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Comorbidity of DSM-IV Pathological Gambling and Other Psychiatric Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions
Abstract
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.
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“Epidemiological research indicates that over 50% of PGs have a lifetime mood disorder, over 40% have a lifetime anxiety disorder, and about 23% have ASPD (Kessler et al. 2008; Petry, Stinson & Grant, 2005).”
From Subtyping Pathological Gamblers Based on Impulsivity, Depression, and Anxiety (2010) · cites this paper as Petry, Stinson & Grant, 2005
In the citing paper
“Furthermore, gambling disorder frequently co-occurs with substance use disorders, particularly alcohol and nicotine, as well as mood and anxiety disorders (Conway, Compton, Stinson, & Grant, 2006; B. F. Grant et al., 2004b; Petry et al., 2005; Ronzitti, Kraus, Hoff, & Potenza, 2018).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Petry et al., 2005
In the citing paper
“In particular, alcohol and nicotine are the most often misused substances among individuals with gambling pathology (Petry et al., 2005).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Petry et al., 2005
In the citing paper
“Approximately 37% (range: 14.0% −60.3%) of subthreshold and clinical gamblers suffer from an anxiety disorder (Kessler et al., 2008; Lorains et al., 2011; Petry et al., 2005)”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Petry et al., 2005
In the citing paper
“Similarly, individuals with nicotine or alcohol related substance use disorders are also more likely to meet the diagnostic criteria for GD compared to the general population (Krmpotich et al., 2015; Petry et al., 2005; Rennert et al., 2014).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Petry et al., 2005
In the citing paper
“A recent meta-analysis including 11 studies conducted between 1998-2010 reported an average comorbidity rate of 28.1% (range: 9.9% - 73.2%) for alcohol use disorders and 60.1% (range: 34.9% - 76.3%) for nicotine dependence in individuals with subthreshold or clinical gambling severity (Lorains et al., 2011; Petry et al., 2005).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Petry et al., 2005
In the citing paper
“These effects do not appear to be merely the result of shared environmental risk factors, as supported by the work of Petry and colleagues, which reported that alcohol use disorders were significantly related to gambling disorder even after controlling for sociodemographic variables highly associated with the risk for gambling pathology, including ethnicity, age, sex, marital status and region of”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Petry et al., 2005
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Metadata
- Authors
- Petry, N. M., Stinson, F. S., & Grant, B. F.
- Affiliations
- UConn Health (US)
- National Institutes of Health (US)
- ORCID
- Petry, Nancy M.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2005-05-15
- Volume
- 66
- Issue
- 05
- Pages
- 564-574
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2016693718
- Cited by
- 1,245
- References
- 0
- Citations by year
- 2026: 14 · 2025: 21 · 2024: 11 · 2023: 23 · 2022: 30 · 2021: 45 · 2020: 85 · 2019: 73 · 2018: 63 · 2017: 62 · 2016: 84 · 2015: 90 · 2014: 96 · 2013: 87 · 2012: 83
- FWCI
- 51.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p50aa003510-27)
- National Institute on Alcohol Abuse and Alcoholism (P50- AA03510)
- National Institute of Mental Health (R01MH060417, R01 MH60417)
- National Institute on Drug Abuse (R01DA014618, R01-DA14618, R01-DA13444, P50DA009241, R01DA016855, P50-DA-0-9241, R01DA013444)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- gambling addiction, comorbidities, mental illness, alcoholism, drug use disorders, nicotine dependence, mood disorders, anxiety disorders, personality disorders, sex differences, lifetime prevalence, risk factors, National Comorbidity Survey
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Mental Disorders, Depressive Disorder, Female, Gambling, Health Surveys, Humans, Disruptive, Impulse Control, and Conduct Disorders, Male, Psychiatric Status Rating Scales, Sex Factors, United States, Cohort Studies, Comorbidity, Prevalence, Logistic Models, Substance-Related Disorders, Alcohol-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders
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