Corbeil Olivier, Anderson Élizabeth, Béchard Laurent, Desmeules Charles, Huot-Lavoie Maxime, Bachand Lauryann, Brodeur Sébastien, Carmichael Pierre-Hugues, Jacques Christian, Solmi Marco, Giroux Isabelle, Dorval Michel, Demers Marie-France, Roy Marc-André
Faculty of Pharmacy, Université Laval, Quebec, Quebec, Canada.
Quebec Mental Health University Institute, Quebec, Quebec, Canada.
Acta Psychiatr Scand. 2024 Jun;149(6):445-457. doi: 10.1111/acps.13686. Epub 2024 Apr 2.
Problem gambling (PBG) is more common in people with mental health disorders, including substance use, bipolar, and personality disorders, than in the general population. Although individuals with psychotic disorders might be expected to be more vulnerable to PBG, fewer studies have focused on this comorbidity. The aim of this review was to estimate the prevalence of PBG in people with psychotic disorders.
Medline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of science, and ProQuest were searched on November 1, 2023, without language restrictions. Observational and experimental studies including individuals with psychotic disorders and reporting the prevalence of PBG were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal for systematic reviews of prevalence data. The pooled prevalence of PBG was calculated using a fixed effects generalized linear mixed model and presented through forest plots.
Of 1271 records screened, 12 studies (n = 3443) were included. The overall prevalence of PBG was 8.7% (95% CI = 7.8%-9.7%, I = 69%). A lower prevalence was found in studies with a low risk of bias (5.6%; 95% CI = 4.4%-7.0%) compared with studies with a moderate risk of bias (10.4%; 95% CI = 9.2%-11.7%). Different methods used to assess PBG also contributed to the heterogeneity found.
This meta-analysis found substantial heterogeneity, partly due to the risk of bias of the included studies and a lack of uniformity in PBG assessment. Although more research is needed to identify those at increased risk for PBG, its relatively high prevalence warrants routine screening for gambling in clinical practice.
问题性赌博（PBG）在患有精神健康障碍的人群中比在普通人群中更为常见，这些精神健康障碍包括物质使用障碍、双相情感障碍和人格障碍。尽管患有精神分裂症的个体可能更容易出现问题性赌博，但针对这种共病情况的研究较少。本综述的目的是估计患有精神分裂症的人群中问题性赌博的患病率。
于2023年11月1日检索了Medline（Ovid）、EMBASE、PsycINFO（Ovid）、CINAHL、CENTRAL、科学网和ProQuest，无语言限制。纳入了包括患有精神分裂症的个体并报告问题性赌博患病率的观察性和实验性研究。使用乔安娜·布里格斯研究所对患病率数据系统评价的批判性评价方法评估偏倚风险。使用固定效应广义线性混合模型计算问题性赌博的合并患病率，并通过森林图呈现。
在筛选的1271条记录中，纳入了12项研究（n = 3443）。问题性赌博的总体患病率为8.7%（95%CI = 7.8%-9.7%，I² = 69%）。与偏倚风险中度的研究（10.4%；95%CI = 9.2%-11.7%）相比，偏倚风险低的研究中患病率较低（5.6%；95%CI = 4.4%-7.0%）。用于评估问题性赌博的不同方法也导致了所发现的异质性。
这项荟萃分析发现存在大量异质性，部分原因是纳入研究的偏倚风险以及问题性赌博评估缺乏一致性。尽管需要更多研究来确定问题性赌博风险增加的人群，但其相对较高的患病率值得在临床实践中对赌博进行常规筛查。
