Comorbid mental health disorders have been linked to problem and pathological gambling in both community and clinical samples. In particular, strong links to mood disorders such as major depression, anxiety disorders, and substance use disorders, have been found. Harmful gambling and nicotine use are also highly associated. Links with lower base rate disorders such as eating disorders and attention deficit disorder have also been observed.
It is possible that a shared vulnerability underlies these high rates of comorbidity, although to date evidence is lacking. There is also limited research assessing the order of onset of mental disorders relative to harmful gambling, but it appears that substance use disorders are more likely to develop earlier than gambling difficulties, whereas mood disorders are equally likely to pre-date or follow harmful gambling.
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