Department of Psychiatry and Psychotherapy, University of Luebeck, Research Group S:TEP, Center for Integrative Psychiatry, Germany; Faculty of Life Sciences, Hamburg University of Applied Sciences, Germany.
Psychiatry Res. 2013 Dec 30;210(3):1065-70. doi: 10.1016/j.psychres.2013.07.026. Epub 2013 Aug 17.
The aim of the present study was to analyze comorbid Axis I-disorders in a sample of individuals with at-risk, problem, and pathological gambling. A number of 164 adult gamblers derived from a random sample of 15,023 individuals were compared with a general population sample. The lifetime prevalence of any psychiatric disorder was 93.6% among pathological (five-10 criteria), 83.5% among problem (three or four criteria), and 81.0% among at-risk gamblers (one or two criteria). Substance use disorders were the most common comorbid disorders in gamblers. Logistic regression analyses revealed elevated odds ratios for having a comorbid disorder in at-risk (Conditional Odds Ratio (COR) 3.5, Confidence Interval (CI) 2.6-4.6), problem (COR 4.9, CI 3.3-7.3), and pathological gamblers (COR 4.6, CI 3.0-6.9) compared to the general population. No significant differences were found between at-risk and problem gamblers or problem and pathological gamblers. Compared to at-risk gamblers, pathological gamblers showed elevated rates of comorbid substance use disorders. The data suggest a linear association between gambling disorder severity and comorbid Axis I-disorders. In conclusion, comorbid disorders are very prevalent in individuals with gambling problems. Even at-risk gamblers with one or two DSM-IV criteria show high rates of Axis I-disorders. Therefore, this group should be included in further studies on problematic gambling.
本研究旨在分析处于风险、问题和病态赌博阶段的个体样本中的共病 Axis I 障碍。从 15023 名随机样本中抽取的 164 名成年赌徒与一般人群样本进行了比较。所有精神障碍的终生患病率在病态赌博者(五项十标准)中为 93.6%,在问题赌博者(三或四项标准)中为 83.5%,在有风险的赌博者(一或两项标准)中为 81.0%。物质使用障碍是赌徒中最常见的共病障碍。逻辑回归分析显示,有风险的赌徒(条件优势比(COR)3.5,置信区间(CI)2.6-4.6)、问题赌徒(COR 4.9,CI 3.3-7.3)和病态赌徒(COR 4.6,CI 3.0-6.9)的共病障碍的可能性比一般人群更高。在有风险的赌徒和问题赌徒之间,或者问题赌徒和病态赌徒之间,没有发现显著差异。与有风险的赌徒相比,病态赌徒表现出更高的共病物质使用障碍率。数据表明,赌博障碍严重程度与共病 Axis I 障碍之间存在线性关联。总之,共病障碍在有赌博问题的个体中非常普遍。即使是有一到两个 DSM-IV 标准的有风险的赌徒也显示出高比率的 Axis I 障碍。因此,这一群体应纳入进一步研究有问题的赌博。
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