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Arch Gen Psychiatry. 2005 Jun;62(6):677-83.

Effect of genes, environment, and lifetime co-occurring disorders on health-related quality of life in problem and pathological gamblers.

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1
Research Service, St Louis Veterans Affairs Medical Center, St Louis, Missouri 63106, USA. scherrej@msnotes.wustl.edu

Abstract

BACKGROUND:

Problem and pathological gambling are associated with many impairments in quality of life, including financial, family, legal, and social problems. Gambling disorders commonly co-occur with other psychiatric disorders, such as alcoholism and depression. Although these consequences and correlates have been reported, little is known about the health-related functional impairment associated with gambling.

OBJECTIVE:

To model differences in the health-related quality of life (HRQoL) among non-problem gamblers, problem gamblers, and pathological gamblers after controlling for lifetime co-occurring substance use disorders, psychiatric disorders, sociodemographics, and genetic and family environmental influences.

DESIGN:

Cohort and co-twin studies.

SETTING:

Nationally distributed community sample.

PATIENTS:

Male twin members of the Vietnam Era Twin Registry: 53 pathological gamblers, 270 subclinical problem gamblers, and 1346 non-problem gamblers (controls).

INTERVENTIONS:

We obtained HRQoL data, via the 8-Item Short-Form Health Survey, from all participants. Data from a subset of twin pairs discordant for gambling behavior was used to control for genetic and family environmental effects on HRQoL and problem gambling. Main Outcome Measure Health-related quality of life.

RESULTS:

Results from adjusted logistic regression analyses suggest little difference across groups in the physical domains of the health survey; however, for each mental health domain, pathological gamblers had lower HRQoL scores than problem gamblers (P<.05), who in turn had lower scores than non-problem gamblers (P<.05). After controlling for genes and family environment, no significant differences existed between the non-problem gambling twins and their problem or pathological gambling brothers, but adjusted co-twin analyses resulted in statistically significant differences in 4 of 8 subscales.

CONCLUSIONS:

Pathological and problem gambling are associated with significant decrements in HRQoL. This association is partly explained by genetic and family environmental effects and by lifetime co-occurring substance use disorders. Implications for clinicians, health care utilization, and public health issues are discussed.

PMID:
15939845
DOI:
10.1001/archpsyc.62.6.677
[Indexed for MEDLINE]
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