Telescoping and gender differences in the time course of disordered gambling: evidence from a general population sample.

Abstract

The course of disordered gambling in women has been described as 'telescoped' compared with that in men, with a later age at initiation of gambling but shorter times from initiation to disorder. This study examined the evidence, for the first time, for such a telescoping effect in a general population rather than a treatment-seeking sample. Participants in a large community-based Australian twin cohort (2001 men, 2662 women) were assessed by structured diagnostic telephone interviews in which they reported the ages at which they had attained various gambling milestones and additional information to be used as covariates (the types of gambling in which they had participated and history of symptoms of alcohol dependence, major depression, and adult antisocial behavior). Cox proportional hazards regression models were used to examine differences between men and women in the time from gambling initiation to the first disordered gambling symptom and a diagnosis of disordered gambling. Men had a higher hazards than women for the time to the first disordered gambling symptom [hazard ratio (HR) = 3.13, P < 0.0001] and to a diagnosis of disordered gambling (HR = 2.53, P < 0.0001). These differences persisted after controlling for covariates. Earlier age of initiation was the most potent predictor of progression to the first symptom. When assessed at the general population level, female gamblers do not appear to show a telescoped disordered gambling trajectory compared with male gamblers.