It’s been estimated that 96% of individuals with gambling disorder have one or more co-occurring psychiatric disorders (Alegria et al., 2015). According to the DSM-5, the most common co-occurring disorders with gambling disorder are substance use disorders (SUDs), depressive disorders, anxiety disorders, and personality disorders.
Typically, the co-occurring disorder presents first, and gambling disorder is only recognized later (Kessler et al., 2008).
Depression and Anxiety
Between 55% and 60% of individuals with depression or anxiety also experience gambling disorder (Kessler et al., 2008). Those with depression or anxiety often begin gambling for the escape it can provide, not realizing the risk involved.
One of the unfortunate outcomes of the high correlation of depression and gambling disorder is a very high suicide rate. In Oklahoma, 18.4% meeting the criteria for GD had seriously contemplated suicide due to gambling, and 23.2% had attempted suicide (Harwell et al., 2022).
Substance Use Disorder
In one study, nearly one third to half of individuals in SUD treatment were identified as having a gambling problem (Himelhoch et al., 2016). Those with more severe SUD, are more likely to have more gambling problems as well (Rush et al., 2008).
Personality Disorder
The most likely personality disorders to co-occur with gambling disorder are narcissistic, antisocial, avoidant, obsessive-compulsive, and borderline personality disorders. As high as 19% of individuals in treatment with diagnosis of schizophrenia or schizoaffective disorder meet criteria for problem gambling (Desai & Potenza, 2009).
Addressing Co-occurring Disorders Is Essential to Treatment
Gambling disorder is complex, yet it is often overlooked in the treatment of co-occurring disorders. In order to adequately meet client needs, counselors will need to address gambling disorder as well as co-occurring disorders in their treatment plans.
References
Alegria, M., Jackson, J. S., Kessler, R. C., & Takeuchi, D. (2015). United States national comorbidity survey: Replication 2001-2003 [United States]. ICPSR20240-v7. Inter-university Consortium for Political and Social Research.
Desai, R. A., & Potenza, M. N. (2009). A cross-sectional study of problem and pathological gambling in patients with schizophrenia/schizoaffective disorder. Journal of Clinical Psychiatry, 70(9), 1250–1257.
Harwell, W. H., Spare, K., & Mills, D. J. (2023). Assessing the prevalence of gambling and problem gambling in Oklahoma among a non-probabilistic sample of adults. Report created by OAPGG and the Kansas City Port Authority Problem Gambling Fund Advisory Committee. Norman, OK: Authors.
Himelhoch, S. S., McLean, H. M. Medoff, D., Kreyenbuhl, J., Rugle, L., Brownley, J., Bailey-Kloch, M., Potts, W., & Welsh, C. (2016). Twelve-month prevalence of DSM-5 gambling disorder and associated gambling behaviors among those receiving methadone maintenance. Journal of Gambling Studies, 32(1), 1–10.
Kessler, R. C. (2008). National Comorbidity Survey: Baseline (NCS-1), 1990–1992. Inter-university Consortium for Political and Social Research [distributor].
Rush, B. R., Bassani, D. G., Urbanoski, K. A., & Castel, S. (2008). Influence of co-occurring mental and substance use disorders on the prevalence of problem gambling in Canada. Addiction, 103(11), 1847–1856.