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Overview
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. Our report, Applying a public health perspective to gambling harm, summarizes literature examining the relationship between problem gambling and comorbid mental health and substance abuse disorders, and the prevalence of gambling disorders among target demographics that are more susceptible to its associated harms
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.
The following poster, presented at the GREO policy forum Mapping Problem Gambling Needs for Ontario, shows the prevalence and breakdown of comorbidities of problem gambling (click for full size):
State of Evidence
GREO's state of evidence review, Co-morbidity in individuals with disordered gambling, contains detailed information on research that has been done worldwide on gambling comorbidities. A summary of the findings was also presented by Dr. David Hodgins at a GREO treatment forum. Click here to watch the video.
Seach the Evidence Centre for Comorbidities
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References
Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction, 106(3), 490-498.
McGrath, D. S., & Barrett, S. P. (2009). The comorbidity of tobacco smoking and gambling: a review of the literature. Drug and Alcohol Review, 28(6), 676-681.
Black, D. W., & Moyer, T. (1998). Clinical features and psychiatric comorbidity of subjects with pathological gambling behavior. Psychiatric Services, 49(11), 1434-1439.
Carlton, P. L., & Manowitz, P. (1994). Factors determining the severity of pathological gambling in males. Journal of Gambling Studies, 10(2), 147-157.
Hodgins, D. C., Peden, N., & Cassidy, E. (2005). The association between comorbidity and outcome in pathological gambling: A prospective follow-up of recent quitters. Journal of Gambling Studies, 21(3), 255-271.