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The prevalence of pathological gambling is 3.4% to 6% in treated Parkinson's disease, which is higher than the background population rate. In this review we discuss current evidence to indicate that dopamine agonists are much more likely to trigger this behavior than either L-dopa or selective monoamine oxidase B inhibitor monotherapy. New insights from recent behavioral and functional imaging studies and possible treatment approaches are also covered. A PubMed literature search using the terms "gambling" and "Parkinson's disease," "impulse control disorder," "impulsive compulsive behaviour," "dopamine agonist," of individual dopamine agonists, and of ongoing drug trials, using http://www.clinicaltrials.gov, was carried out for the period up to January 2011. [ABSTRACT FROM AUTHOR]

The UK has one of the highest rates of recreational gambling in the world. Some vulnerable individuals progressively lose control over gambling and develop at-risk gambling or gambling disorder (GD), characterised by compulsive pursuit of gambling. GD destroys lives and incurs massive costs to societies, yet only a few treatments are available. Failure to develop a wider range of interventions is in part due to a lack of funding that has slowed progress in translational research necessary to understand the individual vulnerability to switch from controlled to compulsive gambling. Current preclinical models of GD do not operationalise the key clinical features of the human condition. The so-called "gambling tasks" for non-human mammals almost exclusively assess probabilistic decision-making, which is not real-world gambling. While they have provided insights into the psychological and neural mechanisms involved in the processing of gains and losses, these tasks have failed to capture those underlying real-world gambling and its compulsive manifestation in humans. Here, we highlight the strengths and weaknesses of current gambling-like behaviour tasks and suggest how their translational validity may be improved. We then propose a theoretical framework, the incentive habit theory of GD, which may prove useful for the operationalisation of the biobehavioural mechanisms of GD in preclinical models. We conclude with a list of recommendations for the development of next-generation preclinical models of GD and discuss how modern techniques in animal behavioural experimentation can be deployed in the context of GD preclinical research to bolster the translational pipeline., (Crown Copyright © 2025. Published by Elsevier Ltd. All rights reserved.)

Background: Clinical guidelines remain unclear on which medications for gambling disorder are to be preferred in terms of efficacy and tolerability. We aimed to compare pharmacological treatments for gambling disorder in terms of efficacy and tolerability, using network meta-analysis (NMA)., Methods: Based on our pre-registered protocol [CRD42022329520], a structured search was conducted across broad range of databases, for double-blind randomized controlled trials (RCTs) of medications for gambling disorder. Data were independently extracted by two researchers. We used standardized mean differences (SMD) using Hedges' g to measure the efficacy outcomes, and for the effect for tolerability we used dropout rate due to medication side effects, expressed as odds ratio (OR). Confidence in the network estimates was assessed using the CINeMA framework. We followed the PRISMA-NMA guidelines for this work. Outcomes were gambling symptom severity and quality of life (for efficacy), and tolerability., Findings: We included 22 RCTs in the systematic review and 16 RCTs (n = 977 participants) in the NMA. Compared with placebo, moderate confidence evidence indicated that nalmefene [Standardized Mean Difference (SMD): -0.86; 95 % confidence interval (CI: -1.32,-0.41)] reduced gambling severity, followed by naltrexone (SMD: -0.42; 95 %CI: (-0.85,0.01)). Naltrexone (SMD: -0.50; 95 %CI: (-0.85,-0.14)) and nalmefene (SMD: -0.36; 95 %CI: (-0.72,-0.01) were also more beneficial than placebo in terms of quality of life. Olanzapine and topiramate were not more efficacious than placebo. Nalmefene [Odds Ratio (OR): 7.55; 95 %CI: (2.24-25.41)] and naltrexone (OR: 7.82; 95 %CI: (1.26-48.70)) had significantly higher dropout due to side effects (lower tolerability) compared with placebo., Interpretation: Based on NMA, nalmefene and naltrexone currently have the most supportive evidence for the pharmacological treatment of gambling disorder. Further clinical trials of novel compounds, and analysis of individual participant data are needed, to strengthen the evidence base, and help tailor treatments at the individual patient level., Competing Interests: Declaration of competing interest Dr. Ioannidis is clinical lead for the Southern Gambling Service and receives a stipend from Elsevier for journal editorial work. Professor Chamberlain is service director for the NHS Southern Gambling Service. Professor Chamberlain receives a stipend from Elsevier for journal editorial work. Professor Bowden-Jones is National Clinical Advisor on Gambling Harms in the UK, and is Director of the National Problem Gambling Clinic and the National Centre for Gaming Disorders. Professor Bowden-Jones' clinics receive funding from NHS England and CNWL NHS Trust. Professor Bowden-Jones' clinics previously received funding from GambleAware. Cinzia Del Giovane's time on the project was funded partly through the grant funding to SRC. Dr. Grant has received research grants from Janssen and Biohaven Pharmaceuticals. He receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. None of the authors have conflicts of interest in relation to the gambling or gaming industry. None of the authors accept voluntary donations from the gambling or gaming industry either personally or in terms of institutional funds held in their name., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Competing Interests: NAF has received support for research or networking from the UK National Institute for Health and Care Research, UK Research and Innovation, COST Action, Orchard, and Compass Pathways; accepted travel or hospitality expenses from the British Association for Psychopharmacology, European College of Neuropsychopharmacology, Royal College of Psychiatrists, International College of Neuropsychopharmacology, International Forum of Mood and Anxiety Disorders, and World Psychiatric Association; has received payment from Elsevier for editorial duties and the Mental Health Academy for lecturing; has accepted paid speaking engagements in various industry-supported symposia; and recruited patients for various industry-sponsored studies in the field of OCD treatment. NAF also leads an NHS treatment service for OCD; holds board membership for various registered charities linked to OCD; gives expert advice on psychopharmacology to the UK Medicines and Healthcare products Regulatory Agency; and has participated in a WHO working group focusing on diagnosis and classification of obsessive compulsive or related disorders for the ICD-11. ZD reports that the University of Gibraltar received funding from the Gibraltar Gambling Care Foundation (an independent, not-for-profit charity) and donations from gambling operators through the Licence Conditions and Codes of Practice RET process supervised by the UK Gambling Commission. MNP has consulted for Opiant Therapeutics, Game Day Data, Baria-Tek, and Boehringer Ingelheim Pharmaceuticals; has been involved in a patent application with Yale University and Novartis; has received research support from Mohegan Sun Casino, Children and Screens, and the Connecticut Council on Problem Gambling; has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse-control disorders or other health topics; has consulted for or advised gambling, non-profit, and legal entities on issues related to impulse control, internet use, and addictive disorders; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, Continuing Medical Education events, and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts. HE has received funding from the Medical Discovery Team on Addiction, University of Minnesota, William K Warren Foundation, Laureate Institute for Brain Research, and Brain and Behavior Foundation. HB-J is director of the National Centre for Behavioural Addictions in the UK, vice-president of the Royal Society of Medicine, and national advisor to Gambling Harms for England. BK is chair of the 5Rights Foundation and chair of Digital Futures for Children. DJS has received consultancy honoraria from Discovery Vitality, Johnson & Johnson, Kanna, L'Oreal, Lundbeck, Orion, Sanofi, Servier, Takeda, and Vistagen. All other authors declare no competing interests.

Alcohol dependence (AD) and gambling disorder (GD) are common addiction disorders with significant physical and mental health consequences. AD and GD are associated with dysregulated responses to reward which could be due to a common mechanism of dysregulated endogenous opioid signalling. We explored associations between reward anticipation responses, using the Monetary Incentive Delay (MID) functional magnetic resonance imaging (fMRI) task, and mu-opioid receptor (MOR) availability and endogenous opioid release capacity using [ 11 C]carfentanil positron emission tomography (PET), in 13 AD, 15 GD and 14 heathy control (HC) participants. We also examined differences in MID task reward anticipation responses between AD, GD and HC participants. These were secondary exploratory analysis of data collected to examine differences in MOR PET in addiction. We did not find significant differences in MID win > neutral anticipation BOLD responses compared between participant groups in a priori ROIs (ventral striatum, putamen, caudate) or whole brain analyses. We found no significant correlations between MID win > neutral anticipation BOLD responses and [ 11 C]carfentanil PET measures, except for limited negative correlations between putamen MOR availability and MID win > neutral anticipation BOLD response in AD participants. Previous research has suggested a limited role of endogenous opioid signalling on MID task reward anticipation responses in AD and HCs as these responses are not modulated by opioid receptor blockade and this may explain our lack of significant correlations in HC and AD or GD participants. Our results, particularly the lack of differences in MID win > neutral anticipation BOLD responses across participants groups, may be limited due to only including AD or GD participants who are abstinent or in active treatment., Competing Interests: Prof Luke Clark is the Director of the Centre for Gambling Research at 10.13039/501100005247UBC, which is supported by funding from the Province of British Columbia and the British Columbia Lottery Corporation (BCLC), a Canadian Crown Corporation. The Province of BC government and the BCLC had no role in the design, analysis, or interpretation of the study, and impose no constraints on publishing. LC has received remuneration from the International Center for Responsible Gaming (travel; speaker honoraria; academic services), the Institut fur Glucksspiel und Gesellschaft (Germany; travel; speaker honoraria), GambleAware (UK; academic services), Gambling Research Australia (academic services), Alberta Gambling Research Institute (Canada; travel; academic services), German Foundation for Gambling Research (advisory board; travel). He has been remunerated for legal consultancy by the BCLC. He has not received any further direct or indirect payments from the gambling industry or groups substantially funded by gambling. LC receives an honorarium for his role as Co-Editor-in-Chief for International Gambling Studies from Taylor & Francis, and he has received royalties from Cambridge Cognition Ltd. relating to neurocognitive testing. Prof David Nutt is the CRO of Awakn Life Sciences, chair of DrugScience [UK] and PAREA Europe, a member of the Lundbeck Foundation Neurotorium programme and chair of its editorial board, advisor to the British National Formulary and a member of the International Centre for Science in Drug Policy. He has received grants or clinical trial payments from Wellcome Trust, MRC, COMPASS Pathways and Usona, speaking honoraria from Janssen, Lundbeck, Otsuka and Rovi, has share options in P1vital, Awakn, Psyched Wellness and Neurotherapeutics and is a director of Equasy Enterprises and GABA Labs. He has been an expert witness in a number of legal cases relating to psychotropic drugs, is editor of the Drug Science Policy and Law Journal and has edited/written 38 books, some of which have been purchased by pharmaceutical companies.Prof Anne Lingford-Hughes reports honoraria for speaking engagements and/or attendance at conferences from 10.13039/501100013327Lundbeck, 10.13039/501100013327Lundbeck Institute UK, 10.13039/100004319Pfizer and Servier; she has received research grants or support from Alcarelle and Lundbeck; she is a member of the 10.13039/501100000544British Association for Psychopharmacology and receives honoraria for speaking at educational events and led their ‘addiction’ guidelines, which received support from Archimedes Pharma, 10.13039/501100013327Lundbeck, 10.13039/100004319Pfizer and Schering.The other authors declare no conflicts of interest in relation to this paper., (© 2024 The Authors.)

Background: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience ( n = 5; 19%), convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally.

Gambling Disorder (GD) is an impactful behavioural addiction for which there appear to be underpinning genetic contributors. Twin studies show significant GD heritability results and intergenerational transmission show high rates of transmission. Recent developments in polygenic and multifactorial risk prediction modelling provide promising opportunities to enable early identification and intervention for at risk individuals. People with GD often have significant delays in diagnosis and subsequent help-seeking that can compromise their recovery. In this paper we advocate for more research into the utility of polygenic and multifactorial risk modelling in GD research and treatment programs and rigorous evaluation of its costs and benefits.

Competing Interests: SD sits on the Executive Committee of the Academic Forum for the Study of Gambling (AFSG) for which he receives an annual honorarium. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Chronic illnesses are a major threat to global population health through the lifespan into older age. Despite world-wide public health goals, there has been a steady increase in chronic and non-communicable diseases (e.g., cancer, cardiovascular and metabolic disorders) and strong growth in mental health disorders. In 2010, 67% of deaths worldwide were due to chronic diseases and this increased to 74% in 2019, with accelerated growth in the COVID-19 era and its aftermath. Aging and wellbeing across the lifespan are positively impacted by the presence of effective prevention and management of chronic illness that can enhance population health. This paper provides a short overview of the journey to this current situation followed by discussion of how we may better address what the World Health Organization has termed the "tsunami of chronic diseases." In this paper we advocate for the development, validation, and subsequent deployment of integrated: 1. Polygenic and multifactorial risk prediction tools to screen for those at future risk of chronic disease and those with undiagnosed chronic disease. 2. Advanced preventive, behavior change and chronic disease management to maximize population health and wellbeing. 3. Digital health systems to support greater efficiencies in population-scale health prevention and intervention programs. It is argued that each of these actions individually has an emerging evidence base. However, there has been limited research to date concerning the combined population-level health effects of their integration. We outline the conceptual framework within which we are planning and currently conducting studies to investigate the effects of their integration., Competing Interests: SRC’s research is funded by the NHS and was previously funded by Wellcome (an independent charity). SRC receives a stipend for editorial work at Elsevier journals (Comprehensive Psychiatry, and Neuroscience & Biobehavioral Reviews). HB-J is the Director of the UK National Problem Gambling Clinic and the UK National Centre for Gaming Disorders which are now fully funded by the NHS. These clinics have previously received funding from NHS England, Central and North West London NHS Trust, and GambleAware. HB-J is Vice President of the Royal Society of Medicine and sits on several national and international Boards. HB-J has been on research teams funded by the Medical Research Council, the Wellcome Trust, and the Wolfson Family Trust. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Thomas, Browning, Charchar, Klein, Ory, Bowden-Jones and Chamberlain.)

Introduction: Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming., Methods: Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R)., Results: High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives., Discussion and Conclusion: The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies., (© 2023 S. Karger AG, Basel.)