title: Gambling problems in bipolar disorder in the UK: prevalence and distribution.
abstract: BACKGROUND
  North American studies show bipolar disorder is associated with elevated rates of problem gambling; however, little is known about rates in the different presentations of bipolar illness.
  
  
  OBJECTIVE
  To determine the prevalence and distribution of problem gambling in people with bipolar disorder in the UK.
  
  
  METHODS
  The Problem Gambling Severity Index was used to measure gambling problems in 635 participants with bipolar disorder.
  
  
  RESULTS
  Moderate to severe gambling problems were four times higher in people with bipolar disorder than in the general population, and were associated with type 2 disorder (OR = 1.74, P = 0.036), history of suicidal ideation or attempt (OR = 3.44, P = 0.02) and rapid cycling (OR = 2.63, P = 0.008).
  
  
  CONCLUSIONS
  Approximately 1 in 10 patients with bipolar disorder may be at moderate to severe risk of problem gambling, possibly associated with suicidal behaviour and a rapid cycling course. Elevated rates of gambling problems in type 2 disorder highlight the probable significance of modest but unstable mood disturbance in the development and maintenance of such problems.
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Metcalf
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Gordon-Smith
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Forty
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Perry
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Lloyd
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: John R
authors.initials: JR
authors.lastname: Geddes
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Craddock
authors.affiliation: Lisa Jones, PhD, Alice Metcalf, Department of Psychiatry, University of Birmingham; Katherine Gordon-Smith, PhD, Department of Psychiatry, University of Birmingham, and National Centre for Mental Health, Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Liz Forty, PhD, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Amy Perry, BSc, Department of Psychiatry, University of Birmingham; Joanne Lloyd, PhD, School of Psychology, Sport and Exercise Health, Staffordshire University, Stoke-on-Trent; John R. Geddes, MD, FRCPsych, Guy M. Goodwin, FMedSci, DPhil, FRCPsych, Department of Psychiatry, University of Oxford; Ian Jones, PhD, MRCPsych, Nick Craddock, PhD, FRCPsych, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University; Robert D. Rogers, PhD, Department of Psychiatry, University of Oxford, and School of Psychology, Bangor University, UK r.rogers@bangor.ac.uk.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Rogers
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001714:Bipolar Disorder / Q000150:complications*; D003865:Major Depressive Disorder / Q000150:complications*; D005260:Female; D005715:Gambling / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D059020:Suicidal Ideation; D013406:Suicide, Attempted; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult