Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of cross-sectional population surveys (graded by design analogy)
PubMed 21210880 · doi:10.1111/j.1360-0443.2010.03300.x
What was done
A systematic review and meta-analysis of peer-reviewed and unpublished articles published between January 1, 1998, and September 20, 2010, was conducted. Studies were included if they examined the prevalence of comorbid conditions (including alcohol use disorder, depression, substance use disorders, nicotine dependence, anxiety disorders, and antisocial personality disorder) in problem and/or pathological gamblers from general population samples using randomized sampling methods and standardized measurement tools. Meta-analytic techniques synthesized weighted mean effect sizes and heterogeneity.
What was found
Across 11 eligible studies, problem and pathological gamblers demonstrated high rates of comorbid disorders. The highest weighted mean prevalence was for nicotine dependence at 60.1%, followed by substance use disorder at 57.5%, any type of mood disorder at 37.9%, and any type of anxiety disorder at 37.4%. Moderate heterogeneity was observed across studies, indicating rate estimates did not converge around a single population figure.
Why it matters
This paper demonstrates that a majority of problem and pathological gamblers in the general population experience co-occurring substance or nicotine use disorders, and over a third experience mood or anxiety disorders. It provides empirical justification for routine screening for comorbid psychiatric disorders upon intake into gambling treatment.
Limits
The review included only 11 studies, and the total participant sample size was not reported in the abstract. Moderate heterogeneity among included studies means pooled estimates should be interpreted with caution. The cross-sectional nature of population surveys precludes determining causal or temporal relationships between gambling severity and comorbidities.
Cited by
- supports A large proportion of problem gamblers are also problem drinkers and addicted to cigarettes.