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한국에서 지역사회 거주 남성 노인과 성인의 도박성향 비교
전진숙(Jin Sook Cheon),권명환(Myong Hwan Kwon),박지용(Ji Yong Park),박소민(So Min Park),박신형(Sin Hyung Park),오병훈(Byoung Hoon Oh) 대한생물치료정신의학회 2007 생물치료정신의학 Vol.13 No.2
Objectives:The rate of participating to gambling even in old age is rapidly increasing. However, there are few studies on the gambling effect to health. The pathological gambling can be related to job loss, bankrupcy, arrest, divorce, mental health problem, general health abnormality. Therefore, the aims of this study were to compare gambling behaviors among Korean elderly and adults, to know the rate of pathological gambling and to determine cutoff point, and to provide data to develop a brief pathological gambling screening test specific to the Korean elderly by comparing items of the rating instrument of pathological gambling. Methods:The subjects who were volunteers without history of neuropsychiatric illnesses living in Busan were randomly selected among elderly males within age 60 to 85(N=105) and adult males within age 30 to 49(N=100). The structured interviews and assessments using various rating instruments which required about 40 minutes were performed by three psychiatric residents with the aid of 3-4th grade medical students who were totally blind about subjects. The demographic data(age, sex, education, occupation, religion, marriage, living style, income, etc), physical illness(stroke, metabolic disorder, degenerative arthritis, cancer, etc), pathological gambling(the Korean Version of the South Oaks Gambling Screen, the SOGS-K), gambling history(initiating age, duration, stakes, frequency, companion, etc) were included. Results:1) On comparing of gambling behavior in the Korean elderly males to those in adult males, there were statistically significant difference in the duration, stakes, motivation and types of gambling(p<0.001, respectively). Otherwise, there were no statistically significant difference in frequency, companion, parental gambling problem and initiating age of gambling. 2) Using cutoff score 5 as in USA, the rate of pathological gambling in elderly(41.0%) was significantly higher than those in adults(24.0%)(p<0.05). However, applying cutoff score tentatively determined by the mean±S.D., there were no statistically significant difference between elderly(cutoff score 7, 12.4%) and adults(cutoff score 6, 21.0%). 3) There were significant difference between normal and pathological gambling subgroups of elderly in severity of gambling(p<0.05), living alone(p<0.05), housing(p<0.005), monthly income(p<0.05), smoking(p<0.05) and motivation of gambling(p<0.05). There were significant difference between normal and pathological gambling subgroups of adults in education(p<0.001), religion(p<0.05), physical illness (p<0.005), initiation age of gambling (p<0.05), frequency of gambling(p<0.005), stakes(p<0.05) and total money spending in gambling per month(p<0.005). 4) In five items including item number 7(p<0.005), 9(p<0.005), 10(p<0.05), 11(p<0.001) and 14(p<0.05) among the countable items of the SOGS-K(item number 4-11, 13-15, and 16a-16i), there were significant difference between adults and elderly, which might be used to make the brief form of the SOGS-K. Conclusions:The gambling behavior of Korean elderly seems to be intimately related to the lack of recreational resources and mental health problems. Therefore, we expect our results can be reflected to the welfare policy for the Korean elderly to provide social and medical services, developing brief pathological gambling screening test to detect gambling problems earlier among Korean elderly.
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박지용(Ji Yong Park),전진숙(Jin Sook Cheon),권명환(Myong Hwan Kwon),박신형(Sin Hyung Park),오병훈(Byoung Hoon Oh) 대한생물치료정신의학회 2008 생물치료정신의학 Vol.14 No.1
Objectives : Although pathological gambling pertains to the impulse control disorder according to the DSM-Ⅳ, it can be comorbid with various psychiatric disorders including personality disorders(antisocial, narcissistic, borderline). Alcohol and other substance related disorders, suicide, obsessive compulsive disorder, anxiety disorder, attention deficit hyperactivity disorder, mood disorder were reported to be related. Therefore, the aim of this study was to identify influencing or risk factors on the gambling behavior among Korean elderly males. Methods : Structured interviews and assessments using various rating instruments to measure cognitive dis-order (the SPMSQ-K), depression(the K-BDI and the HRSD), alcoholism(the Brief MAST-K), pathological gambling (the Korean Version of the South Oaks Gambling Screen, the SOGS-K) were performed for the elderly males with age over 60 who were living in Busan (N=105). Results: 1) There were significant difference between normal and pathological gambling subgroups of elderly in alcoholism(p<0.05), severity of gambling(p<0.05), living alone(p<0.05), housing(p<0.005), monthly income(p<0.05), smoking(p<0.05) and motivation of gambling(p<0.05). 2) The gambling behavior in the elderly had statistically significant positive correlation with age, alcoholism, depression, cognitive function, education and physical illness (p<0.01, respectively), while had statistically significant negative correlation with monthly income(p<0.01). 3) Especially, the more aged group had about 4 times higher risk and more depressed group had about 19 times higher risk for the pathological gambling. Conclusion: The gambling behavior of Korean elderly seems to be intimately related to the psychosocial factors as well as mental health problems. Most of all, early detection and active treatment of geriatric depression seems to be important.
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