Faculty of Pharmacy, Université Laval, Quebec, QC, Canada.
Quebec Mental Health University Institute, Quebec, QC, Canada.
Eur Psychiatry. 2024 Sep 25;67(1):e56. doi: 10.1192/j.eurpsy.2024.1777.
High rates of psychiatric comorbidities have been found in people with problem gambling (PBG), including substance use, anxiety, and mood disorders. Psychotic disorders have received less attention, although this comorbidity is expected to have a significant impact on the course, consequences, and treatment of PBG. This review aimed to estimate the prevalence of psychotic disorders in PBG.
Medline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of Science, and ProQuest were searched on November 1, 2023, without language restrictions. Studies involving people with PBG and reporting the prevalence of schizophrenia spectrum and other psychotic disorders were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for systematic reviews of prevalence data. The pooled prevalence of psychotic disorders was calculated using a random effects generalized linear mixed model and presented with forest plots.
Of 1,271 records screened, 22 studies ( = 19,131) were included. The overall prevalence of psychotic disorders was 4.9% (95% CI, 3.6-6.5%, = 88%). A lower prevalence was found in surveyed/recruited populations, compared with treatment-seeking individuals and register-based studies. No differences were found for factors such as treatment setting (inpatient/outpatient), diagnoses of psychotic disorders (schizophrenia only/other psychotic disorders), and assessment time frame (current/lifetime). The majority of included studies had a moderate risk of bias.
These findings highlight the relevance of screening problem gamblers for schizophrenia spectrum and other psychotic disorders, as well as any other comorbid mental health conditions, given the significant impact such comorbidities can have on the recovery process.
在有问题赌博（PBG）的人群中发现了很高的精神共病率，包括物质使用、焦虑和情绪障碍。精神障碍受到的关注较少，尽管这种共病预计会对 PBG 的病程、后果和治疗产生重大影响。本综述旨在估计 PBG 中精神障碍的患病率。
于 2023 年 11 月 1 日在 Medline（Ovid）、EMBASE、PsycINFO（Ovid）、CINAHL、CENTRAL、Web of Science 和 ProQuest 上进行了无语言限制的搜索。纳入了涉及有 PBG 的人群并报告了精神分裂症谱系和其他精神障碍患病率的研究。使用 Joanna Briggs 研究所对患病率数据进行系统评价的批判性评估清单评估了偏倚风险。使用随机效应广义线性混合模型计算了精神障碍的总患病率，并以森林图呈现。
在筛选出的 1271 条记录中，有 22 项研究（n=19131）被纳入。精神障碍的总体患病率为 4.9%（95%CI，3.6-6.5%，n=88%）。与寻求治疗的个体和基于登记的研究相比，在调查/招募人群中发现的患病率较低。在治疗环境（住院/门诊）、精神障碍诊断（仅精神分裂症/其他精神障碍）和评估时间框架（当前/终生）等因素方面未发现差异。大多数纳入的研究存在中度偏倚风险。
这些发现强调了对问题赌徒进行精神分裂症谱系和其他精神障碍以及任何其他共患精神健康状况筛查的重要性，因为这些共病对康复过程可能产生重大影响。
