title: Comorbid Axis I-disorders among subjects with pathological, problem, or at-risk gambling recruited from the general population in Germany: results of the PAGE study.
abstract: The aim of the present study was to analyze comorbid Axis I-disorders in a sample of individuals with at-risk, problem, and pathological gambling. A number of 164 adult gamblers derived from a random sample of 15,023 individuals were compared with a general population sample. The lifetime prevalence of any psychiatric disorder was 93.6% among pathological (five-10 criteria), 83.5% among problem (three or four criteria), and 81.0% among at-risk gamblers (one or two criteria). Substance use disorders were the most common comorbid disorders in gamblers. Logistic regression analyses revealed elevated odds ratios for having a comorbid disorder in at-risk (Conditional Odds Ratio (COR) 3.5, Confidence Interval (CI) 2.6-4.6), problem (COR 4.9, CI 3.3-7.3), and pathological gamblers (COR 4.6, CI 3.0-6.9) compared to the general population. No significant differences were found between at-risk and problem gamblers or problem and pathological gamblers. Compared to at-risk gamblers, pathological gamblers showed elevated rates of comorbid substance use disorders. The data suggest a linear association between gambling disorder severity and comorbid Axis I-disorders. In conclusion, comorbid disorders are very prevalent in individuals with gambling problems. Even at-risk gamblers with one or two DSM-IV criteria show high rates of Axis I-disorders. Therefore, this group should be included in further studies on problematic gambling.
authors: Department of Psychiatry and Psychotherapy, University of Luebeck, Research Group S:TEP, Center for Integrative Psychiatry, Germany; Faculty of Life Sciences, Hamburg University of Applied Sciences, Germany. Electronic address: anja.bischof@uksh.de.
authors: Anja
authors: A
authors: Bischof
authors: Christian
authors: C
authors: Meyer
authors: Gallus
authors: G
authors: Bischof
authors: Nadin
authors: N
authors: Kastirke
authors: Ulrich
authors: U
authors: John
authors: Hans-Juergen
authors: HJ
authors: Rumpf
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005715:Gambling / Q000453:epidemiology* / Q000523:psychology*; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016017:Odds Ratio; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology
keywords: Comorbidity; Epidemiology; Pathological gambling; Problem gambling