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DSM-IV pathological gambling in the National Comorbidity Survey Replication

Published online by Cambridge University Press:  07 February 2008

R. C. Kessler ,
I. Hwang ,
R. LaBrie ,
M. Petukhova ,
N. A. Sampson ,
K. C. Winters  and
H. J. Shaffer
R. C. Kessler*
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
I. Hwang
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
R. LaBrie
Affiliation:
Division on Addictions, Cambridge Health Alliance and Harvard Medical School, Boston, MA, USA
M. Petukhova
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
N. A. Sampson
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
K. C. Winters
Affiliation:
Department of Psychiatry, University of Minnesota, MN, USA
H. J. Shaffer
Affiliation:
Division on Addictions, Cambridge Health Alliance and Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: R. C. Kessler, Ph.D., Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA. (Email: kessler@hcp.med.harvard.edu)
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Abstract

Background

Little is known about the prevalence or correlates of DSM-IV pathological gambling (PG).

Method

Data from the US National Comorbidity Survey Replication (NCS-R), a nationally representative US household survey, were used to assess lifetime gambling symptoms and PG along with other DSM-IV disorders. Age of onset (AOO) of each lifetime disorder was assessed retrospectively. AOO reports were used to study associations between temporally primary disorders and the subsequent risk of secondary disorders.

Results

Most respondents (78.4%) reported lifetime gambling. Lifetime problem gambling (at least one Criterion A symptom of PG) (2.3%) and PG (0.6%) were much less common. PG was significantly associated with being young, male, and Non-Hispanic Black. People with PG reported first gambling significantly earlier than non-problem gamblers (mean age 16.7 v. 23.9 years, z=12.7, p<0.001), with gambling problems typically beginning during the mid-20s and persisting for an average of 9.4 years. During this time the largest annual gambling losses averaged US$4800. Onset and persistence of PG were predicted by a variety of prior DSM-IV anxiety, mood, impulse-control and substance use disorders. PG also predicted the subsequent onset of generalized anxiety disorder, post-traumatic stress disorder (PTSD) and substance dependence. Although none of the NCS-R respondents with PG ever received treatment for gambling problems, 49.0% were treated at some time for other mental disorders.

Conclusions

DSM-IV PG is a comparatively rare, seriously impairing, and undertreated disorder whose symptoms typically start during early adulthood and is frequently secondary to other mental or substance disorders that are associated with both PG onset and persistence.

Keywords

EpidemiologyNational Comorbidity Survey Replication (NCS-R)pathological gambling

Information

Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 9 , September 2008 , pp. 1351 - 1360
Copyright
Copyright © 2008 Cambridge University Press

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References

Angst, J, Sellaro, R, Merikangas, KR (2000). Depressive spectrum diagnoses. Comprehensive Psychiatry 41, 39–47.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 4th edn, text revision. American Psychiatric Association: Washington, DC.Google Scholar
Bland, RC, Newman, SC, Orn, H, Stebelsky, G (1993). Epidemiology of pathological gambling in Edmonton. Canadian Journal of Psychiatry 38, 108–112.CrossRefGoogle ScholarPubMed
Cunningham-Williams, RM, Cottler, LB, Compton, WM III, Spitznagel, EL (1998). Taking chances: problem gamblers and mental health disorders – results from the St. Louis Epidemiologic Catchment Area Study. American Journal of Public Health 88, 1093–1096.CrossRefGoogle ScholarPubMed
Cunningham-Williams, RM, Cottler, LB, Compton, WM, Spitznagel, EL, Ben-Abdallah, A (2000). Problem gambling and comorbid psychiatric and substance use disorders among drug users recruited from drug treatment and community settings. Journal of Gambling Studies 16, 347–376.CrossRefGoogle ScholarPubMed
Cunningham-Williams, RM, Grucza, RA, Cottler, LB, Womack, SB, Books, SJ, Przybeck, TR, Spitznagel, EL, Cloninger, CR (2005). Prevalence and predictors of pathological gambling: results from the St. Louis personality, health and lifestyle (SLPHL) study. Journal of Psychiatric Research 39, 377–390.CrossRefGoogle Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2002). Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-Patient Edition (SCID-I/NP). Biometrics Research, New York State Psychiatric Institute: New York, NY.Google Scholar
Halli, SS, Rao, KV, Halli, SS (1992). Advanced Techniques of Population Analysis. Plenum: New York, NY.CrossRefGoogle Scholar
Kallick, M, Suits, D, Dielman, T, Hybels, J (1979). A Survey of American Gambling Attitudes and Behavior. University of Michigan Press: Ann Arbor, MI.Google Scholar
Kessler, RC, Abelson, J, Demler, O, Escobar, JI, Gibbon, M, Guyer, ME, Howes, MJ, Jin, R, Vega, WA, Walters, EE, Wang, P, Zaslavsky, A, Zheng, H (2004 a). Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). International Journal of Methods in Psychiatric Research 13, 122–139.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Chiu, WT, Demler, O, Heeringa, S, Hiripi, E, Jin, R, Pennell, B-E, Walters, EE, Zaslavsky, A, Zheng, H (2004 b). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research 13, 69–92.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, HU, Kendler, KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.CrossRefGoogle ScholarPubMed
Kessler, RC, Merikangas, KR (2004). The National Comorbidity Survey Replication (NCS-R): background and aims. International Journal of Methods in Psychiatric Research 13, 60–68.CrossRefGoogle ScholarPubMed
Kessler, RC, Ustun, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.CrossRefGoogle ScholarPubMed
Knauper, B, Cannell, CF, Schwarz, N, Bruce, ML, Kessler, RC (1999). Improving the accuracy of major depression age of onset reports in the US National Comorbidity Survey. International Journal of Methods in Psychiatric Research 8, 39–48.CrossRefGoogle Scholar
Kraemer, HC, Wilson, KA, Hayward, C (2006). Lifetime prevalence and pseudocomorbidity in psychiatric research. Archives of General Psychiatry 63, 604–608.CrossRefGoogle ScholarPubMed
Ladouceur, R (1991). Prevalence estimates of pathological gambling in Quebec. Canadian Journal of Psychiatry 36, 732–734.CrossRefGoogle ScholarPubMed
National Research Council (1999). Pathological Gambling: A Critical Review. National Academy Press: Washington, DC.Google Scholar
Nelson, CB, Heath, AC, Kessler, RC (1998). Temporal progression of alcohol dependence symptoms in the U.S. household population: results from the National Comorbidity Survey. Journal of Consulting and Clinical Psychology 66, 474–483.CrossRefGoogle ScholarPubMed
Petry, NM, Stinson, FS, Grant, BF (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 66, 564–574.CrossRefGoogle ScholarPubMed
Research Triangle Institute (2002). SUDAAN: Professional Software for Survey Data Analysis. Research Triangle Institute: Research Triangle Park, NC.Google Scholar
Scherrer, JF, Slutske, WS, Xian, H, Waterman, B, Shah, KR, Volberg, R, Eisen, SA (2007). Factors associated with pathological gambling at 10-year follow-up in a national sample of middle-aged men. Addiction 102, 970–978.CrossRefGoogle Scholar
Shaffer, HJ, Eber, GB (2002). Temporal progression of cocaine dependence symptoms in the US National Comorbidity Survey. Addiction 97, 543–554.CrossRefGoogle ScholarPubMed
Shaffer, HJ, Hall, MN, Vander Bilt, J (1999). Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis. American Journal of Public Health 89, 1369–1376.CrossRefGoogle Scholar
Simon, GE, Von Korff, M (1995). Recall of psychiatric history in cross-sectional surveys: implications for epidemiologic research. Epidemiologic Reviews 17, 221–227.CrossRefGoogle ScholarPubMed
Specker, SM, Carlson, GA, Edmonson, KM, Johnson, PE, Marcotte, M (1996). Psychopathology in pathological gamblers seeking treatment. Journal of Gambling Studies 12, 67–81.CrossRefGoogle ScholarPubMed
Volberg, RA (1994). The prevalence and demographics of pathological gamblers: implications for public health. American Journal of Public Health 84, 237–241.CrossRefGoogle ScholarPubMed
Welte, J, Barnes, G, Wieczorek, W, Tidwell, MC, Parker, J (2001). Alcohol and gambling pathology among U.S. adults: prevalence, demographic patterns and comorbidity. Journal of Studies on Alcohol 62, 706–712.CrossRefGoogle ScholarPubMed
WHO (1991). International Classification of Diseases (ICD-10). World Health Organization: Geneva, Switzerland.Google Scholar
Willett, JB, Singer, JD (1997). Using discrete-time survival analysis to study event occurrence across the life course. In Trajectories and Turning Points: Stress and Adversity over the Life Course (ed. Gotlib, I. H. and Wheaton, B.), pp. 273–294. Cambridge University Press: New York, NY.CrossRefGoogle Scholar
Wolter, KM (1985). Introduction to Variance Estimation. Springer-Verlag: New York, NY.Google Scholar