University of Toronto, Ontario, Canada.
Can J Psychiatry. 2010 Sep;55(9):568-76. doi: 10.1177/070674371005500905.
To investigate the frequency of gambling in people who have been diagnosed with major depressive disorder (MDD) or bipolar disorder (BD). Secondary objectives were to examine: sex differences in the rates of gambling behaviour, the temporal relation between onset of mood disorders and problem gambling, psychiatric comorbidities associated with problem gambling, and the influences of problem gambling on quality of life.
People (aged 18 years and older) who met criteria for lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision-defined MDD or BD I or II, and were confirmed by the Mini International Neuropsychiatric Interview, were enrolled. Participants were recruited from 5 sites in Canada and 1 in the United States. Prevalence of past-year problem gambling was assessed with the Canadian Problem Gambling Index. Associated comorbidities with problem gambling are presented.
A total of 579 participants were enrolled (female: n = 379, male: n = 200). Prevalence of problem gambling did not differ significantly between the MDD (12.5%) and the BD (12.3%) groups. There was a significant difference in the prevalence of problem gambling between males (19.5%) and females (7.8%) in the BD group (chi-square = 8.695, df = 1, P = 0.003). Among people meeting criteria for problem gambling, the mood disorder was the primary onset condition in 71% of cases. People with a mood disorder with comorbid current panic disorder (OR = 1.96; 95% CI 1.02 to 3.75), obsessive-compulsive disorder (OR = 1.86; 95% CI 1.01 to 3.45), specific phobia (OR = 2.36; 95% CI 1.17 to 4.76), alcohol dependence (OR = 5.73; 95% CI 3.08 to 10.65), or lifetime substance dependence (OR = 2.05; 95% CI 1.17 to 3.58), had significantly increased odds of problem gambling. Problem gambling across MDD and BD populations was also associated with lower quality of life ratings.
These results reaffirm a higher prevalence of gambling both in BD and in MDD populations, compared with previously published community samples. Our study also identifies risk factors for gambling behaviours within these populations.
调查被诊断为重度抑郁症（MDD）或双相情感障碍（BD）的人群中赌博的频率。次要目标是检查：赌博行为的性别差异、心境障碍发病与问题赌博之间的时间关系、与问题赌博相关的精神共病，以及问题赌博对生活质量的影响。
符合《精神障碍诊断与统计手册》第四版修订版（DSM-IV-TR）定义的 MDD 或 BD I 或 II 终生标准，并经 Mini 国际神经精神访谈（MINI）确认的年龄在 18 岁及以上的人群被纳入研究。参与者来自加拿大的 5 个地点和美国的 1 个地点。过去一年的问题赌博发生率采用加拿大问题赌博指数（Canadian Problem Gambling Index）进行评估。同时列出了与问题赌博相关的共病情况。
共纳入 579 名参与者（女性：n=379，男性：n=200）。MDD（12.5%）和 BD（12.3%）组之间的问题赌博发生率无显著差异。BD 组中男性（19.5%）和女性（7.8%）之间的问题赌博发生率存在显著差异（卡方=8.695，df=1，P=0.003）。在符合问题赌博标准的人群中，有 71%的患者是心境障碍首发。伴有当前惊恐障碍（OR=1.96；95%CI 1.02 至 3.75）、强迫症（OR=1.86；95%CI 1.01 至 3.45）、特定恐惧症（OR=2.36；95%CI 1.17 至 4.76）、酒精依赖（OR=5.73；95%CI 3.08 至 10.65）或终生物质依赖（OR=2.05；95%CI 1.17 至 3.58）的心境障碍患者，其问题赌博的发生风险显著增加。MDD 和 BD 人群中的问题赌博也与生活质量评分较低有关。
这些结果再次证实，与以前发表的社区样本相比，BD 和 MDD 人群中赌博的发生率更高。我们的研究还确定了这些人群中赌博行为的风险因素。
