St Vincent's Mental Health, P.O. Box 2900, Fitzroy, Melbourne, Victoria 3065, Australia.
Centre for Academic Primary Care, School of Social & Community Medicine, University of Bristol, Canygne Hall, 39 Whatley Rd., Bristol BS8 2PS, UK; Centre for Gambling Research, School of Sociology, Research School of Social Sciences, The Australian National University, Australian Capital Territory, Australia.
Compr Psychiatry. 2015 Apr;58:122-9. doi: 10.1016/j.comppsych.2015.01.003. Epub 2015 Jan 15.
There are few published studies on the comorbidity of psychosis and problem gambling. This paper provides estimates of the prevalence and clinical correlates of problem gambling in a representative sample of people with psychotic disorders.
The second Australian national survey of psychosis was undertaken in 2010 and included adults (18-64 years) attending mental health services. Problem gambling was measured using the Canadian Problem Gambling Index (CPGI) at two sites of this study, with 442 participants providing data suitable for analysis.
There were 151 participants who screened positive to past-year gambling. 4.1% of the total sample was classified as low risk gamblers, 6.4% were moderate risk gamblers and 5.8% were problem gamblers. Moderate risk/problem gamblers were more likely to be male, have left school with no qualifications and have sought financial assistance in the last year. There was a significant association with substance use, including alcohol use disorders and use of cannabis and 'other' drugs (excluding cannabis).
People with psychosis are four times more likely to have a gambling problem than the general population. The association of gambling with substance use disorders is consistent with community studies, while the increased need for financial assistance suggests that problem gambling increases the likelihood of financial harm for this population. Clinicians should screen for comorbid gambling problems in people with psychosis, while there is also a need for additional research into this area.
关于精神病和赌博问题共病的研究较少。本文提供了在代表性的精神病患者样本中赌博问题的患病率和临床相关性的估计。
2010 年进行了第二次澳大利亚全国精神病学调查，包括在心理健康服务机构就诊的成年人（18-64 岁）。该研究的两个地点使用加拿大赌博问题指数（CPGI）测量赌博问题，442 名参与者提供了适合分析的数据。
有 151 名参与者在过去一年中筛查出有赌博问题。总样本中有 4.1%的人被归类为低风险赌徒，6.4%的人是中度风险赌徒，5.8%的人是问题赌徒。中度风险/问题赌徒更可能是男性，没有毕业且在过去一年中寻求过经济援助。与物质使用，包括酒精使用障碍和使用大麻和“其他”药物（不包括大麻）有显著关联。
精神病患者出现赌博问题的可能性是普通人群的四倍。赌博与物质使用障碍的关联与社区研究一致，而对经济援助的需求增加表明，赌博问题增加了该人群遭受经济伤害的可能性。临床医生应该在精神病患者中筛查出共病赌博问题，同时也需要对这一领域进行更多的研究。
