title: Frequency and correlates of gambling problems in outpatients with major depressive disorder and bipolar disorder.
abstract: OBJECTIVE
  To investigate the frequency of gambling in people who have been diagnosed with major depressive disorder (MDD) or bipolar disorder (BD). Secondary objectives were to examine: sex differences in the rates of gambling behaviour, the temporal relation between onset of mood disorders and problem gambling, psychiatric comorbidities associated with problem gambling, and the influences of problem gambling on quality of life.
  
  
  METHODS
  People (aged 18 years and older) who met criteria for lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision-defined MDD or BD I or II, and were confirmed by the Mini International Neuropsychiatric Interview, were enrolled. Participants were recruited from 5 sites in Canada and 1 in the United States. Prevalence of past-year problem gambling was assessed with the Canadian Problem Gambling Index. Associated comorbidities with problem gambling are presented.
  
  
  RESULTS
  A total of 579 participants were enrolled (female: n = 379, male: n = 200). Prevalence of problem gambling did not differ significantly between the MDD (12.5%) and the BD (12.3%) groups. There was a significant difference in the prevalence of problem gambling between males (19.5%) and females (7.8%) in the BD group (chi-square = 8.695, df = 1, P = 0.003). Among people meeting criteria for problem gambling, the mood disorder was the primary onset condition in 71% of cases. People with a mood disorder with comorbid current panic disorder (OR = 1.96; 95% CI 1.02 to 3.75), obsessive-compulsive disorder (OR = 1.86; 95% CI 1.01 to 3.45), specific phobia (OR = 2.36; 95% CI 1.17 to 4.76), alcohol dependence (OR = 5.73; 95% CI 3.08 to 10.65), or lifetime substance dependence (OR = 2.05; 95% CI 1.17 to 3.58), had significantly increased odds of problem gambling. Problem gambling across MDD and BD populations was also associated with lower quality of life ratings.
  
  
  CONCLUSIONS
  These results reaffirm a higher prevalence of gambling both in BD and in MDD populations, compared with previously published community samples. Our study also identifies risk factors for gambling behaviours within these populations.
authors.affiliation: University of Toronto, Ontario, Canada. sidney.kennedy@uhn.on.ca
authors.forename: Sidney H
authors.initials: SH
authors.lastname: Kennedy
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Welsh
authors.forename: Kari
authors.initials: K
authors.lastname: Fulton
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Soczynska
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.forename: Claire
authors.initials: C
authors.lastname: O'Donovan
authors.forename: Roumen
authors.initials: R
authors.lastname: Milev
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: le Melledo
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Bisserbe
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
authors.forename: Neasa
authors.initials: N
authors.lastname: Martin
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications / Q000523:psychology; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D002170:Canada / Q000453:epidemiology; D016001:Confidence Intervals; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D005715:Gambling / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010555:Personality Inventory; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology; D013997:Time Factors