Pathological Gambling and Obsessive Compulsive Disorder Among Methadone Maintenance Treatment Patients

ABSTRACT

The aims of this study was to assess the prevalence of lifetime pathological gambling (pathological gambling) and current obsessive compulsive disorder among former heroin addicts currently in methadone maintenance treatment. A cross-sectional study of 154 patients from a methadone maintenance treatment clinic affiliated of a tertiary-referral medical center was conducted. The South Oaks Gambling Screen and Yale-Brown Obsessive Compulsive Scale were used for measurement purposes. Lifetime pathological gambling was found in 45 (29.2%) patients (current pathological gambling was found in 10 [6.5%] patients). Clinical obsessive compulsive disorder (defined if scored as moderate to extreme) was found in 51.1% of patients in the pathological gambling groups and 39.4% of patients in the non-pathological gambling group, with higher obsessive scores in the pathological gambling group versus the non-pathological gambling group. Logistic regression (multivariate analyses) found pathological gambling in more males (odds ratio = 3.6, 95% confidence interval = 1.5–8.8), a high obsessive score (odds ratio = 1.07, 95% confidence interval = 0.1–1.1), and older age on admission (40 years and older) (odds ratio = 2.4, 95% confidence interval = 1.1–5.0). Because only 10 (6.5%) patients were still currently gambling, more urgent intervention should be considered to the unexpected high rate of clinical obsessive-compulsive disorder (42.9%) in the sample, possibly because the clinic studied is of a higher severity than that accepted to the methadone maintenance treatment clinics in the community.

KEYWORDS:

• Pathological gambling
• obsessive compulsive disorder
• opiate addiction
• methadone maintenance

The authors thank Esther Eshkol for editorial assistance. The study had only internal support (MA).

Notes

^a ANOVA.

^b Psychiatric diagnosis was missing for one pathological gambling patient.

^c Questionnaire was available in 40 pathological gambling, and 96 non-pathological gambling, based on Modified Fagerstom score.