Occurrence and trajectories of psychiatric disorders in adults with gambling disorder: a longitudinal register-based study of the Finnish population

Purpose To determine the co-occurrence and temporal trajectories between gambling disorder (GD) and other psychiatric diagnoses in the Finnish population. Methods Data were retrieved from two healthcare registers covering primary and specialized care, including 5,172 individuals aged 18 or over (3,720 males, 1,452 females) with diagnosed GD (ICD-10 code F63.0). We also retrieved information on all other psychiatric diagnosis dates (codes F00–99) between 1996 and 2024 for every individual, alongside their official sex, year of birth, and whether GD was a primary, secondary, or long-term diagnosis. Linear mixed modelling (LMM) was used to analyse longitudinal data on multiple diagnosis occurrences. Results Mood, anxiety, and substance use disorders (SUDs) had the highest co-occurrence with GD both preceding and following its diagnosis, indicating bidirectional comorbidity patterns. The most common comorbid categories included unipolar depression, phobic anxiety disorders, alcohol use disorder, and bipolar disorder. Mood disorder comorbidity was especially prominent among women, and SUD comorbidity among men. Most psychiatric diagnoses occurred 112 to 2,697 days before GD (LMM p -values 0.38 – <0.001, marginal and conditional R² = 0.13 and 0.47, respectively). Comorbid diagnoses after GD were, on average, temporally closer to GD onset than diagnoses before GD.Diagnosis occurrences were significantly more frequent among individuals with GD than among psychiatric controls in most diagnostic categories. Conclusions There were distinct and sex-specific temporal trajectories between GD and other psychiatric diagnoses, with mood-, anxiety-, and SUDs showing the strongest and most reciprocal associations. Social and health care professionals should screen for GD among those seeking treatment for these disorders, particularly given the increased suicide risk.