Despite overwhelming acceptance that gaming machines are associated with the highest level of problem gambling, the empirical literature provides inconclusive evidence to support the analogy linking electronic gaming to 'crack-cocaine'. Rigorous and systematic evaluation is required to establish definitively the absolute 'addictive' potential of gaming machines and the degree to which machine characteristics influence the development and maintenance of problem gambling behaviour.
The rates of depression in head and neck cancer patients increase following cancer treatment and are related to tumour/treatment-related physical symptoms. Anxiety levels are higher pre-treatment, lower immediately following cancer treatment but rise to near pre-treatment levels more than a year after completion of cancer treatment.
Objective: To assess symptoms of depression and anxiety in patients with head and neck cancers (HNCs) before and after radiotherapy.
Design, participants and setting: Prospective observational study of 102 outpatients with HNCs at a tertiary cancer centre in Melbourne between 1 May 2008 and 30 May 2009. Eligibility criteria were a first‐time diagnosis of HNC, age over 17 years, and agreement to undergo cancer treatment involving radiotherapy with curative intent. Data were collected before commencement of radiotherapy and again 3 weeks after completing treatment.
Main outcome measures: Symptoms of depression and anxiety as assessed by the Hospital Anxiety and Depression Scale (HADS); physical and psychosocial aspects of quality of life as assessed by the Functional Assessment of Cancer Therapy–Head and Neck (FACT‐H&N).
Results: Seventy‐five participants completed pretreatment and posttreatment questionnaires. Mean depression scores increased significantly from before to after treatment, while anxiety scores decreased significantly over the same period. The prevalence of mild to severe depression was 15% before treatment and 31% after treatment. The prevalence of mild to severe symptoms of anxiety was 30% before treatment, reducing to 17% after treatment. Posttreatment depression was predicted by pretreatment depression and receiving chemotherapy. Posttreatment anxiety was predicted by pretreatment anxiety and male sex.
Conclusions: These findings suggest that rates of depression in patients with HNCs increase after cancer treatment, with a third of patients experiencing clinically significant symptoms of depression after radiotherapy.
The available evidence suggests that pathological gambling significantly disrupts family relationships and has a substantial impact on family members. However, these conclusions are based almost exclusively on male pathological gamblers and their female spouses or partners. The current study, which was a secondary study derived from a treatment outcome study for female pathological gamblers, surveyed three samples with the aim to evaluate (1) the quality of the dyadic and family relationships of treatment-seeking female pathological gamblers; (2) the psychological and relationship functioning of their spouses or partners; and (3) the psychological functioning of their children. Although the findings of this study revealed substantial dysfunction in the intimate and family relationships of female pathological gamblers, the partners and children of the female pathological gamblers in this study did not display elevated rates of psychological dysfunction. It is evident that femalespecific research and direct gender comparisons are warranted in this area of research.
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