan sonra belirgin şekilde düzeldi. KB'nin neden olduğu finansal sorunlar, sorunlu aile ilişkileri ve ilave psikiyatrik hastalıklar intihar girişimi riskini arttırmaktadır. KB tedavisi için başvurular çok azdır. Başvuranlarda psikiyatrik eştanı ve intihar düşüncesi sorgulanmalıdır.

Anahtar Kelimeler

• patolojik kumar,depresyon,bilişsel davranışçı terapi,intihar,bağımlılık,tedavi

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