Comorbidity, family history and personality traits in pathological gamblers compared with healthy controls

Background: While DSM-5 classified pathological gambling as an addictive disorder, there is debate as to whether ICD-11 should follow suit. The debate hinges on scientific evidence such as neurobiological findings, family history of psychiatric disorders, psychiatric comorbidity, and personality var...

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Hauptverfasser: Mann, Karl (VerfasserIn) , Kiefer, Falk (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: May 2017
In: European psychiatry
Year: 2017, Jahrgang: 42, Pages: 120-128
ISSN:1778-3585
DOI:10.1016/j.eurpsy.2016.12.002
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1016/j.eurpsy.2016.12.002
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0924933816301821
Volltext
Verfasserangaben:K. Mann, T. Lemenager, E. Zois, S. Hoffmann, H. Nakovics, M. Beutel, M. Vogelgesang, K. Wölfling, F. Kiefer, M. Fauth-Bühler

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520 |a Background: While DSM-5 classified pathological gambling as an addictive disorder, there is debate as to whether ICD-11 should follow suit. The debate hinges on scientific evidence such as neurobiological findings, family history of psychiatric disorders, psychiatric comorbidity, and personality variables. Methods: In the “Baden-Württemberg Study of Pathological Gambling”, we compared a group of 515 male pathological gamblers receiving treatment with 269 matched healthy controls. We studied differences in sociodemographic characteristics, gambling-related variables, psychiatric comorbidity (lifetime), family history of psychiatric conditions, as well as personality traits such as impulsivity (Barratt Impulsiveness Scale), sensation seeking (Zuckerman's Sensation Seeking Scale) and the NEO-FFI big five. Personality traits were validated in an age- and ethnicity-matched subsample of “pure” gamblers without any psychiatric comorbidity (including nicotine dependence). Data were analyzed using two-sample t-tests, Chi2 analyses, Fisher's exact test and Pearson correlation analysis, as appropriate. Bonferroni correction was applied to correct for multiple comparisons. Results: Only 1% of the gamblers had been diagnosed with an impulse control disorder other than gambling (ICD-10). Notably, 88% of the gamblers in our sample had a comorbid diagnosis of substance dependence. The highest axis I comorbidity rate was for nicotine dependence (80%), followed by alcohol dependence (28%). Early age of first gambling experience was correlated with gambling severity. Compared to first-degree relatives of controls, first-degree relatives of pathological gamblers were more likely to suffer from alcohol dependence (27.0% vs. 7.4%), pathological gambling (8.3% vs. 0.7%) and suicide attempts (2.7% vs. 0.4%). Significant group differences were observed for the NEO-FFI factors neuroticism, agreeableness and conscientiousness. Gamblers were also more impulsive than controls, but did not differ from controls in terms of sensation seeking. Conclusions: Our findings support classifying pathological gambling as a behavioural addiction in the ICD-11. This decision will have a significant impact on the approaches available for prevention (e.g. age limits) and treatment. 
650 4 |a Pathological gambling 
650 4 |a Comorbidity 
650 4 |a Family history 
650 4 |a Personality traits 
650 4 |a Treatment-seeking pathological gamblers 
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