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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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InfluentialA Randomized Controlled Trial for Gambling Disorder and PTSD: Seeking Safety and CBT
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ResultDisordered gambling and dementia
Cipriani, G., Cammisuli, D. M., Danti, S., & Fiorino, M. D. (2016) · European Geriatric Medicine · doi:10.1016/j.eurger.2016.02.009 · Cited by 8
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Suicide and attempted suicide in gambling disorder - results from a nationwide case-control study
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de Oliveira, M. P. M. T., da Silveira, D. X., de Carvalho, S. V. B., Collakis, S. T., Bizeto, J., & Silva, M. T. A. (2009) · Journal of Gambling Studies · doi:10.1007/s10899-009-9152-x · Cited by 6
“Research findings and accurate data would serve to support to public policies and education, prevention and treatment planning (Volberg 1994; Ladouceur 1996; Petry et al. 2005).”
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“In addition, Gambling Disorder and substance addictions share similar psychiatric comorbidities (Petry et al. 2005).”
BackgroundGrant, J. E., & Chamberlain, S. R. (2013) · American Journal on Addictions · doi:10.1111/j.1521-0391.2013.12112.x · Cited by 6
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Ndetei, D. M., Mutiso, V., Momanyi, R. O., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04738-4 · Cited by 6
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“The US National Comorbidity Survey Replication (Kessler et al., 2008) reported that 96% of individuals with GD show at least one other co-occurring disorder, with similar findings in the National Epidemiologic Survey on Alcohol and Related Conditions (Petry et al., 2005).”
Gender Differences in the Temporal Sequencing of Problem Gambling with Other Disorders
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Comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong
Shek, D. T. L., Chan, E., & Wong, R. H. Y. (2012) · International Gambling Studies · doi:10.1080/14459795.2012.689000 · Cited by 5
“Several researchers suggested an association between comorbid mental health conditions among pathological gamblers and tried to generate hypotheses regarding the onset of comorbid psychiatric disorders (Ibáňez et al., 2001; Petry et al., 2005; Kessler et al., 2008).”
BackgroundResultInfluentialDeveloping a Population Health Framework for Studying Problem Gambling
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“as well, research using clinical and community samples found that women problem gamblers are more likely to experience comorbid depression or mood disorders than men problem gamblers (ibanez et al., 2001; petry et al., 2005).”
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Grall‐Bronnec, M., Rocher, B., Challet‐Bouju, G., & Vénisse, J.-L. (2010) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2010.06.004 · Cited by 6
“Toutes les études ont trouvé une corrélation forte entre jeu pathologique et autres conduites addictives, avec une prévalence du jeu pathologique en tant que conduite actuelle ou passée de l’ordre de 15 % chez des patients dépendants, quelle que soit la substance, et une prévalence de conduites d’abus ou de dépendance…”
BackgroundZur Validität des Modells zur psychischen Vulnerabilität der Glücksspielsucht
Vierhaus, M., Ewering, J., Klein, F., Ködding, C., & Petry, J. (2012) · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · doi:10.1024/0939-5911.a000183 · Cited by 6
George, S., & Bowden‐Jones, H. (2016) · BJPsych Bulletin · doi:10.1192/pb.bp.114.050401 · Cited by 6
The use of agomelatine (valdoxan) in gambling therapy: a pilot study
Egorov, A. Y. (2015) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro20151159128-31 · Cited by 6
van der Maas, M. (2016) · Journal of Gambling Issues · doi:10.4309/jgi.2016.32.2 · Cited by 6
“However, in their epidemiological study of the 2001-2002 NESARC survey, Petry et al. found that, after controlling for various demographic factors, both mood disorders and anxiety showed strong and significant relationships with pathological gambling (Petry et al., 2005).”
BackgroundPfund, R. A., Whelan, J. P., Greenburg, J. E., Peter, S. C., Wilson, K. K., & Meyers, A. W. (2016) · Journal of Gambling Studies · doi:10.1007/s10899-016-9645-3 · Cited by 6
“Both prevalence studies (Petry et al. 2005) and MMPI studies (Ciarrocchi et al.”
BackgroundInfluentialExecutive Function in Problem Gamblers with and without History of Depression
Ellis, J. D., Carr, M. M., & Ledgerwood, D. M. (2017) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-017-9804-5 · Cited by 6
“On average, 37.9% of problem and pathological gamblers experience a mood disorder in their lifetime (Lorains et al. 2011), although some studies suggest that this number may be higher (Petry et al. 2005; Kessler et al. 2008).”
BackgroundInfluentialAn Overview of Gambling in India
George, S., Fenn, J., & Robonderdeep, K. (2020) · Global Journal of Medical Pharmaceutical and Biomedical Update · doi:10.25259/gjmpbu_7_2020 · Cited by 6
Technological Interventions for the Treatment of Substance Use Disorders
Schulte, M. H. J., Boumparis, N., Huizink, A. C., & Riper, H. M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00010-8 · Cited by 8
“Given the high comorbidity of alcohol use and other mental disorders such as depression (Boschloo et al., 2011) and problematic gambling (Petry et al., 2005), it is important to assess technological interventions targeting individuals who suffer from both conditions concurrently.”
BackgroundHayer, T., Rumpf, H., & Meyer, G. (2014) · Springer eBooks · doi:10.1007/978-3-642-38364-9_2 · Cited by 7
Pathological Gambling: Psychiatric Models
Westphal, J. R. (2008) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-008-9166-0 · Cited by 6
“(2001) and Potenza (2006) use the co-occurrence data to support the conceptual models, while Petry (2006) discusses the strong co-occurrence of pathological gambling with a broad range of psychiatric disorders including substance use, anxiety, mood and personality disorders (Petry et al. 2005) and evaluates the co-occ…”
BackgroundInfluentialEmerging Conceptual Models of Excessive Behaviors
Westphal, J. R. (2007) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-007-9060-1 · Cited by 7
“Pathological gambling has strong co-occurrence with a broad range of substance use disorders (Petry et al. 2005; Westphal and Johnson 2007).”
BackgroundJackson, S. C. (2015) · ResearchWorks at the University of Washington (University of Washington) · Cited by 5
Neurobiology and genetics of behavioral addictions: a brief review
İzci, F., Sağlam, N. G. U., & Ergelen, M. (2021) · Journal of Dependence · doi:10.51982/bagimli.991533 · Cited by 5
Koç, Ş., Kocakaya, R., Türkmen, A. S., & Çakıcı, A. B. (2023) · Journal of Gambling Studies · doi:10.1007/s10899-023-10209-y · Cited by 6
“Our results support the literature (Petry et al., 2005; Walther et al., 2012; Kotyuk et al., 2020; Wang et al., 2021).”
Prévalence du jeu pathologique en Île de France. Étude préliminaire
Romo, L., Legauffre, C., Genolini, C., Lucas, C., Morvannou, A., Lerfel, Y., & Adès, J. (2011) · L Encéphale · doi:10.1016/j.encep.2011.01.006 · Cited by 5
Albanese, J. S. (2017) · Springer eBooks · doi:10.1007/978-3-319-65361-7_19 · Cited by 5
Anonymous Women? A Scoping Review of the Experiences of Women in Gamblers Anonymous (GA)
Rogers, J., Landon, J., Sharman, S., & Roberts, A. (2019) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-019-00101-5 · Cited by 7
Jeu problématique en France : une première enquête nationale
Costes, J., Kairouz, S., & Pousset, M. (2014) · Drogues santé et société · doi:10.7202/1026875ar · Cited by 6
Co-occurring Disordered Gambling Among Treatment-Seekers at a Community Outpatient Addiction Clinic
Elman, I., Borodovsky, J. T., Howard, M., Scoglio, A. A. J., Steinkamp, J., Sobieszczyk, A., Mysels, D. J., & Albanese, M. A. (2016) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000242 · Cited by 5
“Prediction of presence and of directionality of clinical differences among drug addicted patient with and without co-occurring gambling and theoretical considerations on this score are not unambiguous (Petry et al., 2005; Yau and Potenza, 2015).”
BackgroundPatterns and Motives for Electronic Cigarette Use in a Sample of Community-Recruited Gamblers
McGrath, D. S., Kim, H. S. A., Boothby, C. A., Romanow, N. K., & Hodgins, D. C. (2016) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-016-9722-y · Cited by 5
“Importantly for the present research, smoking has been found to be most common addictive behaviour that is co-morbid with gambling (Cunningham-Williams et al. 1998; Odlaug et al. 2013; Petry et al. 2005).”
BackgroundQualitative Approaches to the Study of Substance and Behavioral Addictions
Simpson, K. A., & Bluthenthal, R. N. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.013 · Cited by 10
Benefits, Risks and Gender Differences in Sport, and Exercise Dependence: Key Role of Alexithymia
Manfredi, P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095288 · Cited by 5
“Among behavioral dependences, substance abuse and gambling are those in which the psychopathological dimension is most relevant [56].”
BackgroundPathological Gambling and Nicotine Dependence
Grant, J. E., Black, D. W., Stein, D. J., & Potenza, M. N. (2009) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e3181a1cc36 · Cited by 5
“Clinical (Grant et al., 2005a) and community data (Petry et al., 2005) indicate high frequencies of Axis I and II disorders in individuals with PG or other impulse control disorders.”
Sleepiness and cognition in young adults who gamble and use alcohol
Harvanko, A. M., Derbyshire, K. L., Schreiber, L. R. N., & Grant, J. E. (2014) · Journal of Behavioral Addictions · doi:10.1556/jba.3.2014.014 · Cited by 5
Self-Reported Gambling Problems and Digital Traces
Phillips, J. G., Sargeant, J., Ogeil, R. P., Chow, Y.-W., & Blaszczynski, A. P. (2014) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2014.0369 · Cited by 5
Pathological Gambling: Clinical Aspects
Grant, J. E., & Odlaug, B. L. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511711930.006 · Cited by 5
Sarkar, S., Balhara, Y. P. S., Parmar, A., & Rajhans, P. (2017) · Journal of Substance Use · doi:10.1080/14659891.2017.1378742 · Cited by 6
“Similarly, patients with pathological gambling are more likely to have a comorbid diagnosis of alcohol and other substance-related disorders (CunninghamWilliams et al., 1998; Petry et al., 2005).”
BackgroundWho Are the Subjects with Gambling-Related Problems Requiring Treatment? A Study in Northern Italy
Pavarin, R. M., Fioritti, A., Marani, S., Gambini, D. M., Turino, E., & Piazza, A. (2018) · Journal of Clinical Medicine · doi:10.3390/jcm7040080 · Cited by 5
“and other impulse control disorders [19–22], suggesting that treatment for one condition should involve assessment and possible associated treatment for comorbid conditions [23].”
BackgroundKnight, H. C., Smith, D. T., Knight, D. C., & Ellison, A. (2018) · Psychopharmacology · doi:10.1007/s00213-018-4987-4 · Cited by 5
“It is known that there is a high comorbidity of addiction and other mental illnesses (Carrá and Johnson 2009), such as anxiety (Petry et al. 2005), depression (Swendsen and Merikangas 2000) and bipolar disorder (Grant et al. 2005).”
Background
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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