Conference Proceeding Open Access

Depression and suicidal risk in Gambling disoder (GD) and Internet gaming disoder (IGD). Clinical, neurobiological and social preconditions for this comorbid psychopathology

Abstract

Numerous clinical studies have shown that people with GD and IGD suffer from other mental disorders in the vast majority of cases (70 - 92%). At the same time, depression is one of the most common concomitant mental disorders in these behavioral dependencies. It is diagnosed in 37.9-60% of patients with GD. Meta-analysis 21 studies and systematic reviews find a high degree of correlation between IGD and depression in 75 -89% of studies. This study examines the clinical syndromes, neurobiological changes and negative social consequences that can contribute to depression and suicidal moods in GD and IGD. Patients with GD, there is a high suicide risk in 50%, in 80% there are suicidal thoughts, which in 48-49.2% of cases having a constant, obsessive nature, 12-35, 8% commit suicide attempts. Suicide is the main cause of death (31%) in this category of patients. High suicidal risk (thoughts, attempts) is found by researchers in different countries in IGD. According to various studies, suicide risk in individuals with IGD is 2-3 times higher than in the general population. The analysis of clinical and neurobiological studies, as well as their own clinical cases, reveals that emotional dysregulation, constant emotional distress, experienced altered states of consciousness with a violation of self-identification during the game as well as increasing negative social consequences, are predisposing risk factors for the development of depression in these behavioral dependencies. Morphometric studies have shown that IGD and GD are associated with structural abnormalities in gray matter (GM), such as decreased gray matter volume (GMV) in the frontal, cingulate, insular, parietal cortex, amygdala and hippocampus. In the same zones, a decrease in the volume of gray matter is found in post-traumatic stress syndrome as a result of severe chronic distress and depression. A decrease in the volume of gray matter in these areas of the brain is observed due to the debilitating effect on the Central nervous system of chronic distress. Indicators of experienced distress are functional and structural changes in the brain, vegetative shifts, changes in the secretion of hormones of the hypatoadrenal system and neurotransmitters: cortisol, norepinephrine, and epinephrine. All this we observe in patients with IGD and GD. As for the time sequence, longitudinal studies have found a bidirectional relationship between depression and the severity of addiction symptoms. Based on all the results obtained, we can conclude that dependent players can become both initially mentally healthy people, and those who have already experienced subclinical and clinical manifestations of depression. In the first case, the depression was added in the process of aggravating the symptoms of addiction, and in the second, the depressive symptoms increased and worsened. But when healthy life activity was restored, the severity of symptoms of depression also decreased. This study also shows that information gaming technologies are the main risk factor for the development of both addiction and comorbid psychopathology, up to suicidal behavior.  

Tetiana Zinchenko

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