Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, 200 Spring Road, Building 5, Room 135B, Bedford, MA 01730, USA.
Addict Behav. 2018 Jul;82:142-150. doi: 10.1016/j.addbeh.2018.03.003. Epub 2018 Mar 5.
Despite the strong associations between personality disorders and problem/pathological gambling, few studies have investigated the relationships between personality disorders, problem-gambling severity and suicidal thoughts/behaviors.
We examined the relationships between problem-gambling severity and personality disorders among individuals with differing levels of suicidality (none, thoughts alone, attempts).
We analyzed data from 13,543 participants of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) study. First, differences in sociodemographic characteristics and prevalence of personality disorders were analyzed according to problem-gambling severity and suicidality status. Second, we performed a logistic regression to assess among the relationship between problem-gambling severity and DSM-IV Axis II psychopathology according to suicidality level.
At-risk or problem/pathological gambling groups showed higher rates of a wide range of personality disorders compared to non-gamblers. Logistic regression showed that at-risk pathological gamblers had a higher odds ratio for any personality disorder in the group with no history of suicidality, particularly for cluster-B personality disorders. Odds ratio interaction analysis identified the relationship between problem-gambling severity and personality disorders, particularly those in cluster B, differ according to suicidality status.
Our findings suggest a complex relationship between suicidality, problem-gambling severity and personality disorders. The stronger relationship between problem-gambling severity and personality disorders in people with no suicidality as compared to some suicidality suggests that some of the relationship between greater problem-gambling severity and Axis II psychopathology is accounted for by increased suicidality. The findings have implications for clinical interventions targeting suicidality in individuals with gambling disorders.
尽管人格障碍与问题/病理性赌博之间存在很强的关联，但很少有研究调查人格障碍、赌博问题严重程度与自杀想法/行为之间的关系。
我们考察了不同自杀倾向个体（无、仅想法、尝试）中赌博问题严重程度与人格障碍之间的关系。
我们分析了来自全国酒精相关情况和流行病学调查（NESARC）研究的 13543 名参与者的数据。首先，根据赌博问题严重程度和自杀状态分析了人口统计学特征和人格障碍患病率的差异。其次，我们进行了逻辑回归，以评估自杀水平与 DSM-IV 轴 II 精神病理学之间的关系。
风险或问题/病理性赌博组与非赌博者相比，表现出更高的各种人格障碍的发生率。逻辑回归显示，在无自杀史的人群中，风险病理性赌徒发生任何人格障碍的比值比更高，尤其是在 B 群人格障碍中。比值比交互分析确定了赌博问题严重程度与人格障碍之间的关系，特别是在 B 群中，根据自杀状态而有所不同。
我们的发现表明自杀、赌博问题严重程度与人格障碍之间存在复杂的关系。与存在一些自杀倾向的个体相比，无自杀倾向个体中赌博问题严重程度与人格障碍之间的关系更强，这表明在更大程度的赌博问题严重程度与轴 II 精神病理学之间的关系中，部分归因于自杀倾向的增加。这些发现对针对赌博障碍患者自杀的临床干预具有启示意义。
