{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:03:28Z","timestamp":1793361808465,"version":"4.5.0"},"reference-count":78,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2015,3,3]],"date-time":"2015-03-03T00:00:00Z","timestamp":1425340800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5\u201393.9) and lifetime (75.5%, 95% CI 46.5\u201391.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9\u201334.0), alcohol use disorders (21.2%, 95% CI 15.6\u201328.1), anxiety disorders (17.6%, 95% CI 10.8\u201327.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7\u201324.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7\u201375.2) and major depressive disorder (29.9%, 95% CI 20.5\u201341.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4\u201324.2), alcohol dependence (15.2%, 95% CI 10.2\u201322.0), social phobia (14.9%, 95% CI 2.0\u201359.8), generalised anxiety disorder (14.4%, 95% CI 3.9\u201340.8), panic disorder (13.7%, 95% CI 6.7\u201326.0), post-traumatic stress disorder (12.3%, 95% CI 3.4\u201335.7), cannabis use disorder (11.5%, 95% CI 4.8\u201325.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1\u201319.6), adjustment disorder (9.2%, 95% CI 4.8\u201317.2), bipolar disorder (8.8%, 95% CI 4.4\u201317.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4\u201318.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should be interpreted with caution as they were highly variable across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The findings highlight the need for gambling treatment services to undertake routine screening and assessment of psychiatric co-morbidity and provide treatment approaches that adequately manage these co-morbid disorders. Further research is required to explore the reasons for the variability observed in the prevalence estimates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004867415575774","type":"journal-article","created":{"date-parts":[[2015,3,3]],"date-time":"2015-03-03T22:12:19Z","timestamp":1425420739000},"page":"519-539","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":321,"title":["Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"49","author":[{"given":"Nicki A","family":"Dowling","sequence":"first","affiliation":[{"name":"School of Psychology, Deakin University, Burwood, VIC, Australia"},{"name":"Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia"},{"name":"School of Psychological Sciences, Monash University, Melbourne, VIC, Australia"},{"name":"Centre for Gambling Research, Australian National University, Canberra, ACT, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Cowlishaw","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, Bristol University, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alun C","family":"Jackson","sequence":"additional","affiliation":[{"name":"Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie S","family":"Merkouris","sequence":"additional","affiliation":[{"name":"School of Psychology, Deakin University, Burwood, VIC, Australia"},{"name":"Problem Gambling Research and Treatment Centre, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate L","family":"Francis","sequence":"additional","affiliation":[{"name":"Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren R","family":"Christensen","sequence":"additional","affiliation":[{"name":"Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia"},{"name":"Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,3,3]]},"reference":[{"key":"bibr1-0004867415575774","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric 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