The Relationship of Gambling Disorder to Obsessive-Compulsive Disorder

Objective: Gambling disorder frequently co-occurs with other psychiatric conditions, yet its relationship with obsessive-compulsive disorder (OCD) remains unclear.Emerging evidence suggests impulsivity and compulsivity may be inter-related rather than diametrically opposed constructs, warranting investigation of their clinical overlap.For example, work in other areas of addiction posits a shift between 'impulsive' and 'compulsive' behavior over time; and reward-driven compulsivity emerged as a distinct component of compulsivity both in conventional factor analysis and network modelling.The aim of this study was to examine the rate of gambling disorder in adults with OCD and to explore associated clinical, behavioral, and treatment-related characteristics.Methods: Adults with probable OCD were recruited via online Reddit groups for OCD, OCD clinics, and support groups and completed a cross-sectional survey.OCD symptom types were assessed using the Obsessive-Compulsive Inventory-Revised, and gambling disorder was identified using the Minnesota Impulsive Disorders Interview (MIDI).Additional measures included gambling severity, impulsivity, and problematic internet use.Group comparisons were conducted between participants with and without gambling disorder.Results: Among 186 adults with OCD, 34 (18.8%)met criteria for gambling disorder.Individuals with comorbid gambling disorder demonstrated significantly greater OCD severity, particularly in ordering, checking, and neutralizing symptoms, and reported later onset of OCD.The comorbid group showed higher impulsivity, greater problematic internet use, and distinct gambling behaviors, including higher rates of online gambling, esports betting, and use of artificial intelligence tools for gambling.They were also less likely to have received pharmacological treatment for OCD.Conclusions: Gambling disorder in adults with OCD is associated with distinct clinical characteristics, greater impulsivity, problematic internet use, and concerning treatment gaps.Contrary to common clinical assumptions, gambling disorder and OCD appear to be highly comorbid, despite being traditionally regarded as 'impulsive' or 'compulsive' respectively.These findings highlight the importance of screening for gambling in OCD, and vice versa, and suggest a need for integrated treatment approaches.