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

Year 2020, Volume 21, Issue 1, 92 - 98, 31.03.2020

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.

References

  • 1. Mallorquí-Bagué N, Mena-Moreno T, Granero R, et al. Suicidal ideation and history of suicide attempts in treatment-seeking patients with gambling disorder: The role of emotion dysregulation and high trait impulsivity. J Behav Addict 2018; 7: 1112-1121.
  • 2. Kessler RC, Hwang I, LaBrie R, et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med 2008; 38: 1351-1360.
  • 3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders - 5. Washington DC, American Psychiatric Publishing, 2013.
  • 4. Lorains FK., Cowlishaw S, Thomas SA. Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction 2011; 106: 490-498.
  • 5. Black DW, Coryell W, Crowe R, et al. Suicide Ideations, Suicide Attempts, and Completed Suicide in Persons with Pathological Gambling and Their First-Degree Relatives. Suicide Life Threat Behav 2015; 45: 700-709.
  • 6. McCormick RA, Russo AM, Ramirez LF, Taber JI. Affective disorders among pathological gamblers seeking treatment. Am J Psychiatry 1984; 141: 215-218.
  • 7. Blaszczynski A, Farrell E. A Case Series of 44 Completed Gambling-Related Suicides. J Gambl Stud 1998; 14: 93-109.
  • 8. Slutske WS. Natural recovery and treatment-seeking in pathological gambling: results of two U.S. national surveys. Am J Psychiatry 2006; 163: 297-302.
  • 9. Güriz S, Ekinci A, Türkçapar M. Bir patolojik kumar hastasının bilişsel davranışçı terapisi. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi 2012; 1: 105-112.
  • 10. Karlsson A, Håkansson A. Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study. J Behav Addict 2018, 7: 1091-1099.
  • 11. Bischof A, Meyer C, Bischof G, et al. Type of gambling as an independent risk factor for suicidal events in pathological gamblers. Psychol Addict Behav 2016; 30: 263-269.
  • 12. Ronzitti S, Soldini E, Smith N, et al. Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems. Addict Behav 2017; 74: 33-40.
  • 13. Potenza MN, Steinberg MA, McLaughlin SD, et al. Gender-related differences in the characteristics of problem gamblers using a gambling helpline. Am J Psychiatry 2001; 158: 1500-1505.
  • 14. Bartley CA, Bloch MH. Meta-analysis: pharmacological treatment of pathological gambling. Expert Rev Neurother 2013; 13: 887-894.
  • 15. Pallesen S, Molde H, Arnestad HM, et al. Outcome of pharmacological treatments of pathological gambling: a review and meta-analysis. J Clin Psychopharmacol 2007; 27: 357-364.

İntihar Girişimi ile Acil Servise Başvuran Kumar Bağımlılığı Olgusu

Year 2020, Volume 21, Issue 1, 92 - 98, 31.03.2020

Abstract

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.

References

  • 1. Mallorquí-Bagué N, Mena-Moreno T, Granero R, et al. Suicidal ideation and history of suicide attempts in treatment-seeking patients with gambling disorder: The role of emotion dysregulation and high trait impulsivity. J Behav Addict 2018; 7: 1112-1121.
  • 2. Kessler RC, Hwang I, LaBrie R, et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med 2008; 38: 1351-1360.
  • 3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders - 5. Washington DC, American Psychiatric Publishing, 2013.
  • 4. Lorains FK., Cowlishaw S, Thomas SA. Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction 2011; 106: 490-498.
  • 5. Black DW, Coryell W, Crowe R, et al. Suicide Ideations, Suicide Attempts, and Completed Suicide in Persons with Pathological Gambling and Their First-Degree Relatives. Suicide Life Threat Behav 2015; 45: 700-709.
  • 6. McCormick RA, Russo AM, Ramirez LF, Taber JI. Affective disorders among pathological gamblers seeking treatment. Am J Psychiatry 1984; 141: 215-218.
  • 7. Blaszczynski A, Farrell E. A Case Series of 44 Completed Gambling-Related Suicides. J Gambl Stud 1998; 14: 93-109.
  • 8. Slutske WS. Natural recovery and treatment-seeking in pathological gambling: results of two U.S. national surveys. Am J Psychiatry 2006; 163: 297-302.
  • 9. Güriz S, Ekinci A, Türkçapar M. Bir patolojik kumar hastasının bilişsel davranışçı terapisi. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi 2012; 1: 105-112.
  • 10. Karlsson A, Håkansson A. Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study. J Behav Addict 2018, 7: 1091-1099.
  • 11. Bischof A, Meyer C, Bischof G, et al. Type of gambling as an independent risk factor for suicidal events in pathological gamblers. Psychol Addict Behav 2016; 30: 263-269.
  • 12. Ronzitti S, Soldini E, Smith N, et al. Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems. Addict Behav 2017; 74: 33-40.
  • 13. Potenza MN, Steinberg MA, McLaughlin SD, et al. Gender-related differences in the characteristics of problem gamblers using a gambling helpline. Am J Psychiatry 2001; 158: 1500-1505.
  • 14. Bartley CA, Bloch MH. Meta-analysis: pharmacological treatment of pathological gambling. Expert Rev Neurother 2013; 13: 887-894.
  • 15. Pallesen S, Molde H, Arnestad HM, et al. Outcome of pharmacological treatments of pathological gambling: a review and meta-analysis. J Clin Psychopharmacol 2007; 27: 357-364.

Details

Primary Language Turkish
Subjects Psychiatry
Journal Section Case Report
Authors

Bahadır GENİŞ> (Primary Author)
ZONGULDAK ÇAYCUMA DEVLET HASTANESİ
0000-0001-8541-7670
Türkiye


Hakan AKSU>
ANKARA T.C. SB. ANKARA YBÜ. YENİMAHALLE EĞİTİM VE ARAŞTIRMA HASTANESİ
0000-0003-2930-5337
Türkiye

Publication Date March 31, 2020
Acceptance Date February 27, 2020
Published in Issue Year 2020, Volume 21, Issue 1

Cite

AMA Geniş B. , Aksu H. İntihar Girişimi ile Acil Servise Başvuran Kumar Bağımlılığı Olgusu. Bağımlılık Dergisi. 2020; 21(1): 92-98.