Skip to main content

Advertisement

SpringerLink
Log in

Prevalence of Problem and Pathological Gambling in Parkinson’s Disease

  • Original Paper
  • Published:
Journal of Gambling Studies Aims and scope Submit manuscript

Abstract

Pathological gambling (PG) has been identified in patients with Parkinson’s disease (PD) treated with dopamine agonists suggesting that dysregulation of brain dopaminergic activity may contribute to the development of gambling problems. The current study was undertaken to further establish the prevalence of problem and PG in patients with PD, identify any clinical correlates, and determine if psychiatric or substance use co-morbidity contributes to the increased prevalence of problem and PG. A cross-sectional survey of 140 serially recruited moderate to severe PD patients was undertaken utilizing the Canadian Problem Gambling Index, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test, Beck Depression Inventory, Beck Anxiety Inventory, and Mini-Mental State Exam augmented by chart review, completed over an 8 month period. The 12 month prevalence of problem and PG in PD was 9.3% compared to 1.6% in the general population within a comparably aged sample. The increased prevalence of problem and PG in the PD group was related to dopamine agonist use and younger age, but not co-morbidity. Most subjects with problem and PG reported their gambling increased after being diagnosed with PD and starting treatment. The results suggest that brain dopaminergic activity is involved in the underlying neurobiology of problem and PG.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington DC: American Psychiatric Association.

    Google Scholar 

  • Avanzi, M., Baratti, M., Cabrini, S., Uber, E., Brighetti, G., & Bonfa, F. (2006). Prevalence of pathological gambling in patients with Parkinson’s disease. Movement Disorders, 21, 2068–2072. doi:10.1002/mds.21072.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897. doi:10.1037/0022-006X.56.6.893.

    Article  PubMed  CAS  Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    PubMed  CAS  Google Scholar 

  • Bergh, C., Eklund, T., Sodersten, P., & Nordin, C. (1997). Altered dopamine function in pathological gambling. Psychological Medicine, 27, 473–475. doi:10.1017/S0033291796003789.

    Article  PubMed  CAS  Google Scholar 

  • Bohn, M. J., Babor, T. F., & Kranzler, H. R. (1995). The alcohol use disorders identification test (AUDIT): validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol, 56, 423–432.

    PubMed  CAS  Google Scholar 

  • Breiter, H. C., Aharon, I., Kahneman, D., Dale, A., & Shizgal, P. (2001). Functional imaging of neural responses to expectancy and experience of monetary gains and losses. Neuron, 30, 619–639. doi:10.1016/S0896-6273(01)00303-8.

    Article  PubMed  CAS  Google Scholar 

  • Crockford, D. N., & el-Guebaly, N. (1998). Psychiatric comorbidity in pathological gambling: a critical review. Canadian Journal of Psychiatry, 43, 43–50.

    CAS  Google Scholar 

  • Crockford, D. N., Goodyear, B., Edwards, J., Quickfall, J., & el-Guebaly, N. (2005). Cue-induced brain activity in pathological gamblers. Biological Psychiatry, 58, 787–795. doi:10.1016/j.biopsych.2005.04.037.

    Article  PubMed  Google Scholar 

  • Daeppen, J. B., Yersin, B., Landry, U., Pecoud, A., & Decrey, H. (2000). Reliability and validity of the alcohol use disorders identification test (AUDIT) imbedded within a general health risk screening questionnaire: results of a survey in 332 primary care patients. Alcoholism, Clinical and Experimental Research, 24, 659–665. doi:10.1111/j.1530-0277.2000.tb02037.x.

    Article  PubMed  CAS  Google Scholar 

  • Dodd, M. L., Klos, K. J., Bower, J. H., Geda, Y. E., Josephs, K. A., & Ahlskog, J. E. (2005). Pathological gambling caused by drugs used to treat Parkinson disease. Archives of Neurology, 62, 1377–1381. doi:10.1001/archneur.62.9.noc50009.

    Article  PubMed  Google Scholar 

  • Driver-Dunckley, E., Samanta, J., & Stacy, M. (2003). Pathological gambling associated with dopamine agonist therapy in Parkinson’s disease. Neurology, 61, 422–423.

    PubMed  CAS  Google Scholar 

  • el-Guebaly, N. (1995). Substance use disorders and mental illness: the relevance of comorbidity. Canadian Journal of Psychiatry, 40, 2–3.

    CAS  Google Scholar 

  • Elliott, R., Friston, K. J., & Dolan, R. J. (2000). Dissociable neural responses in human reward systems. The Journal of Neuroscience, 20, 6159–6165.

    PubMed  CAS  Google Scholar 

  • Endicott, J. (2001). Good diagnoses require good diagnosticians: collecting and integrating the data. American Journal of Medical Genetics, 105, 48–49. doi:10.1002/1096-8628(20010108)105:1<48::AID-AJMG1057>3.0.CO;2-M.

    Article  PubMed  CAS  Google Scholar 

  • Ferris, J., & Wynne, H. (2001). The Canadian Problem Gambling Index: final report. In. Ottawa: Canadian Centre on Substance Abuse.

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2001). Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Research Version New York: Biometrics Research: New York State Psychiatric Institute.

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi:10.1016/0022-3956(75)90026-6.

    Article  PubMed  CAS  Google Scholar 

  • Gavin, D. R., Ross, H. E., & Skinner, H. A. (1989). Diagnostic validity of the drug abuse screening test in the assessment of DSM-III drug disorders. British Journal of Addiction, 84, 301–307. doi:10.1111/j.1360-0443.1989.tb03463.x.

    Article  PubMed  CAS  Google Scholar 

  • Glosser, G. (2001). Neurobehavioral aspects of movement disorders. Neurologic Clinics, 19, 535–551. doi:10.1016/S0733-8619(05)70033-5.

  • Grosset, K. A., Macphee, G., Pal, G., Stewart, D., Watt, A., Davie, J., et al. (2006). Problematic gambling on dopamine agonists: Not such a rarity. Movement Disorders, 21, 2206–2208. doi:10.1002/mds.21110.

    Article  PubMed  Google Scholar 

  • Harrison, J. E., Preston, S., & Blunt, S. B. (2000). Measuring symptom change in patients with Parkinson’s disease. Age and Ageing, 29, 41–45. doi:10.1093/ageing/29.1.41.

    Article  PubMed  CAS  Google Scholar 

  • Henderson, R., Kurlan, R., Kersun, J. M., & Como, P. (1992). Preliminary examination of the comorbidity of anxiety and depression in Parkinson’s disease. The Journal of Neuropsychiatry and Clinical Neurosciences, 4, 257–264.

    PubMed  CAS  Google Scholar 

  • Hoehn, M. M., & Yahr, M. D. (1967). Parkinsonism: onset, progression and mortality. Neurology, 17, 427–442.

    Article  PubMed  CAS  Google Scholar 

  • Kalivas, P. W. (2001). Drug addiction: to the cortex and beyond!. The American Journal of Psychiatry, 158, 349–350. doi:10.1176/appi.ajp.158.3.349.

    Article  PubMed  CAS  Google Scholar 

  • Kalivas, P. W., & Volkow, N. D. (2005). The neural basis of addiction: a pathology of motivation and choice. The American Journal of Psychiatry, 162, 1403–1413. doi:10.1176/appi.ajp.162.8.1403.

    Article  PubMed  Google Scholar 

  • Ladouceur, R., Jacques, C., Chevalier, S., Sevigny, S., & Hamel, D. (2005). Prevalence of pathological gambling in Quebec in 2002. Canadian Journal of Psychiatry, 50, 451–456.

    Google Scholar 

  • Leentjens, A. F., Verhey, F. R., Luijckx, G. J., & Troost, J. (2000). The validity of the Beck depression inventory as a screening and diagnostic instrument for depression in patients with Parkinson’s disease. Movement Disorders, 15, 1221–1224. doi:10.1002/1531-8257(200011)15:6<1221::AID-MDS1024>3.0.CO;2-H.

    Article  PubMed  CAS  Google Scholar 

  • Molina, J. A., Sainz-Artiga, M. J., Fraile, A., Jimenez-Jimenez, F. J., Villanueva, C., Orti-Pareja, M., et al. (2000). Pathologic gambling in Parkinson’s disease: a behavioral manifestation of pharmacologic treatment? Movement Disorders, 15, 869–872. doi:10.1002/1531-8257(200009)15:5<869::AID-MDS1016>3.0.CO;2-I.

    Article  PubMed  CAS  Google Scholar 

  • O’Brien, C. P., & Gardner, E. L. (2005). Critical assessment of how to study addiction and its treatment: human and non-human animal models. Pharmacology & Therapeutics, 108, 18–58. doi:10.1016/j.pharmthera.2005.06.018.

    Article  CAS  Google Scholar 

  • O’Doherty, J., Kringelbach, M. L., Rolls, E. T., Hornak, J., & Andrews, C. (2001). Abstract reward and punishment representations in the human orbitofrontal cortex. Nature Neuroscience, 4, 95–102. doi:10.1038/82959.

    Article  PubMed  CAS  Google Scholar 

  • Petry, N. M. (2005). Pathological Gambling: Etiology, Comorbidity, and Treatment. Washington, DC: American Psychological Association.

    Google Scholar 

  • Philpot, M., Pearson, N., Petratou, V., Dayanandan, R., Silverman, M., & Marshall, J. (2003). Screening for problem drinking in older people referred to a mental health service: a comparison of CAGE and AUDIT. Aging & Mental Health, 7, 171–175. doi:10.1080/1360786031000101120.

    Article  CAS  Google Scholar 

  • Pinninti, N. R., Madison, H., Musser, E., & Rissmiller, D. (2003). MINI international neuropsychiatric schedule: clinical utility and patient acceptance. European Psychiatry, 18, 361–364. doi:10.1016/j.eurpsy.2003.03.004.

    Article  PubMed  Google Scholar 

  • Pontone, G., Williams, J. R., Bassett, S. S., & Marsh, L. (2006). Clinical features associated with impulse control disorders in Parkinson disease. Neurology, 67, 1258–1261. doi:10.1212/01.wnl.0000238401.76928.45.

    Article  PubMed  Google Scholar 

  • Potenza, M. N., Kosten, T. R., & Rounsaville, B. J. (2001). Pathological gambling. Journal of the American Medical Association, 286, 141–144. doi:10.1001/jama.286.2.141.

    Article  PubMed  CAS  Google Scholar 

  • Reinert, D. F., & Allen, J. P. (2002). The alcohol use disorders identification test (AUDIT): a review of recent research. Alcoholism, Clinical and Experimental Research, 26, 272–279.

    PubMed  Google Scholar 

  • Schmidt, A., Barry, K. L., & Fleming, M. F. (1995). Detection of problem drinkers: the alcohol use disorders identification test (AUDIT). Southern Medical Journal, 88, 52–59.

    PubMed  CAS  Google Scholar 

  • Shaffer, H. J., & Hall, M. N. (2001). Updating and refining prevalence estimates of disordered gambling behaviour in the United States and Canada. Canadian Journal of Public Health, 92, 168–172.

    CAS  Google Scholar 

  • Shear, M. K., Greeno, C., Kang, J., Ludewig, D., Frank, E., Swartz, H. A., et al. (2000). Diagnosis of nonpsychotic patients in community clinics. The American Journal of Psychiatry, 157, 581–587. doi:10.1176/appi.ajp.157.4.581.

    Article  PubMed  CAS  Google Scholar 

  • Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The mini-international neuropsychiatric interview (M.I·N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(Suppl 20), 22–33. quiz 34–57.

    PubMed  Google Scholar 

  • Shulman, L. M., Taback, R. L., Bean, J., & Weiner, W. J. (2001). Comorbidity of the nonmotor symptoms of Parkinson’s disease. Movement Disorders, 16, 507–510. doi:10.1002/mds.1099.

    Article  PubMed  CAS  Google Scholar 

  • Slevin, S. (2004). Statistical Analysis of Epidemiologic Data Toronto. ON: Oxford University Press.

    Google Scholar 

  • Statistics Canada. (2003). Canadian Community Health Survey (Cycle 1.2)-Mental Health and Well-being Ottawa. ON: Statistics Canada.

    Google Scholar 

  • Szarfman, A., Doraiswamy, P. M., Tonning, J. M., & Levine, J. G. (2006). Association between pathologic gambling and parkinsonian therapy as detected in the Food and Drug Administration Adverse Event database. Archives of Neurology, 63, 299–300. doi:10.1001/archneur.63.2.299-b. author reply 300.

    Article  PubMed  Google Scholar 

  • Voon, V., Hassan, K., Zurowski, M., de Souza, M., Thomsen, T., Fox, S., et al. (2006a). Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology, 67, 1112–1113.

    Article  Google Scholar 

  • Voon, V., Hassan, K., Zurowski, M., Duff-Canning, S., de Souza, M., Fox, S., et al. (2006b). Prospective prevalence of pathologic gambling and medication association in Parkinson disease. Neurology, 66, 1750–1752. doi:10.1212/01.wnl.0000218206.20920.4d.

    Article  PubMed  CAS  Google Scholar 

  • Weintraub, D., Siderowf, A. D., Potenza, M. N., Goveas, J., Morales, K. H., Duda, J. E., et al. (2006). Association of dopamine agonist use with impulse control disorders in Parkinson disease. Archives of Neurology, 63, 969–973. doi:10.1001/archneur.63.7.969.

    Article  PubMed  Google Scholar 

  • Zink, C. F., Pagnoni, G., Martin-Skurski, M. E., Chappelow, J. C., & Berns, G. S. (2004). Human striatal responses to monetary reward depend on saliency. Neuron, 42, 509–517. doi:10.1016/S0896-6273(04)00183-7.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The study was funded by an unrestricted grant from the Alberta Gaming Research Institute. The authors thank Erin Rolland de-Denus for her work as research assistant in the data acquisition and subsequent analysis and Amanda Wilhelm for her assistance in manuscript preparation. The investigators wish to thank Statistics Canada for access to the CCHS-1.2 public use dataset. However, the opinions and views expressed do not represent those of Statistics Canada.

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada, T2N 2T9

    David Crockford, Jeremy Quickfall & Nady el-Guebaly

  2. Foothills Medical Centre Addictions Program, C203, 1403-29th St. NW, Calgary, Alberta, Canada, T2N 2T9

    David Crockford & Nady el-Guebaly

  3. Mental Health Information & Evaluation Unit, Calgary Health Region, Mental Health and Psychiatric Services, Calgary, Alberta, Canada

    Shawn Currie

  4. Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada, T2N 2T9

    Sarah Furtado

  5. Department of Clinical Neurosciences, Department of Medical Genetics, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada, T2N 2T9

    Oksana Suchowersky

Authors
  1. David Crockford
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeremy Quickfall
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shawn Currie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarah Furtado
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Oksana Suchowersky
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nady el-Guebaly
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Crockford.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Crockford, D., Quickfall, J., Currie, S. et al. Prevalence of Problem and Pathological Gambling in Parkinson’s Disease. J Gambl Stud 24, 411–422 (2008). https://doi.org/10.1007/s10899-008-9099-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10899-008-9099-3

Keywords

Search

Navigation