Gambling disorder frequently co-occurs with other psychiatric conditions, yet its relationship with obsessive-compulsive disorder (OCD) remains unclear. Emerging evidence suggests impulsivity and compulsivity may be inter-related rather than diametrically opposed constructs, warranting investigation of their clinical overlap. The aim of this study is to examine the rate of gambling disorder in adults with OCD and to explore associated clinical, behavioral, and treatment-related characteristics.

Adults with probable OCD were recruited via online Reddit groups for OCD, OCD clinics, and support groups and completed a cross-sectional survey. OCD symptom types were assessed using the Obsessive-Compulsive Inventory-Revised, and gambling disorder was identified using the Minnesota Impulsive Disorders Interview. Additional measures included gambling severity, impulsivity, and problematic internet use. Group comparisons were conducted between participants with and without gambling disorder.

Among 186 adults with OCD, 34 (18.8%) met criteria for gambling disorder. Individuals with comorbid gambling disorder demonstrated significantly greater OCD severity, particularly in ordering, checking, and neutralizing symptoms, and reported later onset of OCD. The comorbid group showed higher impulsivity, greater problematic internet use, and distinct gambling behaviors, including higher rates of online gambling, esports betting, and use of artificial intelligence tools for gambling. They were also less likely to have received pharmacological treatment for OCD.

Gambling disorder in adults with OCD is associated with distinct clinical characteristics, greater impulsivity, problematic internet use, and concerning treatment gaps. These findings highlight the importance of screening for gambling in OCD, and vice versa, and suggest a need for integrated treatment approaches.

Psychiatric comorbidities are common in first-episode psychosis (FEP) and hinder recovery. Problem gambling (PBG), despite potentially serious clinical consequences, remains under-investigated in this population. This study aimed to estimate the incidence of PBG in FEP and identify predictive factors.

This prospective cohort study was conducted at two FEP programmes in Quebec, Canada. Individuals aged 18–35 years diagnosed with FEP between November-1-2019 and January-31-2023 were screened for PBG using the Problem Gambling Severity Index through May-1-2023. The primary outcome was incident PBG. Time-varying Cox regression models were used to estimate hazard ratios (HRs) for candidate predictors.

Among 520 individuals without prior PBG (mean age = 24.6±4.0 years; 28.8% women), 18 developed PBG during a mean follow-up of 478 days, yielding an incidence rate of 2.6 cases/ 100 person-years. In site-adjusted analyses, white ethnicity (HR = 9.7; 95%CI = 1.3–74.8), incomplete high school education (HR = 2.8; 95%CI = 1.1–7.2), stimulant use disorder (HR=2.8; 95%CI = 1.0–7.3), use of D2/D3-5-HT1A partial agonists (HR = 4.6; 95%CI = 1.5–14.1), and prior non-problematic gambling (HR = 3.1; 95%CI = 1.1–8.4) predicted increased risk. Thirteen cases occurred during aripiprazole treatment, which remained associated with increased PBG risk after multivariable adjustment (adjusted HR = 4.7; 95%CI = 1.6–13.9).

Despite the limited number of incident cases, these results suggest that PBG is relatively common PBG and is associated with potential risk factors, including white ethnicity, incomplete high school education, stimulant use disorder, prior non-problematic gambling, and treatment with D2/D3-5-HT1A partial agonists, particularly aripiprazole. These findings underscore the importance of routine screening for PBG and risk-informed antipsychotic prescribing in FEP.

People who gamble experience elevated rates of suicidal thoughts and behaviours. Longitudinal studies have been scarce, and none has focused on those who regularly gamble in the UK.

To examine the relationship between specific products and locations of gambling activity (and their combinations) and risk of subsequent suicidal thoughts.

We analysed a UK longitudinal survey of 3927 adults (18 years old or over) who regularly bet on sports. Data were collected online between June and November 2020. Latent class analysis was used to identify groups of people with similar gambling profiles on the basis of 13 types of gambling activity. Weighted group characteristics are presented. Regression modelling was used to test associations between gambling groups and suicidal thoughts, adjusting for baseline characteristics.

Five distinct groups were identified. One group (5.6% of the sample) reported multiple types of both in-person and online gambling. This group was the most likely to use electronic gambling machines. After adjustment for baseline suicidal thoughts, this group had significantly higher odds of subsequent suicidal thoughts (adjusted odds ratio 3.42; 95% CI: 1.18–9.89) than other groups.

Although many profiles of gambling activity present suicide risk, some types present greater risk. National Institute for Health and Care Excellence guidelines recommend enquiry in primary care settings about gambling behaviours. Our findings suggest that clinicians should consider asking questions on mode (online or in-person) and product (especially electronic gambling machines) to identify those at heightened risk of suicidal ideation. Gambling should also be considered routinely in psychosocial assessments across clinical settings and incorporated into suicide prevention campaigns.

The aim of this study is to determine the prevalence and type of mental disorders associated with pathological gambling/gambling disorder (GD) in the general population.

Systematic review and meta-analysis of adult population-based studies reporting on psychiatric comorbidity of GD according to International Classification of Diseases (ICD-10/ICD-11), Diagnostic and Statistical Manual of Mental Disorders (DSM-IV/DSM-5) criteria, or widely used assessment instruments. PubMed, Scopus, and Web of Science databases were searched for relevant studies in English. The study’s protocol was preregistered in PROSPERO (CRD42024574210).

Of 454 articles published between 1993 and 2024, 12 met the inclusion criteria. Most studies used DSM-IV or DSM-5 criteria (only two ICD-10 criteria), and were evenly distributed across Europe, North America, and Southeast Asia. The weighted average prevalence of any mental disorder in individuals with GD was 82.2%. High comorbidity rates were found for substance use disorders (SUDs) (34.2%), mood disorders (30.9%), and anxiety disorders (29.9%), followed by personality (14.3%) and psychotic (5.9%) disorders. Meta-analysis indicates that individuals with GD are 10.7 (95% confidence interval [CI]: 5.7;20.1) times more likely to develop any mental disorder than the general population. The odds ratio for mental disorders associated with GD were 5–12 times higher for nicotine dependence, drug use disorder, alcohol use disorder, and SUD, and 3–4 times higher for anxiety and mood disorders.

These findings add weight to the view that GD is associated with a significantly increased risk for addictive behaviors, mood, and anxiety disorders.

Gambling-related harm is a global public health concern. Suicide mortality is increased among people who experience gambling harm, and people who die by suicide often have contact with mental health treatment services in the months preceding their death.

To assess via a case–control study how gambling diagnosis predicts suicidal death and mental healthcare utilisation using linked routinely collected healthcare data.

We linked the Welsh Longitudinal General Practice Dataset, Annual District Death Extract, Patient Episode Database for Wales, and Outpatient Appointments Dataset Wales using the Secure Anonymised Information Linkage (SAIL) Databank. A sample of individuals with gambling diagnosis who died by suicide and an age- and sex-matched comparator group of all-cause decedents between 1993 and 2023 were extracted. Predictors of suicidal death, including mental health diagnosis and treatment contacts, were analysed using binary logistic regression models and chi-squared tests.

A matched cohort of 92 individuals diagnosed with a gambling diagnosis (mean age 61.5 years, s.d. 13.1; 71% male) who died by suicide and 2990 comparators were identified. Gambling diagnosis status was a significant predictor of suicide (odds ratio 30.94; 95% CI 3.57–268.28; P = 0.002). Individuals with gambling disorder had significantly more mental health treatment contacts (P < 0.001), particularly in-patient contacts (P < 0.001). No difference in out-patient contacts was found.

Historical diagnosis of gambling harm is a significant predictor of suicidal death and mental health treatment utilisation. Improved screening and coding practices would facilitate greater data linkage research on gambling-related suicide and suicide prevention.

Placebo and nocebo effects are widely reported across psychiatric conditions, yet have seldom been examined in the context of gambling disorder. Through meta-analysis, we examined placebo effects, their moderating factors, and nocebo effects, from available randomised, controlled pharmacological clinical trials in gambling disorder.

We searched, up to 19 February 2024, a broad range of databases, for double-blind randomised controlled trials (RCTs) of medications for gambling disorder. Outcomes were gambling symptom severity and quality of life (for efficacy), and drop outs due to medication side effects in the placebo arms.

We included 16 RCTs (n = 833) in the meta-analysis. The overall effect size for gambling severity reduction in the placebo arms was 1.18 (95%CI 0.91–1.46) and for quality of life improvement was 0.63 (0.42-0.83). Medication class, study sponsorship, trial duration, baseline severity of gambling and publication year significantly moderated effect sizes for at least some of these outcome measures. Author conflict of interest, placebo run-in, gender split, severity scale choice, age of participants or unbalanced randomisation did not moderate effect sizes. Nocebo effects leading to drop out from the trial were observed in 6% of participants in trials involving antipsychotics, while this was less for other medication types.

Placebo effects in trials of pharmacological treatment of gambling disorder are large, and there are several moderators of this effect. Nocebo effects were measureable and may be influenced by medication class being studied. Practical implications of these new findings for the field are discussed, along with recommendations for future clinical trials.