期刊
PSYCHOLOGICAL MEDICINE
卷 38, 期 9, 页码 1351-1360出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291708002900
关键词
epidemiology; National Comorbidity Survey Replication (NCS-R); pathological gambling
资金
- National Institute of Mental Health (NIMH) [U01-MH60220]
- National Institute on Drug Abuse (NIDA)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Robert Wood Johnson Foundation (RWJF) [044708]
- John W. Alden Trust
- National Center for Responsible Gaming
- NIMH [R01 MH070884]
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- US Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Fogarty International Center [FIRCA R01-TW006481]
- Pan American Health Organization
- Bristol-Myers Squibb
- Eli Lilly and Company
- Ortho-McNeil Pharmaceutical, Inc.
- GlaxoSmithKline
- Pfizer
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 nu. 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.
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