The Relationship Between Gambling Disorder, Physical and Mental Health, and Substance Use in Maryland

The Prevention and Etiology of Gambling Addiction Study in the U.S. (PEGASUS) was a prospective cohort study, conducted in Maryland from 2015 to 2022, that sought to measure the comorbidities and impact of gambling behavior. In-person and telephone study visits collected data about gambling history, chronic health conditions, mental health, and substance use. The study used the South Oaks Gambling Screen (SOGS) to categorize participants as having or not having a history of probable pathological gambling (PPG). The analysis included data from 1,195 participants who were each followed for up to four years. The study intentionally over-sampled gamblers, resulting in a sample in which 34.2% of participants met the study criteria for lifetime history of PPG. Of the 22 chronic health conditions with sufficient numbers for analysis, 17 showed statistically significant relationships with PPG, with mental health disorders standing out as having particularly strong associations. Alcohol and drug use problems, along with smoking, were also significantly more common among participants with PPG compared to those without PPG. The physical health conditions that showed the strongest associations with PPG were restless leg syndrome, high blood pressure, seizures and epilepsy, and stroke. This analysis demonstrated which physical health, mental health, and substance use characteristics were most commonly comorbid with Gambling Disorder, which may inform public health policymakers and healthcare professionals as they target screenings for and interventions against problematic gambling.