Desai Rani A, Potenza Marc N
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
J Clin Psychiatry. 2009 Sep;70(9):1250-7. doi: 10.4088/JCP.08m04359. Epub 2009 Jun 16.
Community data suggest frequent co-occurrence between schizophrenia/schizoaffective disorder and problem gambling. However, gambling behaviors in large samples of patients with schizophrenia/schizoaffective disorder have not been systematically examined to date.
A sample of outpatient subjects (N = 337) diagnosed with either schizophrenia or schizoaffective disorder and who were treated in either the VA Connecticut Healthcare System or the Connecticut Mental Health Center was interviewed in order to examine the prevalence estimates and clinical correlates of problem and pathological gambling. Multinomial logistic regression models investigated clinically relevant measures in recreational or problem/pathological gamblers, as compared to nongamblers. Data were collected between June 2002 and November 2003.
Sixty-five participants (19%) met criteria for past-year problem/pathological gambling, with 10% meeting criteria for pathological gambling. Significant correlates of problem and pathological gambling from multivariable models included greater alcohol use severity (P = .007), higher depression scores (P = .04), and more outpatient mental health care utilization (P = .03). Participants with problem/pathological gambling were more likely than recreational gamblers to gamble for excitement, gamble more frequently and heavily, and report either sports or card gambling as favorite.
A substantial proportion of individuals in treatment for psychotic disorders report past-year gambling problems. Patients with co-occurring alcohol use problems and depression may be at particularly high risk. These findings suggest the need for improved prevention and treatment efforts related to problem/pathological gambling in individuals with psychotic disorders.
社区数据显示精神分裂症/分裂情感性障碍与问题赌博之间经常同时出现。然而,迄今为止,尚未对大量精神分裂症/分裂情感性障碍患者的赌博行为进行系统研究。
对337名在康涅狄格州退伍军人医疗保健系统或康涅狄格州心理健康中心接受治疗、被诊断为精神分裂症或分裂情感性障碍的门诊患者进行访谈,以检查问题赌博和病态赌博的患病率估计及其临床相关因素。多项逻辑回归模型研究了与非赌博者相比,娱乐性或问题/病态赌博者的临床相关指标。数据收集于2002年6月至2003年11月之间。
65名参与者(19%)符合过去一年问题/病态赌博的标准,其中10%符合病态赌博的标准。多变量模型中问题赌博和病态赌博的显著相关因素包括更高的酒精使用严重程度(P = .007)、更高的抑郁评分(P = .04)以及更多的门诊心理健康护理利用(P = .03)。与娱乐性赌博者相比,有问题/病态赌博的参与者更有可能为了寻求刺激而赌博,赌博频率更高、赌注更大,并且将体育或纸牌赌博列为最喜欢的赌博方式。
相当一部分接受精神病治疗的人报告过去一年有赌博问题。同时存在酒精使用问题和抑郁的患者可能风险特别高。这些发现表明需要改进对患有精神疾病的个体中问题/病态赌博的预防和治疗措施。