MedWire News: Patients with psychotic disorders are at greater risk for gambling problems than other psychiatric patients, Spanish research suggests.
"Pathological gambling is known to be associated with psychiatric diagnoses," observe Núria Aragay and colleagues from Consorci Sanitari de Terrassa in Barcelona.
But they add that most studies investigating the association have focused on patients with alcohol-related disorders, mood disorders, and personality disorders, and "there is little available work on the relationship between psychotic disorders and problem gambling."
For the current study, Aragay and team investigated the prevalence of gambling difficulties among 100 consecutive patients, aged at least 18 years, admitted to the psychiatric unit of a general teaching hospital and 100 age- and gender-matched mentally healthy patients (controls) from nonpsychiatric units.
Of the psychiatric patients, 45% had mood disorders, 35% psychotic disorders, 3% anxiety disorders, 3% personality disorders, and 14% had other psychiatric conditions, including 13 adjustment disorders and one eating disorder.
All of the patients were assessed for gambling behavior using the National Opinion Research Center DSM-IV Screen for Gambling Problems (NODS). This is a 17-item questionnaire with scores ranging from 0-10 with four established levels of severity; no gambling behavior (NODS 0), risk gambling (NODS 1-2), problem gambling (NODS 3-4), and pathological gambling (NODS (≥5).
The researchers found that nine of the psychiatric patients met criteria for gambling difficulties (NODS ≥3), of whom eight met criteria for pathologic gambling and one for problem gambling. In contrast, just three controls met criteria for gambling difficulties, including two with pathologic gambling and one with problem gambling.
Of the psychiatric patients with gambling difficulties, six had psychotic disorders (four with schizoaffective disorder and two with paranoid schizophrenia), one had bipolar disorder, one had an adjustment disorder, and one had an eating disorder.
A significantly higher prevalence of gambling difficulties was found in patients with a psychotic disorder than controls (17 vs 3%), and between patients with a psychotic disorder and patients with any other psychiatric disorder (17 vs 5%). There were no significant differences between patients with a nonpsychotic psychiatric disorder and controls (5 and 3%, respectively).
Aragay et al conclude in the journal Comprehensive Psychiatry: "We found a higher prevalence and more severe patterns of gambling disorder in psychiatric inpatients than nonpsychiatric inpatients.
"We suggest the need for clinicians to routinely assess for gambling difficulties as part of the overall psychiatric evaluation."
They add: "Larger studies will lead to a better understanding of the links between gambling difficulties and psychiatric disorders and will be of help in the development of specific therapies, particularly in subjects with psychotic disorders."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
Free abstract
