Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
J Gambl Stud. 2023 Dec;39(4):1765-1780. doi: 10.1007/s10899-023-10255-6. Epub 2023 Oct 9.
Gambling disorder is associated with increased mental comorbidity, unhealthy lifestyle, criminality, and costs-of-illness, but the available evidence is mainly based on self-reported survey data. We examined the registry-recorded mental and somatic comorbidities, medication use, criminality, and costs-of-illness associated with gambling disorder. We identified individuals diagnosed with or treated for gambling disorder in hospitals or specialized treatment centers during 2013-2017 and matched them by age and sex to general population comparisons. Using individual-level healthcare and socioeconomic registries, we characterized their history of mental and somatic comorbidities, medication use, and criminality. We estimated their cost-of-illness of welfare services (direct) and lowered productivity (indirect) using the human capital approach. We identified 1381 individuals with gambling disorder, primarily young (median age: 34 years) men (87%). Individuals with gambling disorder more frequently than their comparisons had previous hospital-recorded comorbidity [e.g., myocardial infarction (0.8% vs. 0.5%)], medication use [e.g., respiratory system drugs (35.6% vs. 28.6%)], and hospital-recorded or pharmacologically treated mental comorbidity [e.g., depression (39.8% vs. 14.9%)]. Also, sentenced criminality was much more common in individuals with gambling disorder (7.0%) than in comparisons (1.1%). The estimated attributable direct costs were €4.0 M corresponding to €2.9 K per person with gambling disorder, and attributable indirect costs were €17.6 M, corresponding to €13.2 K per person with gambling disorder in 2018. In conclusion, individuals diagnosed with or treated for gambling disorder have a high burden of mental and somatic comorbidities as well as criminality compared with the general population. This needs attention to minimize the societal and personal costs of gambling disorder.
赌博障碍与精神共病、不健康的生活方式、犯罪和疾病负担增加有关，但现有证据主要基于自我报告的调查数据。我们研究了与赌博障碍相关的登记记录的精神和躯体共病、药物使用、犯罪和疾病负担。我们确定了 2013-2017 年期间在医院或专门治疗中心被诊断或治疗赌博障碍的个体，并按年龄和性别与普通人群进行匹配。利用个体水平的医疗和社会经济登记，我们描述了他们的精神和躯体共病、药物使用和犯罪史。我们使用人力资本方法估算了福利服务（直接）和降低的生产力（间接）的疾病负担。我们确定了 1381 名患有赌博障碍的个体，主要是年轻（中位数年龄：34 岁）男性（87%）。与对照组相比，患有赌博障碍的个体更频繁地出现先前的住院记录共病[例如，心肌梗死（0.8%比 0.5%）]、药物使用[例如，呼吸系统药物（35.6%比 28.6%）]和住院记录或药物治疗的精神共病[例如，抑郁症（39.8%比 14.9%）]。此外，患有赌博障碍的个体更常见被判犯罪（7.0%比 1.1%）。估计的归因于直接成本为 400 万欧元，相当于每个患有赌博障碍的人 2900 欧元，归因于间接成本为 1760 万欧元，相当于每个患有赌博障碍的人 13200 欧元，这是在 2018 年。总之，与普通人群相比，被诊断或治疗赌博障碍的个体有更高的精神和躯体共病以及犯罪负担。这需要引起重视，以尽量减少赌博障碍的社会和个人成本。
