On the Limits of Cross-Sectional Retrospective Data for Characterizing the Course of Pathological Gambling and its Relation With Comorbid Psychopathology: A Reply to Afifi, Cox, and Sareen

摘要: TO THE EDITOR: Using two epidemiological surveys, Wendy S. Slutske, PH.D. (1) conducted important investigations on the persistence and chronicity of pathological gambling. Dr. Slutske found that one-third gamblers made a “natural recovery” (p. 300), as indicated by absence symptoms in previous year without treatment-seeking for their gambling problems. concluded may not be chronic persistent commonly believed, results from surveys “may eventually overturn established wisdom about disorder” 301). Further discussion findings is necessary. National Epidemiologic Survey Alcohol Related Conditions data, same data used separate study Petry colleagues was highly comorbid with other mental disorders, including alcohol use mood disorders (2). It therefore likely individuals disorder seek help or specifically In addition, it plausible seeking services improve We an additional analysis using to investigate problems among gamblers. Individuals were asked if they had ever sought 1) 2) mood. When considering conditions gambling, reduced approximately one-half, 34% 18% current Conditionsbased analysis. Although some are able overcome problems, emphasize majority lifetime diagnosis continue experience level gambling-related past year. Interestingly, prognosis Slutske’s investigation almost identical natural course such major depression, 40% continuing meet DSM criteria diagnosis, 20% meeting subthreshold criteria, experiencing no (3). analytical approach continued 22% subdiagnostic symptoms, 38% symptoms. Therefore, this criterion conclude would have implications which well recognized being disorder. Finally, must mentioned relied retrospective assess onset offset Firm conclusions regarding will ultimately require longitudinal prospective data. hope our commentary contribute ongoing initiated Slutske.