Psychiatric correlates of gambling in adolescents and young adults grouped by age at gambling onset.

Background:Gambling is a prevalent behavior, yet few studieshaveinvestigateditsmentalhealthcorrelates.Although early-onset engagement in behaviors with addictive potential has generally been associated with more severe problems, direct investigation of a nationally representative sample of gamblers grouped by age at onset of gambling has not been performed. Objective: To identify differences in psychiatric correlates of gambling and gambling-related attitudes and behaviors in adolescents (aged 16-17 years) and in young adults(aged18-29years)withearly-onset(beforeage18 years) and adult-onset gambling. Design: Logistic regression analysis. Setting: Public access data set derived from randomdigit-dialing telephone surveys. Patients: The study analyzed data from adolescent (n=235), early-onset adult (n=151), and adult-onset (n=204)past-yeargamblersandadolescent(n=299)and adult(n=187)nongamblersintheGamblingImpactand Behavior Study. Main Outcome Measures: Gamblers and nongamblers were compared within each group on measures of sociodemographics and psychiatric health. Adolescent, early-onsetadult,andadult-onsetpast-yeargamblerswere compared on measures of gambling attitudes and behaviors. Results:Adolescentgamblersweremorelikelythanadolescent nongamblers to report alcohol and drug use and abuse/dependence and depression. Elevated rates of alcohol and drug use and abuse/dependence were observed in early-onset adult gamblers vs adult nongamblers,andonlyelevatedratesofalcoholusewereobserved in adult-onset gamblers vs adult nongamblers. Substantial differences in reasons for and patterns of gambling were observed among the 3 groups of gamblers. Conclusions: Adolescent-onset gambling is associated with more severe psychiatric problems, particularly substance use disorders, in adolescents and young adults. More research is needed to investigate the relationships and inform prevention and treatment strategies. Arch Gen Psychiatry. 2004;61:1116-1122