赌博障碍的心理行为特征与健康相关服务体系

doi:10.3969/j.issn.1006-9771.2024.10.007

Abstract

Abstract:

Objective To investigate the psychological and behavioral manifestations of gambling disorder and its implications for health services.

Methods International Classification of Diseases, 11th Revision (ICD-11) and International Classification of Functioning, Disability and Health (ICF) were employed to analyze the psychological, behavioral and functional impacts of gambling disorder. World Health Organization (WHO) mental health policy documents and gambling disorder-related health services were systematically reviewed, encompassing Comprehensive Mental Health Action Plan 2013-2030, mhGAP Intervention Guide 2.0, UN Mental Health and Human Rights Action Plan and Sustainable Development Goals (SDGs). A health service system tailored for gambling disorder was constructed, drawing upon the WHO Rehabilitation in Health Systems framework.

Results Gambling disorders primarily characterized with impaired control, escalating bets (tolerance), repeated unsuccessful attempts to quit, gambling as an escape mechanism, and the persistent detrimental effects of gambling on personal, familial and social functioning. Individuals with gambling disorder impaired in attention, decision-making and emotional regulation, leading to poor work performance and social relationship. Environmental factors were very important that family and social support systems fostered recovery, while gambling environments, socioeconomic pressures and other adverse factors exacerbated addiction. The WHO health service for gambling disorder included prevention, intervention, treatment, rehabilitation and health promotion. The health service system included six building blocks: leadership and governance, financing, mental health workforce development, service delivery, medical products and technologies, and health information systems.

Conclusion Gambling disorder may impair attention, decision-making and emotional function, and diminish work productivity and social relationship. Environmental factors play a pivotal role. Health-related services for gambling disorder should encompass prevention, treatment, rehabilitation and health promotion, necessitating a comprehensive health service system addressing leadership and governance, financing, workforce, service delivery, medical products and technologies, and health information systems.

Key words: gambling disorder, psychological behavior characteristics, health-related services

CLC Number:

R197.1

GAN Zheng, LIU Lian. Psychological and behavioral characteristics of gambling disorder and related health service system[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(10): 1172-1178.

Figures/Tables 1

Table 1

Health service system for gambling disorder based on the WHO framework"

要素	服务内容	服务实施策略
领导力与治理	提供全球和国家层面的治理框架，确保赌博障碍的预防、治疗和康复得到充分的政策支持和法律保障	制定并实施赌博障碍的国家政策和法律框架，明确服务提供方的责任加强跨部门合作，涉及卫生、司法、教育和社会福利部门鼓励跨国合作，特别是在线赌博的监管，通过共享数据和最佳实践减少全球范围的赌博障碍
资金保障	保障赌博障碍相关服务的资金支持，包括预防、治疗和康复服务	政府拨款支持赌博障碍预防项目，特别是在青少年群体中将赌博障碍治疗纳入公共和私人健康保险的报销范围向赌博行业征收特别税，用于资助赌博障碍的治疗和康复项目
心理健康人力资源	培训卫生工作者，尤其是心理健康和成瘾治疗领域的专业人员，确保他们具备足够的技能应对赌博障碍	提供定期的成瘾行为管理和心理治疗培训课程鼓励多学科团队协作，涵盖心理医生、社会工作者和社区健康工作者建立成瘾行为管理的专家网络，促进知识共享和能力建设
服务提供	鼓励将赌博障碍的预防、治疗和康复服务整合到常规卫生服务中，确保服务的普及性和可及性	将行为成瘾的治疗纳入基本心理健康服务提供标准化成瘾治疗服务，如CBT和药物治疗设立社区成瘾支持和康复服务，保证服务持续提供
医疗产品与技术	确保治疗赌博障碍的药物、技术和工具的可及性，尤其是用于治疗并发症的药物	提供抗抑郁药、抗焦虑药物等辅助治疗药物使用远程医疗技术，提供在线心理咨询和治疗服务开发移动应用程序，用于自我管理和监控赌博行为
卫生信息支持系统	建立赌博障碍的监测与评估机制，收集和分析有关成瘾行为的流行数据	开发并实施赌博障碍的全国监测系统，跟踪服务利用率和成效收集成瘾行为相关的流行病学数据，用于政策制定和资源分配实现电子健康记录系统广泛应用，确保赌博障碍患者信息的共享与管理

Table 1

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Psychological and behavioral characteristics of gambling disorder and related health service system

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