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

Published online by Cambridge University Press:  23 March 2020

K. Mann ,
T. Lemenager ,
E. Zois ,
S. Hoffmann ,
H. Nakovics ,
M. Beutel ,
M. Vogelgesang ,
K. Wölfling ,
F. Kiefer  and
M. Fauth-Bühler
K. Mann
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
T. Lemenager
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
E. Zois
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
S. Hoffmann
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
H. Nakovics
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
M. Beutel
Affiliation:
Kraichtal-Kliniken Am Mühlberg, Kraichtal76703, Germany
M. Vogelgesang
Affiliation:
AHG Klinik Münchwies, Neunkirchen, Germany
K. Wölfling
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
F. Kiefer
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
M. Fauth-Bühler*
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
*
*Corresponding author at: Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Department of Addictive Behavior and Addiction Medicine, Research Group on Pathological Gambling, Square J5, 68159 Mannheim, Germany. Tel.: +49 (0)621 1703 3543; fax: +49 (0)621 1703 3505. E-mail address:mira.fauth-buehler@zi-mannheim.de (M. Fauth-Bühler).
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Abstract

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.

Keywords

Pathological gamblingComorbidityFamily historyPersonality traitsTreatment-seeking pathological gamblers
Type
Original article
Information
European Psychiatry , Volume 42 , May 2017 , pp. 120 - 128
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

1

Tel.: +49 (0)621 1703 3543; fax: +49 (0)621 1703 3505.

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