Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK.
NHS Southern Gambling Service/Southern Health NHS Foundation Trust, Southampton, UK.
CNS Spectr. 2024 Aug;29(4):273-278. doi: 10.1017/S1092852924000300. Epub 2024 May 17.
Gambling disorder affects 0.5-2.4% of the population and shows strong associations with lifetime alcohol use disorder. Very little is known regarding whether lifetime alcohol use disorder can impact the clinical presentation or outcome trajectory of gambling disorder.
Data were pooled from previous clinical trials conducted on people with gambling disorder, none of whom had current alcohol use disorder. Demographic and clinical variables were compared between those who did versus did not have lifetime alcohol use disorder.
Of the 621 participants in the clinical trials, 103 (16.6%) had a lifetime history of alcohol use disorder. History of alcohol use disorder was significantly associated with male gender (relative risk [RR] = 1.42), greater body weight (Cohen's D = 0.27), family history of alcohol use disorder in first-degree relative(s) (RR = 1.46), occurrence of previous hospitalization due to psychiatric illness (RR = 2.68), and higher gambling-related legal problems (RR = 1.50). History of alcohol use disorder was not significantly associated with other variables that were examined, such as severity of gambling disorder or extent of functional disability. Lifetime alcohol use disorder was not significantly associated with the extent of clinical improvement in gambling disorder symptoms during the subsequent clinical trials.
These data highlight that lifetime alcohol use disorder is an important clinical variable to be considered when assessing gambling disorder because it is associated with several untoward features (especially gambling-related legal problems and prior psychiatric hospitalization). The study design enabled these associations to be disambiguated from current or recent alcohol use disorder.
赌博障碍影响 0.5-2.4%的人群，与终身酒精使用障碍有很强的关联。对于终身酒精使用障碍是否会影响赌博障碍的临床表现或预后轨迹，知之甚少。
数据来自以前针对赌博障碍患者进行的临床试验的汇总，这些患者均无当前的酒精使用障碍。在有或没有终身酒精使用障碍的患者之间比较人口统计学和临床变量。
在临床试验中的 621 名参与者中，有 103 名（16.6%）有终身酒精使用障碍史。酒精使用障碍史与男性性别显著相关（相对风险 [RR] = 1.42）、更大的体重（Cohen's D = 0.27）、一级亲属中酒精使用障碍的家族史（RR = 1.46）、因精神疾病住院的既往发生率（RR = 2.68）和更高的与赌博相关的法律问题（RR = 1.50）。酒精使用障碍史与其他检查的变量无显著相关，如赌博障碍的严重程度或功能障碍的严重程度。在随后的临床试验中，酒精使用障碍的终身病史与赌博障碍症状的临床改善程度无显著相关性。
这些数据突出表明，终身酒精使用障碍是评估赌博障碍时需要考虑的一个重要临床变量，因为它与一些不良特征（特别是与赌博相关的法律问题和既往精神科住院治疗）有关。该研究设计使这些关联能够与当前或近期的酒精使用障碍区分开来。
