スイス・カジノ依存症対策 「ギャンブル行為、経過、依存と結果の実証的研究」(4)

スイスにおけるギャンブルとギャンブル依存症-ギャンブル行為、経過、依存と結果の実証的研究

BASS(Büro für arbeites-und sozialpolitische Studien)(訳: 労働と社会政策研究所)
スイス連邦ゲーミング委員会および連邦法務局の委任を受けて
Kilian Künzi, Tobias Fritschi, Theres Egger 共著 ベルン 2004年11月15日
日本語訳 平沼由紀子
用語/名称について(訳:)とあるのは意味を訳したもので、正式な用語/名称ではない。

problem gamblingとgambling addiction (ギャンブル依存症)の発生率

■現在のところ、スイスにおけるギャンブル依存症の発生率に関する研究は2例のみであり、どちらも1998年のデータに基づいている。

Osiek et al.による1999年の研究で示された成人のprevalence rate (有病率) は、pathological gambling (訳:病的なギャンブル依存症) が0.79%(32,700~77,800人)、problem gamblingが2.18%(107,100~179,800人)であった。

Molo Bettelini et al.の2000年の調査によると、Ticino州の 18歳~74歳人口における有病率は、pathological gamblingとproblem gamblingともに0.6%であった。

■世界的には、ギャンブルの機会の多寡にもよるが、殆どの国で0.5~2%の有病率を示す。これに近い有病率が最終的にスイスでも示されることが推察できる。
■カウンセリング施設、セラピー施設に送付した質問表への回答から、近年、problem gamblingの相談に訪れる人の数は、1998年には146人だったのが2003年には751人と大幅に増えていることがうかがえる。
(表1参照)

相談者全体のなかの割合でみると1.61%へと、約4倍に増加している。

さまざまな推定を重ねた結果、2003年にカウンセリングを受けているproblem gamblerの実際の人数は1,000人~1,500人であろう。

■problem gamblingでカウンセリングを受けている人数の、人口100,000人あたりの分布には明らかなパターンがある。ある地方でギャンブルの機会が多い程、カウンセリングを受けているproblem gamblerも多い。
最もその影響力の大きかった要素は、カジノ外におけるゲーミングマシンの密度とAカジノの有無であった。

■重度のギャンブル依存症や、ギャンブル依存症の他にも精神疾患を抱えている場合、精神科への入院治療が必要な場合もある。
1998~2001年のSwiss Hospital Medical Statistics(スイス医療統計)によると、その期間中、ギャンブル依存症に関連した入院は325例、2001年だけで102例。
そのうち、ギャンブル依存症を主たる病名とするのが約4分の1、残りの4分の3は2次的な病名としてギャンブル依存症の診断を受けていた。

■前述のSwiss Health Census 2002によって確認されたfrequent gamblerのうち、2.8%(3,1000人)は今まで既に1回以上、gambling problemsについてカウンセリングまたは何らかの支援を受けたと回答している。

■電話カウンセリングサービス Telefons143(Die Dargebotene Hand)(訳:救いの手)の統計によると、2002~2003年の間に、problem gamblingの相談件数は138件(0.07%)から 2,450件(1.04%)、増加率1,675%、と劇的な増加を示したが、これはカウンセラーのこの種の問題に対する関心と注意が高まったことに多くを負うものである。

■2002年のCasino Act施行以降、カジノ利用者に発せれた exclusion orders(訳: 入場禁止措置)は、2002年には約700回、 2003年には2,301回と著しく増加した。
実際に発令された数の5倍の申請があり、2003年の終わりまでに6,923人のギャンブラーが措置を受けた。
スイスゲーミング委員会は、この数字が2004年中に10,000を越したと推定している。

■インタビューした専門家の推定によると、スイス国内のギャンブル依存症の有病率は1%程度。前述のOsiek et al.が1999年に導き出した変動幅は確かである。

■様々な情報源の比較評価により、model for estimating prevalence(訳:有病率を推定するためのモデル)をつくりあげた。このモデルはまた、カウンセリング施設やセラピー施設へ送付した質問表に含まれる無数の仮定や推測、専門家へのインタビュー、文献や入場禁止措置数などにも基づいている。
このモデルを用いて、我々は、2003年のスイス国内の成人人口におけるギャンブル依存症の有病率を0.62~0.84%、35,500人~48,000人と推定した。

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