ABSTRACT
INTRODUCTION: Pathological gambling shows high comorbidity rates, especially with substance use disorders, although affective, anxiety and other impulse control disorders, as well as personality disorders, are also frequently associated. OBJECTIVES: To explore comorbidity in pathological gambling with other mental disorders in a consecutive sample of patients attending a unit specialized in pathological gambling, and specifically the relationship between substance-related disorders, on the one hand, and personality and clinical variables in pathological gamblers, on the other. METHOD: A total of 498 patients with a DSM-IV-TR diagnosis of Pathological Gambling (11.8% women) were assessed with a semi-structured clinical interview and several clinical and personality scales. RESULTS: Higher comorbidity with affective disorders was found in women (30.5%), while higher comorbidity with substance-related disorders was found in men (11.2%). A positive association was also detected between a history of psychiatric disorders and current comorbidity with substance-use disorders, as well as between alcohol abuse and age. Finally, some personality traits such as low reward dependence (OR=0.964) and high impulsivity (OR=1.02) predicted other substance abuse (not alcohol). High selftranscendence scores predicted both alcohol and other substance abuse (OR=1.06). CONCLUSIONS: Our results suggest a high prevalence of comorbid disorders in pathologic gambling, mainly with affective and substance-related disorders. The results of the present study, conducted in a broad sample of consecutively admitted pathologic gamblers, may contribute to understanding of this complex disorder and treatment improvement.
ABSTRACT
This paper reviews some of the characteristics of the informants as well as some of the attributes of the DICA-R interview that could influence the test-retest reliability in a sample of 109 psychiatric outpatients aged 7-17 years. Different regression models using reliability coefficients constructed from the kappa statistic were obtained. Of those characteristics evaluated in the children, a high level of psychological impairment proved to be significant when it came to predicting the lowest test-retest reliability of the answers; none of the subject-related characteristics were significant in the adolescent patient model. The attributes of the questions that proved to be significant when explaining the lower reliability obtained for the individual question in the children's model were the length of the questions (longest questions), the content (internalising), the presence of time concepts, comparison with the peer group, and the need to exercise judgement; in the adolescents' model, the significant attributes were found to be the internalising content, the presence of time concepts, evaluation concerning the impairment caused by the disorder, and the need to exercise judgement. In the group of children our results are in accordance with the original paper. Similar results were found with adolescents. These findings have implications for the development and revision of new interview schedules.
