Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-anaylsis

Journal article


Dowling, Nicki, Cowlishaw, Sean, Jackson, Alun, Merkouris, Stephanie, Francis, Kate and Christensen, Darren. (2015) Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-anaylsis. Australian and New Zealand Journal of Psychiatry. 49(6), pp. 519 - 539. https://doi.org/10.1177/0004867415575774
AuthorsDowling, Nicki, Cowlishaw, Sean, Jackson, Alun, Merkouris, Stephanie, Francis, Kate and Christensen, Darren
Abstract

Objective: The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers. Methods: A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies. Results: Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5–93.9) and lifetime (75.5%, 95% CI 46.5–91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9–34.0), alcohol use disorders (21.2%, 95% CI 15.6–28.1), anxiety disorders (17.6%, 95% CI 10.8–27.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7–24.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7–75.2) and major depressive disorder (29.9%, 95% CI 20.5–41.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4–24.2), alcohol dependence (15.2%, 95% CI 10.2–22.0), social phobia (14.9%, 95% CI 2.0–59.8), generalised anxiety disorder (14.4%, 95% CI 3.9–40.8), panic disorder (13.7%, 95% CI 6.7–26.0), post-traumatic stress disorder (12.3%, 95% CI 3.4–35.7), cannabis use disorder (11.5%, 95% CI 4.8–25.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1–19.6), adjustment disorder (9.2%, 95% CI 4.8–17.2), bipolar disorder (8.8%, 95% CI 4.4–17.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4–18.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should be interpreted with caution as they were highly variable across studies. Conclusions: The findings highlight the need for gambling treatment services to undertake routine screening and assessment of psychiatric co-morbidity and provide treatment approaches that adequately manage these co-morbid disorders. Further research is required to explore the reasons for the variability observed in the prevalence estimates.

Year2015
JournalAustralian and New Zealand Journal of Psychiatry
Journal citation49 (6), pp. 519 - 539
ISSN0004-8674
Digital Object Identifier (DOI)https://doi.org/10.1177/0004867415575774
Page range519 - 539
Research GroupCentre for Health and Social Research
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https://acuresearchbank.acu.edu.au/item/8q50w/prevalence-of-psychiatric-co-morbidity-in-treatment-seeking-problem-gamblers-a-systematic-review-and-meta-anaylsis

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