Comorbidity on disorders with loss of impulse-control: pathological gambling, addictions and personality disorders.
OBJECTIVE
To analyze the comorbidity of pathological gamblers, mainly in disorders with loss of impulse-control as addictions and personality disorders (PD). Also, to discuss addictive and impulsive characteristics of pathological gambling (PG), and their implications in prognosis and treatment.


METHODS
Cross-sectional study on 162 patients with PG admitted for treatment in a specific residential unit. The SCID-I and II were used for the addiction and the PD diagnosis. For the diagnosis and evaluation of PG the SOGS, AGQ III and the Gambling Severity Index were also used.


RESULTS
The 61.1 % of the patients presented some PD, where the cluster B ones (impulsive group) were more frequent, followed by C and A ones. 63.3% of patients had had in their lives substance dependence criteria, where alcohol dependence was the most prevalent. The presence of PD is related to the gravity of the addiction by the dependence to more than one substance (chi2=7.15; p<0.008).


CONCLUSIONS
TP and substance-related disorders (SRD) are frequent comorbidities of the PG. Their co-presentation could mean worse prognosis of this patients. The PG as impulsive disorder could help to the understanding of the etiopathogenia of this disorder, but also of the prognosis. This hypothesis will add to the addictive one other treatment approaches that should be included in future studies of PG.
Louis Stokes Cleveland Veterans Affairs Medical Center, Brecksville, OH, USA.
N
N
Kruedelbach
H I
HI
Walker
H A
HA
Chapman
G
G
Haro
C
C
Mateu
C
C
Leal
D015897:Comorbidity; D003430:Cross-Sectional Studies; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires