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A direct, controlled, blind family study of DSM-IV pathological gambling
Journal article   Peer reviewed

A direct, controlled, blind family study of DSM-IV pathological gambling

Donald W Black, William H Coryell, Raymond R Crowe, Brett McCormick, Martha C Shaw and Jeff Allen
The journal of clinical psychiatry, Vol.75(3), pp.215-221
03/2014
DOI: 10.4088/JCP.13m08566
PMCID: PMC4221079
PMID: 24500179

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Abstract

Pathological gambling is a major public health problem. We sought to examine the familiality of pathological gambling and determine patterns of familial aggregation of disorders. We assessed probands with DSM-IV pathological gambling, controls, and their first-degree relatives. Detailed family history information was collected on relatives who were deceased or unavailable. Ninety-five pathological gambling probands, 91 controls, and their 1,075 first-degree relatives over age 18 (537 relatives of pathological gambling probands, 538 relatives of controls) were evaluated between February 2005 and June 2010. Relatives were assessed blind to proband status. Best estimate diagnoses were assigned. Rates of lifetime pathological gambling (definite/probable) was significantly greater among the first-degree relatives of probands with pathological gambling than among comparison relatives (11% vs 1%, OR = 8.19, P < .001). The prevalence of pathological gambling and subclinical pathological gambling combined was 16% and 3% in case and control relatives, respectively (OR = 6.57, P < .001). Pathological gambling relatives had higher rates of major depression (OR = 1.49, P < .05), bipolar disorder (OR = 3.82, P < .05), any mood disorder (OR = 1.59, P < .05), social anxiety disorder (OR = 4.76, P < .01), any substance use disorder (OR = 1.47, P < .05), posttraumatic stress disorder (OR = 2.59, P < .05), and antisocial personality disorder (OR = 3.72, P < .001). Antisocial personality disorder (OR = 3.12, P < .01), social anxiety disorder (OR = 4.15, P < .01), and posttraumatic stress disorder (OR = 2.85, P < .05) were more frequent in case relatives independent of the presence of pathological gambling. Age at onset of pathological gambling in case probands (< 40 years/≥ 40 years) was not related to familiality in their first-degree relatives (OR = 1.03, P = .927). Pathological gambling is familial. Mood and substance use disorders may emerge as a consequence of the pathological gambling or as a more complex syndrome. In contrast, antisocial personality disorder, social anxiety disorder, and posttraumatic stress disorder may share a common familial etiology with pathological gambling. The phenotype may extend beyond pathological gambling to include subclinical forms of the disorder.
 Family - psychology Single-Blind Method Prevalence Mood Disorders - genetics Humans Middle Aged Stress Disorders, Post-Traumatic - epidemiology Anxiety Disorders - diagnosis Male Substance-Related Disorders - genetics Mood Disorders - epidemiology Mental Disorders - genetics Psychiatric Status Rating Scales Substance-Related Disorders - epidemiology Stress Disorders, Post-Traumatic - diagnosis Adult Female Registries Mental Disorders - diagnosis Substance-Related Disorders - diagnosis Gambling - epidemiology Diagnostic and Statistical Manual of Mental Disorders Mental Disorders - epidemiology Comorbidity Anxiety Disorders - epidemiology Gambling - diagnosis Phenotype Mood Disorders - diagnosis Anxiety Disorders - genetics Stress Disorders, Post-Traumatic - genetics Gambling - genetics

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