Background and Objectives Gambling disorder is defined as persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress in DSM-5 diagnostic criteria. According to the DSM-5, the past-year prevalence rate of gambling disorder is about 0.2%-0.3% in the general population, and the lifetime prevalence is about 0.4%-1.0%. Japan currently has no casinos, but three integrated resorts (IRs), including casinos, are scheduled to open in the late 2020s. In abroad, there have been studies on the effect of casinos on the prevalence of gambling in a region, but similar empirical studies do not exist in Japan. There are a lot of surveys being conducted in many areas, but the different screening tests used make it difficult to compare the results. However, comparisons between screening tests are less common. The first objective of this study is to measure the prevalence of gambling disorder in areas where IRs are planned to open and control areas. The second objective is to identify relationships among screening tests and examine differences between measures by administering multiple screening tests for gambling disorder to the same subjects.

Materials and methods This survey was a self-administered, online survey of 2000 people in Japan, ranging in age from 20 to 69 conducted in 2021. We administered 4 gambling disorder screening tests (SOGS, PGSI, LieBet Screen,DSM-5). Experience rates for each of 8 gambles were measured. Percentage above cut-off score (PAC) was calculated and compared by gender and region for 4 tests.

Results Among the eight gambling activities, the lottery had the largest experience rate at 58.5%, PACHINKO was second at 42.2%, and there were no major regional disparities. In each of the 4 screening tests, PAC was greater in males, and regional differences were found in SOGS and DSM-5. The distribution of PAC for different cut-off scores for each test is illustrated in a “dango chart” for comparison.

Discussion This study indicates PACs for 4 gambling disorder screening tests in planned and non-IR areas, and this will be a baseline survey to measure the impact of opening an IR. Although our results will contain some biases likely due to methodological factors, by continuing to use the same measurement method, our research project will be able to reach its ultimate goal of observing changes in the applicable rate before and after the opening of the IR. In addition, this study administered several gambling disorder screening tests to the same subjects in the same region and illustrated them in a chart format named the dango chart. This visualized the changes in the applicable person rate when the cut-off scores of the screening tests were changed (within-test comparisons) and the differences in the distribution of the applicable person rate across tests (between-test comparisons). We think that the dango chart is a useful presentation method for comparing several different tests.

The authors have declared no competing interest.

This work was supported by JSPS KAKENHI Grant Number JP17K09092 and JP20K14237.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Permission to conduct this study was obtained from the Nara Medical University Ethics Committee (Permission No. 2892. on 2021-3-26).

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Role of funding source This work was supported by JSPS KAKENHI Grant Number JP17K09092 and JP20K14237.

Conflict of interest The authors have no conflicts of interest to this manuscript.

All data from this study are available upon reasonable request to the authors.