Traumatic brain injury as an independent risk factor for problem gambling: a matched case-control study
Traumatic brain injury as an independent risk factor for problem gambling: a matched case-control study
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DOI：
10.1007/s00127-018-1583-1
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发表时间：
2019-04-01
影响因子：
4.4
通讯作者：
Redelmeier, Donald A.
中科院分区：
文献类型：
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作者：
Bhatti, Junaid A.;Thiruchelvam, Deva;Redelmeier, Donald A.
PurposeTo评估创伤性脑损伤（TBI）是否会增加随后的问题gamblings.MethodsWe进行了匹配的病例对照分析，在加拿大安大略的成年人的风险。这项研究包括那些在2007-2008年加拿大社区健康调查中自我报告赌博活动的人。使用问题赌博严重程度指数，我们定义的情况下，那些谁是问题赌徒和控制谁是娱乐赌徒。使用基于人口统计学、既往心理健康和自我报告行为的倾向评分，将病例与对照组1：2匹配。主要预测因素是既往TBI（定义为需要紧急护理），并使用行政卫生数据库中的ICD-10代码进行识别。我们估计的可能性，以前TBI的问题赌徒相比，控制使用条件logistic regression.ResultsOf 30，652调查参与者，16，002（53%）报告赌博活动，其中14，910（49%）是娱乐赌徒和4%（n=1092）的问题赌徒。共有1469名受访者（5%）有既往TBI。倾向评分匹配产生了2038个匹配对，1019例匹配到2037个对照。病例对照分析显示，既往TBI与随后的赌博问题之间存在显著相关性（比值比1.27，95%置信区间1.07-1.51，P=0.007）。在35至64岁报告饮酒或吸烟的男性中，风险增加最明显。问题赌博的相对风险在那些有两个或两个以上的TBI等同于2.04（95%置信区间1.05-3.99）的比值比。ConclusionsWe发现，先前的TBI与随后的问题赌博的风险增加。我们的研究结果支持更多的意识，筛查和治疗TBI患者中的问题赌博风险。
PurposeTo assess whether traumatic brain injury (TBI) increases the risks of subsequent problem gambling.MethodsWe conducted a matched case-control analysis of adults in Ontario, Canada. The study included those who self-reported their gambling activities in the Canadian Community Health Survey 2007-2008. Using Problem Gambling Severity Index, we defined cases as those who were problem gamblers and controls who were recreational gamblers. Cases were matched to controls 1:2 using propensity scores based on demographics, prior mental health, and self-reported behaviours. The main predictor was prior TBI defined as requiring emergency care and identified using ICD-10 codes from administrative health databases. We estimated the likelihood of prior TBI in problem gamblers compared to controls using conditional logistic regression.ResultsOf 30,652 survey participants, 16,002 (53%) reported gambling activity of whom 14,910 (49%) were recreational gamblers and 4% (n=1092) were problem gamblers. A total of 1469 respondents (5%) had a prior TBI. Propensity score matching yielded 2038 matched pairs with 1019 cases matched to 2037 controls. Case-control analysis showed a significant association between prior TBI and subsequent problem gambling (odds ratio 1.27, 95% confidence interval 1.07-1.51, P=0.007). The increased risk was mostly apparent in men aged 35 to 64years who reported alcohol use or smoking. The relative risk of problem gambling in those with two or more TBIs equated to an odds ratio of 2.04 (95% confidence interval 1.05-3.99).ConclusionsWe found that a prior TBI was associated with an increased subsequent risk of problem gambling. Our findings support more awareness, screening, and treating problem gambling risks among TBI patients.