A qualitative analysis of the effects of a comorbid disordered gambling diagnosis with schizophrenia

Abstract

Little research has examined the association between disordered gambling and psychosis. In addition, clinicians treating schizophrenia or schizoaffective disorders rarely screen for or treat comorbid gambling problems due to diagnostic overshadowing. Thus, the effects of disordered gambling on symptoms of schizophrenia and vice versa remain largely unexplored and unidentified in research and clinical practice. The goal of the present study was to explore qualitatively the reciprocal associations between schizophrenia/schizoaffective disorder and disordered gambling through content and functional analyses from the perspective of the affected individual. Eight participants who met DSM-IV criteria for schizophrenia or schizoaffective disorder and disordered gambling participated in a qualitative interview examining key antecedents associated with their gambling, as well as perceived functional consequences of gambling. Content analysis revealed unique patterns of responses specific to individuals with schizophrenia or schizoaffective disorder that are not typically observed in individuals with disordered gambling alone. Specifically, gambling as filling a need for activity, and gambling as a means of connecting with society/world were the notable reasons for engaging in problematic gambling. Furthermore, some, but not all participants described a direct exacerbation of their psychosis by gambling and a greater involvement in gambling due to their symptoms of schizophrenia.

Keywords: Comorbidity; Disordered gambling; Pathological gambling; Psychosis; Schizophrenia.