Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics.

Morgane Guillou Landreat, Isabelle Chereau Boudet, Bastien Perrot, Lucia Romo, Irene Codina, David Magalon, Melina Fatseas, Amandine Luquiens, Georges Brousse, Gaëlle Challet-Bouju, Marie Grall-Bronnec
BMJ Open. 2020-02-01; 10(2): e030424
DOI: 10.1136/bmjopen-2019-030424

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Objectives
Gambling characteristics are factors that could influence problem gambling development. The aim of this study was to identify a typology of gamblers to frame risky behaviour based on gambling characteristics (age of initiation/of problem gambling, type of gambling: pure chance/chance with pseudoskills/chance with elements of skill, gambling online/offline, amount wagered monthly) and to investigate clinical factors associated with these different profiles in a large representative sample of gamblers.

Design and setting
The study is a cross-sectional analysis to the baseline data of the french JEU cohort study (study protocol : Challet-Boujuet al, 2014). Recruitment (April 2009 to September 2011) involved clinicians and researchers from seven institutions that offer care for or conduct research on problem gamblers (PG). Participants were recruited in gambling places, and in care centres. Only participants who reported gambling in the previous year between 18 and 65 years old were included.Participants gave their written informed consent, it was approved by the French Research Ethics Committee.

Participants
The participants were 628 gamblers : 256 non-problem gamblers (NPG), 169 problem gamblers without treatment (PGWT) and 203 problem gamblers seeking treatment (PGST).ResultsSix clustering models were tested, the one with three clusters displayed a lower classification error rate (7.92%) and was better suited to clinical interpretation : ‘Early Onset and Short Course’ (47.5%), ‘Early Onset and Long Course’ (35%) and ‘Late Onset and Short Course’ (17.5%). Gambling characteristics differed significantly between the three clusters.

Conclusions
We defined clusters through the analysis of gambling variables, easy to identify, by psychiatrists or by physicians in primary care. Simple screening concerning these gambling characteristics could be constructed to prevent and to help PG identification. It is important to consider gambling characteristics : policy measures targeting gambling characteristics may reduce the risk of PG or minimise harm from gambling.Trial registration numberNCT01207674(ClinicalTrials.gov); Results.

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