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Additional file 1: Supplementary Table 1. Diagnostic classifications for definition of type 2 diabetes and selected brain disorders. Supplementary Table 2. Crude and adjusted estimates based on logistic regression analyses and temporally ordered Cox regression analyses. Supplementary Table 3. Temporally ordered analyses of sex-specific associations between diagnoses of brain disorders and type 2 diabetes. Supplementary Table 4. Adjusted estimates based on logistic regression analyses and temporally ordered Cox regression analyses without and with adjustment for highest attained level of education. Supplementary Table 5. Adjusted estimates based on logistic regression analysis applying the main and two alternative register-based T2DM definitions.

Interest in gambling disorder, formerly known as pathological gambling, has been growing in both the clinical and scientific community. The increase in empirical evidence concerning gambling disorder has permitted a better understanding of the pathology, as well as the identification of common comorbidities and the design of potential therapeutic options. The present review addresses all these issues, including recent findings in this area of study.

Impulsivity; Compulsivity; Diabetes type 2 Impulsivitat; Compulsivitat; Diabetis tipus 2 Impulsividad; Compulsividad; Diabetes tipo 2 Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive-compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity. This manuscript and research were supported by grants from the Instituto de Salud Carlos III (ISCIII) (FIS PI14/00290, PI17/01167 and PI20/132) and (PI13/00462, PI16/00501, PI19/00576), by the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call “Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut” (PERIS) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn is an initiative of ISCIII. This research was also partially funded by EU-H2020 grants (Eat2beNICE/H2020-SFS-2016-2, Ref 728018; PRIME/H2020-SC1-BHC-2018-2020, Ref: 847879). CG-M receives a predoctoral grant from the University of Rovira i Virgili (2020PMFPIPF- 37). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Background Type 2 diabetes mellitus (T2DM) is linked with several neurodegenerative and psychiatric disorders, either as a comorbid condition or as a risk factor. We aimed to expand the evidence by examining associations with a broad range of brain disorders (psychiatric and neurological disorders, excluding late-onset neurodegenerative disorders), while also accounting for the temporal order of T2DM and these brain disorders. Methods In a population-based cohort-study of 1,883,198 Danish citizens, born 1955–1984 and followed until end of 2016, we estimated associations between T2DM and 16 brain disorders first diagnosed between childhood and mid-adulthood. We calculated odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) in temporally ordered analyses (brain disorder diagnosis after T2DM and vice versa), adjusted for sex, age, follow-up, birth year, and parental factors. Results A total of 67,660 (3.6%) of the study population were identified as T2DM cases after age 30 and by a mean age of 45 years (SD of 8 years). T2DM was associated with most psychiatric disorders. Strongest associations were seen with other (i.e. non-anorectic) eating disorders (OR [95% CI]: 2.64 [2.36–2.94]) and schizophrenia spectrum disorder (2.73 [2.63–2.84]). Among neurological disorders especially inflammatory brain diseases (1.73 [1.57–1.91]) and epilepsy (1.67 [1.60–1.75]) were associated with T2DM. Most associations remained in both directions in the temporally ordered analyses. For most psychiatric disorders, associations were strongest in females. Conclusions T2DM was associated with several psychiatric and neurological disorders, and most associations were consistently found for both temporal order of disorders. This suggests a shared etiology of T2DM and those brain disorders. This study can form the starting point for studies directed at further elucidating potential causal links between disorders and shared biological mechanisms.