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“赌博障碍”的访谈与诊治
引用本文:郝凤仪,张道龙.“赌博障碍”的访谈与诊治[J].四川精神卫生,2017,30(2):178-182.
作者姓名:郝凤仪  张道龙
作者单位:1. 重庆医科大学附属第一医院精神科,重庆,400016;2. 美国伊利诺伊大学精神医学系,伊利诺伊州 芝加哥 IL 60612
摘    要:咨客是一名26岁大专学历的已婚未育男性,事业单位职员。从初中开始参与小额赌博,逐渐加大赌注,反复戒赌失败,目前欠下巨额赌债,严重影响工作和生活,感到内疚后悔。咨客本次咨询的目的是想了解如何才能彻底戒除赌瘾。该咨客被诊断为赌博障碍,属于物质相关及成瘾障碍,容易复发,应采用生物-心理-社会的综合干预。具体做法是鼓励咨客发展健康的爱好来激活大脑;采用认知行为疗法(CBT)让咨客直面赌博的严重后果,认识到自己作为儿子、丈夫的责任和义务;使用动机面询激发咨客为家人和未来孩子戒赌的决心;鼓励患者认真工作,回归家庭,脱离赌博圈子,按时复诊。

关 键 词:赌博障碍  药物治疗  心理治疗

Interview and treatment of gambling disorder
Hao Fengyi,Zhang Daolong.Interview and treatment of gambling disorder[J].Sichuan Mental Health,2017,30(2):178-182.
Authors:Hao Fengyi  Zhang Daolong
Abstract:The patient is a twenty-six-year-old, college-educated government employee who is married without children.In his youth, he participated in small amount money of gambling starting from junior high school and gradually raised the stakes involved until he felt compelled to quit gambling several times.He owes a fair amount of debts presently which affected his work and daily life.He frequently felt guilt and regret and sought advice for how to get rid himself from his gambling addiction entirely.In therapy, he was diagnosed with gambling disorder which was a substance-related or addictive disorder.The rate of relapse in this disorder was high in clincal.Consequently, medical professionals should take a biopsychosocial integrated intervention approach.Specific treatments include encouraging the patient to develop healthy hobbies instead of gambling to stimulate the pleasure centers of the brain, Cognitive Behavior Therapy(CBT) was adopted to help the patient to recognize the serious impacts of his behavior on his family, and through Motivational Interviewing inspiring him to find the method for staying away from gambling activity in favor of time spent at work or with his family.
Keywords:Gambling disorder  Medical treatment  Psychotherapy
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