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Heavy Drinking, Gambling Linked to Personality Disorders

Posted in Addiction News

Heavy-DrinkingAlcohol use disorder and gambling disorder are two addiction-related conditions currently recognized by the American Psychiatric Association. People affected by either of these conditions have increased risks for developing some sort of separately diagnosable mental illness. However, gambling problems and alcohol problems often occur in the same individual and doctors don’t always know which issue has a greater impact on mental illness risks. In a study published in March 2014 in the journal Addictive Behaviors, a team of Australian researchers sought to separate the mental health impact of alcohol use disorder from the mental health impact of gambling disorder.

The Basics

Alcohol use disorder is one manifestation of a condition called substance use disorder. Some affected individuals have a chemical dependence on the continuing use of alcohol (commonly known as alcoholism), while others don’t suffer from chemical dependence but still engage in patterns of alcohol use that seriously harm their day-to-day welfare (commonly known as alcohol abuse). Gambling disorder (pathological gambling, problem gambling, compulsive gambling) is the only non-substance-related addiction to receive official status from the American Psychiatric Association (APA). People affected by the condition develop some of the key brain and behavioral changes that characterize individuals affected by substance addiction, but in the context of gambling-related issues rather than in the context of drug or alcohol use. The APA views both alcohol use disorder and gambling disorder (and all other diagnosable forms of abuse or addiction) as forms of mental illness; the category that contains these illnesses is called “substance-related and addictive disorders.”

Known Degree of Overlap

Mental health and addiction experts know that a person affected by alcohol use disorder or any other form of substance use disorder has an increased likelihood of experiencing or eventually developing a range of other mental health problems, including severe illnesses such as schizophrenia, bipolar I disorder and major depression. A number of factors account for this overlap, including a tendency among people with untreated or improperly treated mental illnesses to self-medicate with alcohol or other substances, the potential for active alcohol or drug abuse to help set the stage for the onset of mental illness and the potential for alcohol or drug withdrawal to also damage mental health.

For a number of reasons, people affected by alcohol use disorder in general and alcoholism in particular also have increased chances of developing gambling-related problems that qualify for a diagnosis of gambling disorder. Chief among these reasons is the notable similarity between the changes in brain chemistry produced by habitual heavy drinking and the changes in brain chemistry produced by compulsive, repeated gambling.

Separating the Impact

In the study published in Addictive Behaviors, researchers from Australia’s University of Adelaide used information gathered from 140 adults to help separate the mental health impact of gambling disorder (identified in the study as pathological gambling) from the mental health impact of alcohol use disorder.  All of these adults were affected by serious, gambling-related issues. Each of them took a series of tests designed to uncover the presence of alcohol use disorder, as well as personality disorders and other diagnosable mental illnesses.

After reviewing the results of their tests, the researchers reached several conclusions. First, they found that people affected by both gambling disorder and alcohol use disorder are substantially more likely to develop another mental illness than people affected by only gambling disorder or only alcohol use disorder. They also found that individuals affected by gambling disorder alone and individuals unaffected by either gambling disorder or alcohol use disorder are more likely to develop another mental illness than individuals affected only by alcohol use disorder. The forms of mental illness most likely to appear in an individual with both gambling disorder and alcohol use disorder are the group of 10 conditions known collectively as personality disorders.

Significance and Considerations

Based on their findings, the authors of the study published in Addictive Behaviors concluded that the risks for other mental illnesses associated with gambling disorder and alcohol use disorder cannot be separated in most cases. Instead, the two conditions apparently work in tandem to increase the chances that any given individual will experience another diagnosable mental health problem. For this reason, the authors recommend that doctors screening their patients for gambling disorder also screen for alcohol use disorder; they also make a reciprocal recommendation for doctors screening their patients for alcohol use disorder.