Prevalence, clinical correlations, comorbidities, and suicidal tendencies in pathological Korean gamblers: results from the Korean Epidemiologic Catchment Area Study

  • Subin Park
  • Maeng Je Cho
  • Hong Jin Jeon
  • Hae Woo Lee
  • Jae Nam Bae
  • Jong Ik Park
  • Jee Hoon Sohn
  • You Ra Lee
  • Jun Young Lee
  • Jin Pyo Hong
Original Paper

Abstract

Objective

Based on the National Epidemiological Survey of Psychiatric Disorders in South Korea conducted in 2006, we examined the prevalence, clinical correlations, comorbidities, and suicidal tendencies of pathological gamblers in the community.

Method

Of the 6,510 participants who completed the Korean version of the Composite International Diagnostic Interview (K-CIDI) administered by trained lay interviewers, 5,333 subjects fully completed the Diagnostic Interview Schedule (DIS) exploring pathological gambling. The DIS has 13 items mapping to 10 criteria. Endorsement of five DSM-IV criteria was considered to reflect pathological gambling, and we considered endorsement of one to four criteria to indicate problem gambling. The frequencies of psychiatric disorders and suicidal tendency were analyzed among pathological/problem gamblers in comparison with controls; both odds ratios and significance levels were calculated.

Results

The lifetime prevalence rates of pathological gambling and problem gambling were 0.8% and 3.0%, respectively. Of pathological gamblers, 79.1% had at least one psychiatric illness in comparison to the control level of 28.1%, and 62.0% of problem gamblers also had psychiatric conditions. Associations between pathological/problem gambling and alcohol use disorder, nicotine dependence, mood disorder, anxiety disorder, and suicidality were overwhelmingly positive and significant (p < 0.05), even after controlling for age and gender. Male gender, divorced/separated/widowed marital status, and urban living were all associated with increased risks of pathological and problem gambling (p < 0.05).

Conclusion

Pathological/problem gambling is highly associated with substance abuse, mood and anxiety disorders, and suicidality, suggesting that clinicians should carefully evaluate and treat such psychiatric disorders in gamblers.

Keywords

Epidemiology Pathological gambling Comorbidity Psychiatric disorders Suicidality 

References

  1. 1.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th text revision edn. American Psychiatric Association, Washington, DCGoogle Scholar
  2. 2.
    Black DW, Moyer T (1998) Clinical features and psychiatric comorbidity of subjects with pathological gambling behavior. Psychiatr Serv 49:1434–1439PubMedGoogle Scholar
  3. 3.
    Bland RC, Newman SC, Orn H, Stebelsky G (1993) Epidemiology of pathological gambling in Edmonton. Can J Psychiatry 38:108–112PubMedGoogle Scholar
  4. 4.
    Bondolfi G, Osiek C, Ferrero F (2000) Prevalence estimates of pathological gambling in Switzerland. Acta Psychiatr Scand 101:473–475CrossRefPubMedGoogle Scholar
  5. 5.
    Cho MJ HB, Bae JN, Suh TW, Lee DW, Cho SJ, Kim JK (1999) Development of the Korean version of Composite International Diagnostic Interview. Annual Meeting of the Korean Neuropsychiatric Association. Korean Neuropsychiatric Association, SeoulGoogle Scholar
  6. 6.
    Committee on the Social and Economic Impact of Pathological Gambling, National Research (1999) Pathological gambling: a critical review. National Academy Press, Washington DC, pp 15–21Google Scholar
  7. 7.
    Crockford DN, el-Guebaly N (1998) Psychiatric comorbidity in pathological gambling: a critical review. Can J Psychiatry 43:43–50PubMedGoogle Scholar
  8. 8.
    Cunningham-Williams RM, Cottler LB, Compton WM, 3rd, Spitznagel EL (1998) Taking chances: problem gamblers and mental health disorders—results from the St. Louis Epidemiologic Catchment Area Study. Am J Public Health 88:1093–1096CrossRefPubMedGoogle Scholar
  9. 9.
    Cunningham-Williams RM, Cottler LB, Compton WM, Spitznagel EL, Ben-Abdallah A (2000) Problem gambling and comorbid psychiatric and substance use disorders among drug users recruited from drug treatment and community settings. J Gambl Stud 16:347–376CrossRefPubMedGoogle Scholar
  10. 10.
    Dannon PN, Lowengrub K, Sasson M, Shalgi B, Tuson L, Saphir Y, Kotler M (2004) Comorbid psychiatric diagnoses in kleptomania and pathological gambling: a preliminary comparison study. Eur Psychiatry 19:299–302CrossRefPubMedGoogle Scholar
  11. 11.
    Desai RA, Maciejewski PK, Dausey DJ, Caldarone BJ, Potenza MN (2004) Health correlates of recreational gambling in older adults. Am J Psychiatry 161:1672–1679CrossRefPubMedGoogle Scholar
  12. 12.
    Gotestam KG, Johansson A (2003) Characteristics of gambling and at problematic gambling in the Norwegian context: a DSM-IV-based telephone interview study. Addict Behav 28:189–197CrossRefPubMedGoogle Scholar
  13. 13.
    Griffiths M (2003) Internet gambling: issues, concerns, and recommendations. Cyberpsychol Behav 6:557–568CrossRefPubMedGoogle Scholar
  14. 14.
    Ibanez A, Blanco C, Donahue E, Lesieur HR, Perez de Castro I, Fernandez-Piqueras J, Saiz-Ruiz J (2001) Psychiatric comorbidity in pathological gamblers seeking treatment. Am J Psychiatry 158:1733–1735CrossRefPubMedGoogle Scholar
  15. 15.
    Jeoung MJ, Park CA, Lee MY (1993) Go-stop, gambling addict and living problems, marital conflict tactics. J soc sci Univ Ulsan 3:115–146Google Scholar
  16. 16.
    Kessler RC, Borges G, Walters EE (1999) Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry 56:617–626CrossRefPubMedGoogle Scholar
  17. 17.
    Kessler RC, Hwang I, LaBrie R, Petukhova M, Sampson NA, Winters KC, Shaffer HJ (2008) DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med 38:1351–1360PubMedGoogle Scholar
  18. 18.
    Kim KH, Seong HG, Lhee MK (2004) Psycho-social characteristics of Korean gamblers and predictors of pathological and problem gambling. Korean J Health Psychol 9:285–320Google Scholar
  19. 19.
    King SA, Barak A (1999) Compulsive internet gambling: a new form of an old clinical pathology. Cyberpsychol Behav 2:441–456CrossRefPubMedGoogle Scholar
  20. 20.
    Korean Ministry of Justice (2005) Sect. 246 to 249, Gambling Ordinance, Korean Criminal CodeGoogle Scholar
  21. 21.
    Lee CK, Kwak YS, Yamamoto J, Rhee H, Kim YS, Han JH, Choi JO, Lee YH (1990) Psychiatric epidemiology in Korea. Part I: gender and age differences in Seoul. J Nerv Ment Dis 178:242–246CrossRefPubMedGoogle Scholar
  22. 22.
    Lejoyeux M, Arbaretaz M, McLoughlin M, Ades J (2002) Impulse control disorders and depression. J Nerv Ment Dis 190:310–314CrossRefPubMedGoogle Scholar
  23. 23.
    Lester D (1994) Access to gambling opportunities and compulsive gambling. Int J Addict 29:1611–1616PubMedGoogle Scholar
  24. 24.
    Newman SC, Thompson AH (2003) A population-based study of the association between pathological gambling and attempted suicide. Suicide Life Threat Behav 33:80–87CrossRefPubMedGoogle Scholar
  25. 25.
    Newman SC, Thompson AH (2007) The association between pathological gambling and attempted suicide: findings from a national survey in Canada. Can J Psychiatry 52:605–612PubMedGoogle Scholar
  26. 26.
    Oh YS (2006) Strategic perspectives in casino industry in Korea. Unpublished doctoral dissertation. University of Kyoungwon, GyeonggiGoogle Scholar
  27. 27.
    Petry NM (2005) Comorbidity of disordered gambling and other psychiatric disorders. Pathological gambling: etiology, comorbidity, and treatment. American Psychological Association, Washington DC, pp 85–115Google Scholar
  28. 28.
    Petry NM, Kiluk BD (2002) Suicidal ideation and suicide attempts in treatment-seeking pathological gamblers. J Nerv Ment Dis 190:462–469CrossRefPubMedGoogle Scholar
  29. 29.
    Petry NM, Stinson FS, Grant BF (2005) Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 66:564–574CrossRefPubMedGoogle Scholar
  30. 30.
    Robins L, Marcus L, Reich W, Cunningham R, Gallagher T (1996) NIMH diagnostic interview schedule—version IV (DIS-IV). Department of Psychiatry, Washington University School of Medicine, St. Louis, MOGoogle Scholar
  31. 31.
    Shaffer HJ, Korn DA (2002) Gambling and related mental disorders: a public health analysis. Annu Rev Public Health 23:171–212CrossRefPubMedGoogle Scholar
  32. 32.
    Shaffer HJ, Hall MN, Vander Bilt J (1999) Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis. Am J Public Health 89:1369–1376CrossRefPubMedGoogle Scholar
  33. 33.
    Shaffer HJ, LaBrie RA, LaPlante DA, Nelson SE, Stanton MV (2004) The road less travelled: moving from distribution to determinants in the study of gambling epidemiology. Can J Psychiatry 49:504–516PubMedGoogle Scholar
  34. 34.
    Suh GH, Son HG, Choi SS, Lee MK, Yi JS, Choi IG, Bang HS, Yeon BK (2001) Development and validation of DIS-IV, Korean version. J Korean Neuropsychiatr Assoc 40:777–787Google Scholar
  35. 35.
    Volberg RA, Abbott MW, Ronnberg S, Munck IM (2001) Prevalence and risks of pathological gambling in Sweden. Acta Psychiatr Scand 104:250–256CrossRefPubMedGoogle Scholar
  36. 36.
    Welte J, Barnes G, Wieczorek W, Tidwell MC, Parker J (2001) Alcohol and gambling pathology among U.S. adults: prevalence, demographic patterns and comorbidity. J Stud Alcohol 62:706–712PubMedGoogle Scholar
  37. 37.
    Welte JW, Barnes GM, Wieczorek WF, Tidwell MC, Parker J (2002) Gambling participation in the U.S.: results from a national survey. J Gambl Stud 18:313–337CrossRefPubMedGoogle Scholar
  38. 38.
    Welte JW, Barnes GM, Wieczorek WF, Tidwell MC, Parker JC (2004) Risk factors for pathological gambling. Addict Behav 29:323–335CrossRefPubMedGoogle Scholar
  39. 39.
    Welte JW, Wieczorek WF, Barnes GM, Tidwell MC, Hoffman JH (2004) The relationship of ecological and geographic factors to gambling behavior and pathology. J Gambl Stud 20:405–423CrossRefPubMedGoogle Scholar
  40. 40.
    Welte JW, Wieczorek WF, Barnes GM, Marie-Cecile OT (2006) Multiple risk factors for frequent and problem gambling: individual, social, and ecological. J Appl Soc Psychol 36:1548–1568CrossRefGoogle Scholar
  41. 41.
    Wong IL, So EM (2003) Prevalence estimates of problem and pathological gambling in Hong Kong. Am J Psychiatry 160:1353–1354CrossRefPubMedGoogle Scholar
  42. 42.
    World Health Organization (1990) Composite international diagnostic interview (CIDI), Version 1.0. World Health Organization, GenevaGoogle Scholar
  43. 43.
    World Health Organization (1997) Procedures for the development of new language versions of the WHO composite international diagnostic interview (WHO-CIDI). World Health Organization, GenevaGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Subin Park
    • 1
  • Maeng Je Cho
    • 2
  • Hong Jin Jeon
    • 3
  • Hae Woo Lee
    • 2
  • Jae Nam Bae
    • 4
  • Jong Ik Park
    • 5
  • Jee Hoon Sohn
    • 2
  • You Ra Lee
    • 6
  • Jun Young Lee
    • 7
  • Jin Pyo Hong
    • 1
  1. 1.Department of Psychiatry, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  2. 2.Department of Psychiatry and Behavioral ScienceSeoul National University College of MedicineSeoulSouth Korea
  3. 3.Department of Psychiatry, Depression Center, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  4. 4.Department of Psychiatry, College of MedicineInha UniversityIncheonSouth Korea
  5. 5.Department of PsychiatryKangwon National University School of MedicineChuncheonSouth Korea
  6. 6.Department of PsychiatrySeoul Bukbu Geriatric HospitalSeoulSouth Korea
  7. 7.Department of PsychiatrySeoul National University Boramae HospitalSeoulSouth Korea

Personalised recommendations