Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-gu, Seoul, 138-736, South Korea.
Soc Psychiatry Psychiatr Epidemiol. 2010 Jun;45(6):621-9. doi: 10.1007/s00127-009-0102-9. Epub 2009 Jul 28.
Based on the National Epidemiological Survey of Psychiatric Disorders in South Korea conducted in 2006, we examined the prevalence, clinical correlations, comorbidities, and suicidal tendencies of pathological gamblers in the community.
Of the 6,510 participants who completed the Korean version of the Composite International Diagnostic Interview (K-CIDI) administered by trained lay interviewers, 5,333 subjects fully completed the Diagnostic Interview Schedule (DIS) exploring pathological gambling. The DIS has 13 items mapping to 10 criteria. Endorsement of five DSM-IV criteria was considered to reflect pathological gambling, and we considered endorsement of one to four criteria to indicate problem gambling. The frequencies of psychiatric disorders and suicidal tendency were analyzed among pathological/problem gamblers in comparison with controls; both odds ratios and significance levels were calculated.
The lifetime prevalence rates of pathological gambling and problem gambling were 0.8% and 3.0%, respectively. Of pathological gamblers, 79.1% had at least one psychiatric illness in comparison to the control level of 28.1%, and 62.0% of problem gamblers also had psychiatric conditions. Associations between pathological/problem gambling and alcohol use disorder, nicotine dependence, mood disorder, anxiety disorder, and suicidality were overwhelmingly positive and significant (p < 0.05), even after controlling for age and gender. Male gender, divorced/separated/widowed marital status, and urban living were all associated with increased risks of pathological and problem gambling (p < 0.05).
Pathological/problem gambling is highly associated with substance abuse, mood and anxiety disorders, and suicidality, suggesting that clinicians should carefully evaluate and treat such psychiatric disorders in gamblers.
基于韩国 2006 年进行的全国性精神障碍流行病学调查，我们考察了社区中病理性赌博者的流行率、临床相关性、共病和自杀倾向。
在完成由经过培训的非专业访谈员实施的韩国版复合国际诊断访谈（K-CIDI）的 6510 名参与者中，有 5333 名受试者完整地完成了探索病理性赌博的诊断访谈时间表（DIS）。DIS 有 13 项与 10 项标准相对应。如果符合 DSM-IV 标准的 5 项标准，则被认为反映了病理性赌博，而如果符合 1 至 4 项标准，则表示存在问题赌博。在与对照组相比，分析病理性/问题赌博者中各种精神障碍和自杀倾向的频率；并计算了比值比和显著性水平。
病理性赌博和问题赌博的终生患病率分别为 0.8%和 3.0%。与对照组的 28.1%相比，病理性赌博者中有 79.1%至少有一种精神疾病，而问题赌博者中有 62.0%也存在精神疾病。病理性/问题赌博与酒精使用障碍、尼古丁依赖、心境障碍、焦虑障碍和自杀意念之间存在着压倒性的正相关和显著性（p<0.05），即使在控制了年龄和性别后也是如此。男性、离婚/分居/丧偶的婚姻状况和城市居住与病理性和问题赌博的风险增加有关（p<0.05）。
病理性/问题赌博与物质滥用、心境和焦虑障碍以及自杀意念高度相关，这表明临床医生应该仔细评估和治疗赌徒的这些精神障碍。
