尼古丁依赖、亚综合征及病理性赌博与其他精神障碍的关系：来自国家酒精及相关疾病流行病学调查的数据
Relationship of nicotine dependence, subsyndromal and pathological gambling, and other psychiatric disorders: data from the National Epidemiologic Survey on Alcohol and Related Conditions.
作者信息
Grant Jon E, Desai Rani A, Potenza Marc N
机构信息
Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55454, USA.
出版信息
J Clin Psychiatry. 2009 Mar;70(3):334-43. doi: 10.4088/jcp.08m04211. Epub 2009 Feb 24.
OBJECTIVE
Nicotine dependence frequently co-occurs with subsyndromal and pathological levels of gambling. The relationship of nicotine dependence, levels of gambling pathology, and other psychiatric disorders, however, is incompletely understood.
METHOD
To use nationally representative data from the National Epidemiologic Survey on Alcohol and Related Conditions to examine the influence of DSM-IV nicotine dependence on the association between pathological gambling severities and other psychiatric disorders. Face-to-face interviews were conducted with 43,093 adults living in households and group-quarters in the United States. The main outcome measure was the co-occurrence of current nicotine dependence and Axis I and II disorders and severity of gambling based on the 10 inclusionary diagnostic criteria for pathological gambling. The study was conducted from 2001 to 2002.
RESULTS
Among non-nicotine-dependent respondents, increasing gambling severity was associated with greater psychopathology for the majority of Axis I and II disorders. This pattern was not uniformly observed among nicotine-dependent subjects. Significant nicotine-by-gambling-group interactions were observed for multiple Axis I and II disorders. All significant interactions involved stronger associations between gambling and psychopathology in the non-nicotine-dependent group.
CONCLUSIONS
In a large national sample, nicotine dependence influences the associations between gambling and multiple psychiatric disorders. Subsyndromal levels of gambling are associated with significant psychopathology. Nicotine dependence accounts for some of the elevated risks for psychopathology associated with subsyndromal and problem/pathological levels of gambling. Additional research is needed to examine specific prevention and treatment for individuals with problem/pathological gambling with and without nicotine dependence.
目的
尼古丁依赖常与亚综合征及病态水平的赌博行为同时出现。然而，尼古丁依赖、赌博病态水平与其他精神障碍之间的关系尚未完全明确。
方法
利用来自全国酒精及相关状况流行病学调查的具有全国代表性的数据，来检验《精神疾病诊断与统计手册》第四版（DSM-IV）中尼古丁依赖对病态赌博严重程度与其他精神障碍之间关联的影响。对居住在美国家庭及集体住所的43,093名成年人进行了面对面访谈。主要结局指标是当前尼古丁依赖与轴I和轴II障碍的共现情况，以及基于病态赌博的10项纳入诊断标准的赌博严重程度。该研究于2001年至2002年进行。
结果
在非尼古丁依赖的受访者中，对于大多数轴I和轴II障碍而言，赌博严重程度的增加与更严重的精神病理学相关。在尼古丁依赖的受试者中，并未一致观察到这种模式。对于多种轴I和轴II障碍，观察到了显著的尼古丁与赌博组交互作用。所有显著的交互作用均涉及非尼古丁依赖组中赌博与精神病理学之间更强的关联。
结论
在一个大型全国样本中，尼古丁依赖会影响赌博与多种精神障碍之间的关联。亚综合征水平的赌博与显著的精神病理学相关。尼古丁依赖是与亚综合征及问题/病态水平赌博相关的精神病理学风险升高的部分原因。需要进一步研究，以探讨对有或无尼古丁依赖的问题/病态赌博个体的具体预防和治疗方法。
Zotero 插件