A clinical perspective of Gambling Dual Disorder: an italian cross-sectional multicenter study

Gambling Dual Disorder (GDD) is a proposed clinical construct describing the co-occurrence of Gambling Disorder (GD) with other psychiatric conditions. Although preliminary evidence supports this model, clinical data remain limited. This multicenter, cross-sectional Italian study aimed to further characterize GDD by comparing patients with GD only and those with co-occurring psychiatric disorders.

A total of 227 outpatients diagnosed with GD were consecutively recruited from two specialized psychiatric clinics in Milan. Patients were stratified into two subgroups: GD-only and GDD (i.e., GD plus ≥1 additional DSM-5 psychiatric disorder). Sociodemographic and clinical variables were collected, including the distribution of lifetime comorbidities. Psychometric questionnaires were used to assess gambling severity and key psychopathological dimensions.

Among the total sample, 137 patients (60.4%) met criteria for GDD. Compared to the GD-only group, GDD patients were significantly older (44.35 ± 14.85 vs. 36.76 ± 15.03 years; p < .05) and reported a later onset of gambling behavior (33.16 ± 13.13 vs. 26.03 ± 11.58 years; p < .005). The GDD group showed higher rates of lifetime suicidal ideation and suicide attempts, along with significantly greater emotional dysregulation. Personality disorders and mood disorders emerged as the most frequent psychiatric comorbidities.

This study confirms that psychiatric comorbidities are highly prevalent among patients with GD and are associated with distinct sociodemographic and clinical features. These findings support the clinical relevance of the GDD model and underscore the importance of recognizing and integrating this model into clinical practice to enhance diagnostic accuracy, improve therapeutic strategies, and guide future investigations in refining the management of gambling-related disorders.