title: Problem gambling in bipolar disorder: results from the Canadian Community Health Survey.
abstract: OBJECTIVE
  This investigation was undertaken to explore the prevalence and associated features of problem gambling amongst individuals with bipolar I disorder.
  
  
  METHODS
  The data for this analysis were procured from the Canadian Community Health Survey: Mental Health and Well-being (CCHS 1.2) conducted by Statistics Canada. Individuals screening positive for a lifetime (World Mental Health- Composite International Diagnostic Interview) WMH-CIDI-defined manic episode (i.e. bipolar I disorder) or depressive episode (i.e. major depressive disorder) and current (i.e. past 12-month) problem gambling were compared to the general population without these disorders. Past year problem gambling was operationalized with the Canadian Problem Gambling Index (CPGI).
  
  
  RESULTS
  The sample consisted of 36,984 individuals (> or = 15 years old); the weighted prevalence of problem gambling was significantly higher (6.3%) amongst the population with bipolar disorder as compared to the general population (2.0%, p<0.001) and those with major depressive disorder (2.5%, p<0.01). Compared to those without bipolar disorder, the odds of problem gambling for bipolar individuals were over twice as high (OR=2.3; 95% CI 1.4-3.7), even when controlling for potential confounders. Males also had higher odds of problem gambling (OR=1.8; 95% CI 1.4-2.3), as did individuals without post-secondary education (OR=1.4; 95% CI 1.1-1.8). Persons who were married/cohabiting had lowered odds of problem gambling, compared with those who were unmarried (OR=0.6; 95% CI 0.5-0.8). Comorbid alcohol dependence (OR=3.4; 95% CI 2.3-5.0) and illicit drug dependence (OR=2.6; 95% CI 1.1-6.2) each conferred an increased risk for problem gambling. Physical activity level (moderate to active) was associated with a decreased risk for problem gambling (OR=0.8; 95% CI 0.6-0.9).
  
  
  CONCLUSIONS
  Individuals with bipolar I disorder are differentially affected by problem gambling. Opportunistic screening for problem gambling is warranted, particularly in persons with comorbid alcohol or substance dependence.
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, ON, Canada. roger.mcintyre@uhn.on.ca
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.forename: Susan L
authors.initials: SL
authors.lastname: McElroy
authors.forename: Jakub Z
authors.initials: JZ
authors.lastname: Konarski
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Soczynska
authors.forename: Kathryn
authors.initials: K
authors.lastname: Wilkins
authors.forename: Sidney H
authors.initials: SH
authors.lastname: Kennedy
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000453:epidemiology*; D005260:Female; D005715:Gambling / Q000523:psychology*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology