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Treatment Plans

Gambling Disorder

Still too few people know about the risks related to Gambling and even fewer know that Gambling Disorder can be treated.

At the Istituto di Neuroscienze, we offer personalized treatment programs that integrate Psychological Support, Pharmacological Therapy and Neuromodulation Therapies.

Gambling, when it can no longer be controlled, becomes a drug without drugs, a substance that cannot be seen. Still too few people know the risks related to Gambling Disorder and even fewer know that it can be cured, not only with psychological support but also with medications and Neuromodulation Therapies.

In our Country's tradition, playing with money is normal: in the family even young children happen to play with real money. Differently, abroad, they play with fake money.

Those who are already familiar with playing with money in the family run a greater risk of widening their gaze to easily accessible propositions such as those the Scratchcards or the Instant Lottery: games that can be easily found in tobacco shops or bars next door. There are now also several real gaming rooms with easily accessible slot machines ― available even digitally on the Internet. Last but not least are the casinos, which remain a popular tourist destination.

Characteristics of Gambling Disorder

In 2018, the Italian National Institute of Health published the result of a research study where it can be read that "36.4% of Italians have gambled at least once in the 12 months preceding the interview. Gambling in the past year affected almost one in two men and one in three women."

In addition to a number of people who gamble occasionally, it has been shown that there are also individuals who become addicted very quickly: in the same research of the Italian National Institute of Health, it is estimated that there are 1.5 million people in Italy alone.

In DSM-5, Gambling Disorder has been placed within the chapter of Addictions (in DSM-IV it was instead included in the chapter of Impulse-Control Disorders) on the basis of neurobiological and neuroimaging evidence showing that there are important areas of overlap between the dysfunction of certain brain circuits in Substance Addictions and Gambling Disorder. In particular, activation of reward systems seems to be central.

The name of the disorder also underwent a change: from "pathological gambling" to "gambling disorder," thus eliminating any distinction between an abuse diagnosis and an addiction diagnosis, unifying them into a syndrome characterized by different levels of severity.

The prevalence of gambling disorder is between 0.4 percent and 1 percent in the general population.

In the case of gambling disorder, there is maladaptive, persistent and recurrent gambling behavior, which impacts on a personal, family or vocational level.

There is also often a pattern whereby the subject attempts to make up for losses, often ending up gambling even more. Many persons frequently lie to family, friends, and therapist to hide their gambling problem, especially masking the illegal behaviors they engage in as a consequence of gambling.

Comorbidity is very high with substance use disorders, depressive disorders, anxiety disorders, and personality disorders. Gambling is also associated with worse overall health, and certain medical diagnoses such as angina and tachycardia are more common in this population.

(translated and adapted from the book Psichiatria e Salute Comportamentale, Stefano Pallanti)

Treatment of Gambling Disorder

The holistic approach of the Istituto di Neuroscienze

Given the growing number of people suffering from Gambling Disorder, there is an increasing urgency to develop cutting-edge treatment programs that can effectively address the disorder. The treatment of Gambling Disorder is a complex process that requires a holistic approach such as the one adopted by Dr. Stefano Pallanti's Istituto di Neuroscienze to address the many different challenges associated with this addiction and ensure successful treatment.

➜ First, Psychological and Motivational Support plays a key role in the recovery process, helping individuals understand the roots of their behavior and find the motivation to change.

➜ In addition to psychological support, Pharmacological Therapy can be a valuable resource for managing the symptoms associated with Gambling Disorder. In fact, if well selected and dosed, medications can help reduce the desire to enact addictive behaviors.

Neuromodulation Therapies constitute an innovative treatment option for Gambling Disorder that can be used to non-painfully and non-invasively modulate brain activity in areas involved in the disorder. This targeted approach can help reduce compulsive desires and improve control over gambling behaviors.

Nutraceuticals can play an important role in supporting health and well-being during the recovery process, supporting the achievement of desired therapeutic outcomes.

➜ Finally, it is important not to underestimate the importance of family support services. By involving the patient's family members in the entire recovery process, it is possible to create a strong supportive environment that promotes the changing process of the patient. Involving the family in the recovery process can contribute significantly to long-term success.

The treatment of Gambling Disorder requires a comprehensive, multidisciplinary approach that involves different aspects of well-being and, therefore, combines different treatments methods and specialized expertise. Such a comprehensive approach aims to provide patients with the tools and support they need to be able to overcome the disorder and return to leading a fulfilling life.

Dr. Pallanti's Credentials

Dr. Stefano Pallanti is a leading expert and researcher on behavioral addiction disorders.

In 2017, Dr. Stefano Pallanti won a major grant funded by the National Institute of Mental Health to study the use of Transcranial Magnetic Stimulation (TMS) in the treatment of gambling disorder. The journal UPDATE from Montefiore Medical Center at the Albert Einstein School of Medicine reported the news in December 2017.

Back in 1998, Dr. Stefano Pallanti had already undertaken the research and treatment of Gambling Disorder when almost nothing was known about it.

Dr. Pallanti is the author of the PG-YBOCS rating scale: Yale-Brown Obsessive-Compulsive Scale adapted to Behavioral Addiction and Gambling Disorder.

Dr. Pallanti is a faculty member at the International Training School and Conference on Problematic Usage of the Internet at Clare College of Cambridge University. The school consists of a group of experienced researchers on new addictions.

In addition, Dr. Pallanti is Editor in Chief of Archives of Behavioral Addictions.

Access the latest research results on Gambling Disorder by registering at this link.