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Spilleavhengighet

Sist revidert:
Sist revidert av:

Definisjon:
Psykisk lidelse med en sterk trang til å spille pengespill, som dominerer pasientens liv slik at andre områder i livet skades. Betydelig komorbiditet med andre psykiske lidelser og rusmisbruk
Forekomst:
Forekommer særlig hos unge menn, men omtrent 2% av befolkningen står i fare for å utvikle spilleavhengighet
Symptomer:
Symptomer omfatter manglende impulskontroll i forbindelse med spilling, atferden påvirker egen og eventuelt andres livskvalitet, helse og psykososial funksjon
Funn:
Spilleatferden kan føre til depresjon og ev. suicidalrisiko, og dette bør kartlegges
Diagnostikk:
Ingen fysiske eller biokjemiske prøver kan bekrefte/avkrefte diagnosen, men det finnes en rekke spørreskjema som kan bidra til diagnosen
Behandling:
Tar sikte på å begrense spilleatferden (samtaleterapi, støttegrupper, medikamentelt) og utbedre skadeffektene av atferden, samt å hindre tilbakefall. Prognosen er god ved inngripen i atferden.
  1. Łabuzek K, Beil S, Beil-Gawełczyk J, et al. The latest achievements in the pharmacotherapy of gambling disorder. Pharmacol Rep. 2014 Oct;66(5):811-20 . pmid:25149985 PubMed  
  2. Leppink EW, Redden SA, Chamberlain SR, Granta JE. Cognitive flexibility correlates with gambling severity in young adults. J Psychiatr Res. 2016 Oct; 81: 9–15 . doi:10.1016/j.jpsychires.2016.06.010 DOI  
  3. Topf JL, Yip SW, Potenza MN. Pathological Gambling: Biological and Clinical Considerations. J Addict Med 2009; 3: 111-119. PubMed  
  4. Potenza MN. Review. The neurobiology of pathological gambling and drug addiction: an overview and new findings. Philos Trans R Soc Lond B Biol Sci 2008; 363: 3181-9. PubMed  
  5. Slutske WS. Natural recovery and treatment-seeking in pathological gambling: results of two U.S. national surveys. Am J Psychiatry 2006; 163: 297-302. American Journal of Psychiatry  
  6. Wenzel H, Dahl A. Female pathological gamblers - a critical review of the clinical findings. Int J Ment Health Addiction 2009; 7: 190-202. PubMed  
  7. Pallesen, Ståle; Molde, Helge; Mentzoni, Rune Aune; Hanss, Daniel; Morken, Arne Magnus. Omfang av penge- og dataspillproblemer i Norge 2015. Bergen: Institutt for samfunnspsykologi 2016 (ISBN 978-82-91713-60-1) 103 s.UiB.
  8. Shead NW, Derevensky JL, Gupta R. Risk and protective factors associated with youth problem gambling. Int J Adolesc Med Health 2010; 22: 39-58. PubMed  
  9. Lotteri- og stiftelsestilsynet. Norske Pengespill 2018. https://lottstift.no/nb/pengespill/pengespillstatistikk/
  10. Potenza MN. Neurobiology of gambling behaviors. Curr Opin Neurobiol 2013; 23(4): 660-667. PubMed  
  11. Murch WS, Clark L. Games in the Brain: Neural Substrates of Gambling Addiction. Neuroscientist 2016; 22(5): 534-545. PubMed  
  12. Linnet J, Møller A, Peterson E, et al. Inverse association between dopaminergic neurotransmission and Iowa Gambling Task performance in pathological gamblers and healthy controls. Scand J Psychol 2011; 52: 28-34. PubMed  
  13. Linnet J, Møller A, Peterson E, et al. Dopamine release in ventral striatum during Iowa Gambling Task performance is associated with increased excitement levels in pathological gambling. Addiction 2011; 106: 383-90. PubMed  
  14. Grant JE, Kim SW, Odlaug BL. A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptomania. Biol Psychiatry 2009; 65: 600-6. PubMed  
  15. Dowling NA, Oldenhof E, Shandley K, et al. The intergenerational transmission of problem gambling: the mediating role of offspring gambling expectancies and motives. Addict Behav 2018; 77: 16-20. PubMed  
  16. Yau YH, Potenza MN. Gambling disorder and other behavioral addictions: recognition and treatment. Harv Rev Psychiatry. 2015 Mar-Apr;23(2):134-46 . pmid:25747926 PubMed  
  17. Grant JE, Odlaug BL, Chamberlain SR. Neural and psychological underpinnings of gambling disorder: A review. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65: 188-193. PubMed  
  18. Grant J. Impulse control disorders: a clinician’s guide to understanding and treating behavioural addictions. New York: W.W Norton; 2008.
  19. James RJ, Tunney RJ. The need for a behavioural analysis of behavioural addictions. Clin Psychol Rev 2017; 52: 69-76. PubMed  
  20. Moore TJ, Glenmullen J, Mattison DR. Reports of Pathological Gambling, Hypersexuality, and Compulsive Shopping Associated With Dopamine Receptor Agonist Drugs. JAMA Intern Med 2014. pmid:25329919 PubMed  
  21. Dowling, N. A., S. S. Merkouris, C. J. Greenwood, E. Oldenhof, J. W. Toumbourou and G. J. Youssef (2017). "Early risk and protective factors for problem gambling: A systematic review and meta-analysis of longitudinal studies." Clin Psychol Rev 51: 109-124.
  22. Subramaniam M, Abdin E, Shahwan S, et al. Culture and age influences upon gambling and problem gambling. Addict Behav Rep. 2015 Jun; 1: 57–63 . doi:10.1016/j.abrep.2015.04.004 DOI  
  23. Volberg RA, McNamara LM, Carris KL. Risk Factors for Problem Gambling in California: Demographics, Comorbidities and Gambling Participation. Journal of Gambling Studies 2017. DOI: 10.1007/s10899-017-9703-5. DOI  
  24. Dowling NA, Cowlishaw S, Jackson AC, et al. Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis. Aust N Z J Psychiatry 2015; 49(6): 519-539. PubMed  
  25. Dannon PN, Lowengrub K, Gonopolski Y, et al. Pathological gambling: a review of phenomenological models and treatment modalities for an underrecognized psychiatric disorder. Prim Care Companion J Clin Psychiatry 2006; 8: 334-9. PubMed  
  26. Hansen M, Rossow I. Pengespill og suicidal atferd. Tidsskr Nor Legeforen 2008; 128: 174-6. PubMed  
  27. KoRus-Øst (2017). Problematisk spilleatferd i penge- og dataspill: Kartlegging av behandlingsmetoder og behandlingssteder, Kompetansesenter rus - region øst.
  28. Lotteri- og stiftelsestilsynet. Årsmelding 2011. Førde: Lotteri og Stiftelsestilsynet; 2012.
  29. Carlbring P, Jonsson J, Josephson H, Forsberg L. Motivational interviewing versus cognitive behavioral group therapy in the treatment of problem and pathological gambling: a randomized controlled trial. Cogn Behav Ther 2010; 39: 92-103. PubMed  
  30. Pallesen S, Molde H, Arnestad HM et al. Medikamentell behandling ved spilleavhengighet Tidsskr Nor Lægeforen 2006; 126: 1322 – 4.
  31. Dell'Osso B, Altamura AC, Allen A, et al. Epidemiologic and clinical updates on impulse control disorders: a critical review. Eur Arch Psychiatry Clin Neurosci 2006; 256: 464-75. PubMed  
  32. Grant JE, Kim SW. Medication management of pathological gambling. Minn Med 2006; 89: 44-8. PubMed  
  33. Genton P, Bauer J, Duncan S, et al. On the association between valproate and polycystic ovary syndrome. Epilepsia 2001; 42: 295-304. PubMed  
  34. Grant JE, Odlaug BL, Schreiber LR. Pharmacological treatments in pathological gambling. Br J Clin Pharmacol 2014; 77(2): 375-381. PubMed  
  35. Labuzek K, Beil S, Beil-Gawelczyk J, et al. The latest achievements in the pharmacotherapy of gambling disorder. Pharmacol Rep 2014; 66(5): 811-820. PubMed  
  36. Kulturdepartementet. Handlingsplan mot spillproblemer 2013 - 2015. 2012.
  37. Norsk Tipping - Produkter. In; 2012.
  38. Cunningham-Williams RM, Cottler LB, Compton WM 3d, Spitznagel EL. Taking chances: problem gamblers and mental health disorders--results from the St. Louis Epidemiologic Catchment Area Study. Am J Public Health 1998; 88: 1093-6 Published erratum in Am J Public Health 1998; 88: 1407.
  39. Shead NW, Derevensky JL, Gupta R. Risk and protective factors associated with youth problem gambling. Int J Adolesc Med Health 2010; 22: 39-58. PubMed  
  40. Bjelland B. Kognitive prosesser og spilleavhenighet. In: Psykologisk arbeid med rus- og avhengighets-problemer. N-Haugesund: Norsk psykologforening, Rogaland lokalavdeling; 2006.
  • Hanne Gro Wenzel, overlege, PhD, Orkdal DPS, St Olav Hospital