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    Problem gambling and substance use in patients attending community mental health services

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    Author
    Manning, V; Dowling, NA; Lee, S; Rodda, S; Garfield, JBB; Volberg, R; Kulkarni, J; Lubman, DI
    Date
    2017-12-01
    Source Title
    Journal of Behavioral Addictions
    Publisher
    AKADEMIAI KIADO ZRT
    University of Melbourne Author/s
    Dowling, Nicole
    Affiliation
    Melbourne Graduate School of Education
    Metadata
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    Document Type
    Journal Article
    Citations
    Manning, V., Dowling, N. A., Lee, S., Rodda, S., Garfield, J. B. B., Volberg, R., Kulkarni, J. & Lubman, D. I. (2017). Problem gambling and substance use in patients attending community mental health services. JOURNAL OF BEHAVIORAL ADDICTIONS, 6 (4), pp.678-688. https://doi.org/10.1556/2006.6.2017.077.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255575
    DOI
    10.1556/2006.6.2017.077
    Abstract
    Background and aims Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia. Methods A total of 837 adult patients were surveyed about their gambling and administered standardized screening tools for problem gambling and harmful tobacco, alcohol, and drug use. Prevalence of gambling problems was estimated and regression models used to determine predictors of problem gambling. Results The gambling participation rate was 41.6% [95% CI = 38.2-44.9]. The Problem Gambling Severity Index identified 19.7% [CI = 17.0-22.4] as "non-problem gamblers," 7.2% [CI = 5.4-8.9] as "low-risk" gamblers, 8.4% [CI = 6.5-10.2] as "moderate-risk" gamblers, and 6.3% [CI = 4.7-8.0] as "problem gamblers." One-fifth (21.9%) of the sample and 52.6% of all gamblers were identified as either low-risk, moderate-risk, or problem gamblers (PGs). Patients classified as problem and moderate-risk gamblers had significantly elevated rates of nicotine and illicit drug dependence (p < .001) according to short screening tools. Current diagnosis of drug use (OR = 4.31 [CI = 1.98-9.37]), borderline personality (OR = 2.59 [CI = 1.13-5.94]), bipolar affective (OR = 2.01 [CI = 1.07-3.80]), and psychotic (OR = 1.83 [CI = 1.03-3.25]) disorders were significant predictors of problem gambling. Discussion and conclusions Patients were less likely to gamble, but eight times as likely to be classified as PG, relative to Victoria's adult general population. Elevated rates of harmful substance use among moderate-risk and PG suggest overlapping vulnerability to addictive behaviors. These findings suggest mental health services should embed routine screening into clinical practice, and train clinicians in the management of problem gambling.

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