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

Dowling, Nicki A., Cowlishaw, Sean, Jackson, Alun C., Merkouris, Stephanie S., Francis, Kate L. and Christensen, Darren R. 2015, Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis, Australian New Zealand journal of psychiatry, vol. 49, no. 6, pp. 519-539, doi: 10.1177/0004867415575774.

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Title Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis
Author(s) Dowling, Nicki A.ORCID iD for Dowling, Nicki A.
Cowlishaw, Sean
Jackson, Alun C.
Merkouris, Stephanie S.ORCID iD for Merkouris, Stephanie S.
Francis, Kate L.ORCID iD for Francis, Kate L.
Christensen, Darren R.
Journal name Australian New Zealand journal of psychiatry
Volume number 49
Issue number 6
Start page 519
End page 539
Total pages 21
Publisher Sage Publications
Place of publication Abingdon, Eng.
Publication date 2015-06
ISSN 1440-1614
Keyword(s) Gambling
psychiatric disorders
systematic review
Summary 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.
Language eng
DOI 10.1177/0004867415575774
Field of Research 11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
170106 Health, Clinical and Counselling Psychology
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Sage Publications
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School of Psychology
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