Retz Wolfgang, Ringling Jutta, Retz-Junginger Petra, Vogelgesang Monika, Rösler Michael
Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany.
AHG Klinik Münchwies, Zentrum für Psychosomatische Medizin, Psychotherapie und Suchtmedizin, Neunkirchen, Germany.
J Neural Transm (Vienna). 2016 Aug;123(8):1013-9. doi: 10.1007/s00702-016-1566-x. Epub 2016 Jun 21.
Attention-deficit/hyperactivity disorder (ADHD) is a frequent mental disorder with childhood onset and high persistence into adulthood. There is much evidence that ADHD increases the risk for the development of other psychiatric disorders and functional problems in several domains of everyday life. In this study, the association of ADHD with gambling disorder (GD) was investigated. 163 adult subjects suffering from GD were examined for childhood and current ADHD according to DSM-5 as well as co-morbid psychiatric disorders. Moreover, characteristics of gambling behavior have been evaluated. The prevalence of lifetime ADHD was 28.8 %, with 25.2 % of the study population presenting ADHD as a full syndrome according to DSM-5. The prevalence of co-morbid substance use disorders and adjustment disorders and cluster B personality disorders was higher in GD patients with current ADHD than in the group without. Also, an increased rate of suicide attempts was detected in gamblers with ADHD. In contrast with gamblers without ADHD, those with ADHD were reported to spend more time with gambling, a sedative effect of gambling and a faster development of GD. The high prevalence of ADHD in patients with GD indicates that childhood ADHD is a risk factor for the development of GD in later life. Moreover, treatment of patients with GD and ADHD is complicated by a high rate of co-morbid disorders. Regarding therapeutic approaches, it should be considered that functional aspects of gambling differ in GD patients with and without ADHD.
注意缺陷多动障碍（ADHD）是一种常见的精神障碍，起病于儿童期，且成年后仍有较高的持续性。有大量证据表明，ADHD会增加患其他精神障碍的风险以及在日常生活多个领域出现功能问题的风险。在本研究中，对ADHD与赌博障碍（GD）之间的关联进行了调查。根据《精神疾病诊断与统计手册》第5版（DSM-5），对163名患有GD的成年受试者进行了童年期和当前ADHD以及共病精神障碍的检查。此外，还评估了赌博行为的特征。终生患ADHD的患病率为28.8%，根据DSM-5，25.2%的研究人群表现为完全综合征的ADHD。当前患有ADHD的GD患者中，共病物质使用障碍、适应障碍和B类人格障碍的患病率高于无ADHD的组。此外，在患有ADHD的赌徒中，自杀未遂率也有所增加。与无ADHD的赌徒相比，有ADHD的赌徒据报告花在赌博上的时间更多，赌博有镇静作用且GD发展更快。GD患者中ADHD的高患病率表明，童年期ADHD是晚年患GD的一个危险因素。此外，GD和ADHD患者的治疗因共病障碍的高发生率而变得复杂。关于治疗方法，应考虑到有和无ADHD的GD患者赌博的功能方面存在差异。
