Yale Therapeutic Neuroscience Clinic, New Haven, CT, USA.
CNS Spectr. 2010 Jan;15(1):33-44. doi: 10.1017/s1092852900000286.
Alcohol abuse and/or dependence, alcohol use disorders (AUDs), and problem and/or pathological gambling (PPG) frequently co-occur with each other and other psychiatric disorders. However, prior studies have not investigated the relative influence of AUDs on the associations between PPG and other psychiatric disorders,
Nationally representative data froni the National Epidemiologic Survey on Alcohol and Related Conditions (n=43,093; United States residents > or = 18 years of age) was used to examine the influence of AUDs on the associations between gambling and other psychiatric disorders and behaviors. The main outcome measures were co-occurrence of past-year AUD and Axis I and II disorders and severity of gambling based on the 10 inclusionary diagnostic criteria for pathological gambling.
Among non-AUD respondents, increasing gambling severity was associ- ated with increasingly elevated odds for the majority of Axis I and II disorders. Among AUD respondents, this pattern was typically not observed. Alcohol-by-gambling-group interactions for PPG were also found and the odds of these disorders was significantly increased in non-AUD respondents with PPG, but either unchanged or significantly lower in AUD respondents with PPG.
Gambling-related associations exist with multiple psychiatric disorders, but particularly in those without AUD. These associations have important implications with respect to conceptualization, prevention, and treatment of psychiatric disorders in individuals with gambling and/or AUDs.
酗酒和/或依赖、酒精使用障碍（AUD）以及问题性和/或病理性赌博（PPG）常常相互伴随，且与其他精神疾病同时存在。然而，之前的研究尚未调查 AUD 对 PPG 与其他精神疾病之间关联的相对影响。
使用来自全国酒精流行病学调查和相关条件的全国代表性数据（n=43093；美国年龄≥18 岁的居民），检查 AUD 对赌博和其他精神疾病及行为之间关联的影响。主要结局指标为过去一年 AUD 和轴 I 和 II 障碍的共病和基于病理性赌博的 10 项纳入性诊断标准的赌博严重程度。
在非 AUD 受访者中，赌博严重程度的增加与大多数轴 I 和 II 障碍的几率呈递增关系。在 AUD 受访者中，通常观察不到这种模式。在 PPG 中还发现了酒精与赌博组之间的交互作用，并且在没有 AUD 的 PPG 受访者中，这些障碍的几率显著增加，但在有 AUD 的 PPG 受访者中，要么不变，要么显著降低。
与多种精神疾病存在与赌博相关的关联，但尤其存在于没有 AUD 的个体中。这些关联对于个体中存在赌博和/或 AUD 时的精神疾病的概念化、预防和治疗具有重要意义。
