Dual Psychiatric Diagnosis and Substance Abuse in Pathological Gamblers

Abstract

Background: Pathological Gambling (PG) is a highly prevalent and disabling impulse control disorder. Recent studies have consistently shown that PG patients have responded well to treatment with SSRIs, mood stabilizers, and opioid antagonists. These findings have supported the observation that PG is strongly associated with both mood and anxiety disorders as well as substance abuse. The aim of the study is to evaluate the comorbid psychiatric diagnoses in our sample of pathological gamblers. Methods: Thirty-six female, and forty-two male PGs were enrolled in our study. A comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were screened for symptoms of depression and anxiety using the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Yale-Brown Obsessive Compulsive Scale, and the Frost Multidimensional Perfectionism Scale. In addition, the patients completed self-report questionnaires about their demographic status and substance abuse. Results: The majority of patients were married with full or part-time employment. The study results demonstrated that PG in males is correlated with substance and alcohol abuse. Diagnoses which were prevalent among our cohort of female PGs included major depression, affective disorders, anxiety disorders, and eating disorders. Conclusion: In our sample of PGs, the men and women had different patterns of psychiatric comorbidity. The different patterns of psychiatric comorbidity seen in our male versus female PGs raises the question of whether the underlying etiopathology in PG may differ according to gender.