Addictive Behaviours Laboratory, Department of Psychology,University of Calgary, Calgary, AB,Canada.
Outpatient Unit for Excessive Sexual Drive and Prevention of Negative Outcomes Associated with Sexual Behavior, Institute of Psychiatry, Clinicas' Hospital,University of São Paulo Medical School, São Paulo,Brazil.
J Behav Addict. 2019 Sep 1;8(3):451-462. doi: 10.1556/2006.8.2019.35. Epub 2019 Aug 16.
Gambling disorder (GD) and compulsive sexual behavior (CSB) may commonly co-occur. Yet, the psychiatric correlates of these co-occurring disorders are an untapped area of empirical scrutiny, limiting our understanding of appropriate treatment modalities for this dual-diagnosed population. This study examined the demographic and clinical correlates of CSB in a sample of treatment-seeking individuals with GD ( = 368) in São Paulo, Brazil.
Psychiatrists and psychologists conducted semi-structured clinical interviews to identify rates of CSB and other comorbid psychiatric disorders. The Shorter PROMIS Questionnaire was administered to assess additional addictive behaviors. The TCI and BIS-11 were used to assess facets of personality. Demographic and gambling variables were also assessed.
Of the total sample, 24 (6.5%) met diagnostic criteria for comorbid CSB (GD + CSB). Compared to those without compulsive sexual behaviors (GD - CSB), individuals with GD + CSB were more likely to be younger and male. No differences in gambling involvement emerged. Individuals with GD + CSB tended to have higher rates of psychiatric disorders (depression, post-traumatic stress disorder, and bulimia nervosa) and engage in more addictive behaviors (problematic alcohol use, drug use, and exercise) compared to GD - CSB. Those with GD + CSB evidenced less self-directedness, cooperativeness, self-transcendence, and greater motor impulsivity. Logistic regression showed that the predictors of GD + CSB, which remained in the final model, were being male, a diagnosis of bulimia, greater gambling severity, and less self-transcendence.
Given those with GD + CSB evidence greater psychopathology, greater attention should be allocated to this often under studied comorbid condition to ensure adequate treatment opportunities.
赌博障碍（GD）和强迫性性行为（CSB）可能经常同时发生。然而，这些共病障碍的精神科相关性是一个尚未得到实证审查的领域，限制了我们对这一双重诊断人群的适当治疗模式的理解。本研究在巴西圣保罗的一组寻求治疗的 GD 患者（n=368）中，检查了 CSB 的人口统计学和临床相关性。
精神科医生和心理学家进行了半结构化的临床访谈，以确定 CSB 和其他共病精神障碍的发生率。使用简短的 PROMIS 问卷评估其他成瘾行为。使用 TCI 和 BIS-11 评估人格特质的各个方面。还评估了人口统计学和赌博变量。
在总样本中，24 人（6.5%）符合共病 CSB（GD+CSB）的诊断标准。与没有强迫性行为的人（GD-CSB）相比，患有 GD+CSB 的人更年轻，更男性化。在赌博参与方面没有差异。与 GD-CSB 相比，患有 GD+CSB 的人更有可能患有精神障碍（抑郁症、创伤后应激障碍和神经性贪食症）和更多的成瘾行为（问题性饮酒、药物使用和运动）。与 GD-CSB 相比，患有 GD+CSB 的人自我导向性、合作性、自我超越性较低，运动冲动性较高。逻辑回归显示，仍留在最终模型中的 GD+CSB 的预测因素是男性、贪食症诊断、赌博严重程度增加和自我超越性降低。
鉴于患有 GD+CSB 的人表现出更多的精神病理学，应更加关注这种经常被忽视的共病情况，以确保有足够的治疗机会。
