Factors contributing to development of pathological gambling and substance-use disorder comorbidity according to patients and professionals

Introduction
In psychiatry, comorbidity is defined as an overlap of two or more mental disorders. Understanding the problem of comorbidity is an important condition for meeting individual patients’ needs. However, the problem is still insufficiently recognised in Polish conditions. Therefore the aim of this study is to determine what psychological and social factors can contribute to development of pathological gambling and substance-use disorder comorbidity.

Material and methods
A total of 65 semi-structured interviews were conducted of which 40 were with people with comorbidity of pathological gambling and substance-use disorders and 25 interviews with professionals.

Results
Our study, apart from confirming what was already known, revealed new factors like: 1) substance-use helps to cope with the excitement associated with the expectation of winning, 2) gambling allows get rid of excess of energy after use of stimulants, 3) the search for new sources of stimulation and behaviours that are easy to hide, 4) need to earn peer respect, 5) spending time in the company of people who have problems with different addictions.

Discussion
The study revealed the internal (individual) and external (environmental) factors that contribute to the development of comorbidity. Using the perspectives of professionals and people with disorders allowed us to extend the catalogue of factors that may influence the development of comorbidity in comparison to previous studies

Conclusions
The awareness of the factors that contribute to the development of the comorbidity of pathological gambling and psychoactive substance-use disorders allows for inclusion of this knowledge both in treatment and prevention programmes.