Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the national epidemiologic survey on alcohol and related conditions
Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the national epidemiologic survey on alcohol and related conditions
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DOI：
10.4088/jcp.v66n0504
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发表时间：
2005-05-01
影响因子：
5.3
通讯作者：
Grant, BF
中科院分区：
文献类型：
--
作者：
Petry, NM;Stinson, FS;Grant, BF
目的：介绍病理性赌博与其他精神疾病的终生患病率和共病的全国代表性数据，并评估共病关联强度的性别差异。方法：数据来源于美国的一个大的国家样本。共有43093名年龄在18岁及以上的住户和团体宿舍居民参加了2001-2002年的调查。患病率和关联的终身病理性赌博和其他终身精神障碍提出。诊断性访谈是国家酒精滥用和酒精中毒研究所酒精使用障碍和相关残疾访谈时间表- dsm - iv版。15个症状项操作10项病态赌博标准。结果：病理性赌博终生患病率为0.42%。近四分之三（73.2%）的病态赌徒有酒精使用障碍，38.1%有药物使用障碍，60.4%有尼古丁依赖，49.6%有情绪障碍，41.3%有焦虑障碍，60.8%有人格障碍。病理性赌博与物质使用、情绪、焦虑和人格障碍之间的绝大多数关联是绝对积极和显著的（p < 0.05），即使在控制了社会人口统计学和社会经济特征之后。男性、黑人、离婚/分居/丧偶的婚姻状况、中年、居住在西部和中西部地区与病态赌博的风险增加有关。此外，酒精依赖、任何药物使用障碍、药物滥用、尼古丁依赖、重度抑郁发作、广泛性焦虑障碍和病理性赌博之间的关联在女性中比男性更强（p < 0.05）。结论：病理性赌博与物质使用、情绪、焦虑和人格障碍高度共病，提示对一种疾病的治疗应包括评估和可能的共病治疗。
Objective: To present nationally representative data on lifetime prevalence and comorbidity of pathological gambling with other psychiatric disorders and to evaluate sex differences in the strength of the comorbid associations.Method: Data were derived from a large national sample of the United States. Some 43,093 household and group quarters residents age 18 years and older participated in the 2001-2002 survey. Prevalence and associations of lifetime pathological gambling and other lifetime psychiatric disorders are presented. The diagnostic interview was the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. Fifteen symptom items operationalized the 10 pathological gambling criteria.Results: The lifetime prevalence rate of pathological gambling was 0.42%. Almost three quarters (73.2%) of pathological gamblers had an alcohol use disorder, 38.1% had a drug use disorder, 60.4% had nicotine dependence, 49.6% had a mood disorder, 41.3% had an anxiety disorder, and 60.8% had a personality disorder. A large majority of the associations between pathological gambling and substance use, mood, anxiety, and personality disorders were overwhelmingly positive and significant (p < .05), even after controlling for sociodemographic and socioeconomic characteristics. Male sex, black race, divorced/separated/widowed marital status, middle age, and living in the West and Midwest were associated with increased risk for pathological gambling. Further, associations between alcohol dependence, any drug use disorder, drug abuse, nicotine dependence, major depressive episode, and generalized anxiety disorder and pathological gambling were stronger among women than men (p > .05).Conclusion: Pathological gambling is highly comorbid with substance use, mood, anxiety, and personality disorders, suggesting that treatment for one condition should involve assessment and possible concomitant treatment for comorbid conditions.