Abstract
Macao, China’s only city with legalized casinos, has maintained a high prevalence of gambling participation and gambling disorder (GD) over the past decade. The mental health risks associated with such high levels have been overlooked. In order to estimate the comorbid prevalence of GD with depression, anxiety, and Internet gaming disorder (IGD) and to explore the potential buffering effect of psychological resilience and purpose in life, this study obtained a representative adult Chinese sample (N = 1000, 44% male, aged 18–97 years) from a telephone survey conducted between October and November of 2016. As hypothesized, the highest psychiatric comorbid prevalence was observed in the GD subgroup (n = 19, 21.1% probable IGD, 26.3% probable depression, and 37.0% probable anxiety). All these mental health problems could increase one’s proclivity to GD, and vice versa. Psychological resilience was found to buffer the association between anxiety symptoms and probable GD (χ2(1) = 4.30, p = 0.04/GD symptoms, Fchange (1,162) = 6.29, p = 0.01), whereas purpose in life did not display any hypothesized moderating effect. These results indicate the usefulness of mental health screening for GD, taking into consideration its associated risks, and of fostering psychological resilience in prevention and treatment programs.
Highlights
Macao, with its reputation as the Las Vegas in the East and with its over 170 years of gambling industry history, is the only city in the greater China territory with legalized casino gambling since its sovereignty was returned to China, from Portugal, in 1999 [1,2]
Senior secondary and higher]) were more likely to engage in gambling in the past year. This pattern was observed among probable gambling disorder (GD) gamblers compared to non-GD gamblers (OR = 3.04 for males; OR = 3.43 for less educated)
Probable GD gamblers, relative to non-GD gamblers, reported spending significantly more money on gambling (p < 0.001) and showed a significantly higher tendency to suffer from Internet gaming disorder (IGD) (OR = 12.53) and from depression (OR = 4.15)
Summary
With its reputation as the Las Vegas in the East and with its over 170 years of gambling industry history, is the only city in the greater China territory with legalized casino gambling since its sovereignty was returned to China, from Portugal, in 1999 [1,2]. Similar prevalence has been reported in other local studies, such as 5.6% probable pathological gambling in 2010 (N = 2011) [7] and 2.1% probable disordered gambling in 2014 (N = 1018) [8]. These estimated percentages are considerably higher than those in other regions that have legalized casino gambling, such as a low 0.1% probable disordered gambling in Singapore (N = 3000) [9]. Public Health 2018, 15, 2774; doi:10.3390/ijerph15122774 www.mdpi.com/journal/ijerph
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