Unique versus shared associations between self-reported behavioral addictions and substance use disorders and mental health problems: A commonality analysis in a large sample of young Swiss men

J Behav Addict. 2019 Dec 1;8(4):664-677. doi: 10.1556/2006.8.2019.70.


Background and aims: Behavioral addictions (BAs) and substance use disorders (SUDs) tend to co-occur; both are associated with mental health problems (MHPs). This study aimed to estimate the proportion of variance in the severity of MHPs explained by BAs and SUDs, individually and shared between addictions.

Methods: A sample of 5,516 young Swiss men (mean = 25.47 years old; SD = 1.26) completed a self-reporting questionnaire assessing alcohol, cannabis, and tobacco use disorders, illicit drug use other than cannabis, six BAs (Internet, gaming, smartphone, Internet sex, gambling, and work) and four MHPs (major depression, attention-deficit hyperactivity disorder, social anxiety disorder, and borderline personality disorder). Commonality analysis was used to decompose the variance in the severity of MHPs explained (R2) by BAs and SUDs into independent commonality coefficients. These were calculated for unique BA and SUD contributions and for all types of shared contributions.

Results: BAs and SUDs explained between a fifth and a quarter of the variance in severity of MHPs, but individual addictions explained only about half of this explained variance uniquely; the other half was shared between addictions. A greater proportion of variance was explained uniquely or shared within BAs compared to SUDs, especially for social anxiety disorder.

Conclusions: The interactions of a broad range of addictions should be considered when investigating their associations with MHPs. BAs explain a larger part of the variance in MHPs than do SUDs and therefore play an important role in their interaction with MHPs.

Keywords: Switzerland; behavioral addictions; commonality analysis; mental health; substance use disorders.

MeSH terms

  • Adult
  • Anxiety Disorders / epidemiology*
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Behavior, Addictive / epidemiology*
  • Borderline Personality Disorder / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Depressive Disorder, Major / epidemiology*
  • Gambling / epidemiology*
  • Humans
  • Internet*
  • Male
  • Substance-Related Disorders / epidemiology*
  • Switzerland / epidemiology
  • Young Adult

Grants and funding

Funding sources: The C-SURF study was funded by the Swiss National Science Foundation (FN 33CSC0_122679, FN 33CS30_139467, and FN 33CS30_148493).