Problem gambling in bipolar disorder: Results from the Canadian Community Health Survey

McIntyre, Roger S.; McElroy, Susan L.; Konarski, Jakub Z.; Soczynska, Joanna K.; Wilkins, Kathryn; Kennedy, Sidney H.

doi:10.1016/j.jad.2006.12.005

« Previous Next »Journal of Affective Disorders
Volume 102, Issue 1 , Pages 27-34, September 2007

Problem gambling in bipolar disorder: Results from the Canadian Community Health Survey

Roger S. McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Corresponding author. Department of Psychiatry and Pharmacology, University of Toronto, Head, Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street — Toronto, ON, Canada M5T 2S8. Tel.: +1 416 603 5279; fax: +1 416 603 5368.
Susan L. McElroy
- Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
Jakub Z. Konarski
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
Joanna K. Soczynska
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
Kathryn Wilkins
- Health Statistics Division, Statistics Canada, Ottawa, ON, Canada
Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada

Received 5 July 2006; received in revised form 22 September 2006; accepted 5 December 2006.

Abstract

Objective

This investigation was undertaken to explore the prevalence and associated features of problem gambling amongst individuals with bipolar I disorder.

Methods

The data for this analysis were procured from the Canadian Community Health Survey: Mental Health and Well-being (CCHS 1.2) conducted by Statistics Canada. Individuals screening positive for a lifetime (World Mental Health- Composite International Diagnostic Interview) WMH-CIDI-defined manic episode (i.e. bipolar I disorder) or depressive episode (i.e. major depressive disorder) and current (i.e. past 12-month) problem gambling were compared to the general population without these disorders. Past year problem gambling was operationalized with the Canadian Problem Gambling Index (CPGI).

Results

The sample consisted of 36,984 individuals (≥15 years old); the weighted prevalence of problem gambling was significantly higher (6.3%) amongst the population with bipolar disorder as compared to the general population (2.0%, p<0.001) and those with major depressive disorder (2.5%, p<0.01). Compared to those without bipolar disorder, the odds of problem gambling for bipolar individuals were over twice as high (OR=2.3; 95% CI 1.4–3.7), even when controlling for potential confounders. Males also had higher odds of problem gambling (OR=1.8; 95% CI 1.4–2.3), as did individuals without post-secondary education (OR=1.4; 95% CI 1.1–1.8). Persons who were married/cohabiting had lowered odds of problem gambling, compared with those who were unmarried (OR=0.6; 95% CI 0.5–0.8). Comorbid alcohol dependence (OR=3.4; 95% CI 2.3–5.0) and illicit drug dependence (OR=2.6; 95% CI 1.1–6.2) each conferred an increased risk for problem gambling. Physical activity level (moderate to active) was associated with a decreased risk for problem gambling (OR=0.8; 95% CI 0.6–0.9).

Conclusions

Individuals with bipolar I disorder are differentially affected by problem gambling. Opportunistic screening for problem gambling is warranted, particularly in persons with comorbid alcohol or substance dependence.

Keywords: Bipolar disorder, Major depressive disorder, Problem gambling, Pathological gambling, Substance dependence, Alcohol dependence