Pathological Gambling

Belongs to the group of F63: Habit and impulse disorder

Definition

 * Internal compulsion to gamble despite negative consequences
 * try to stop often times without success

Epidemiology

 * m > w, can happen in any age group
 * Often occurs in conjunction with other psychiatric disorders (antisocial personality disorder, depressive disorder, bipolar disorder, and substance use disorders)

Etiology

 * multifactorial (i.e. genetic, neurochemical abnormalities, environment)

Diagnosis according to the clinical criteria of the DSM V

 * need 4 or more over a 12 month period
 * Criteria
 * Using increasing amounts of money to gamble
 * Relying on others for financial support to maintain habit
 * Restlessness or irritability when attempting to stop gambling
 * Constant preoccupation with gambling
 * Continuous gambling in an attempt to undo losses (“chasing one's losses”)
 * Jeopardizing relationships or careers as a result of gambling
 * Numerous failed attempts to quit gambling
 * Lying to others to conceal the extent of gambling
 * Gambling when feeling helpless, guilty, anxious or depressed

DDx:

 * excessive gambling by manic patients (F30.-)
 * gambling and betting NOS (Z72.6)
 * gambling in dissocial personality disorder (F60.2)

Treatment

 * Psychotherapy > Pharmacotherapy
 * Gamblers Anonymous
 * CBT
 * Pharmacotherapy is being researched
 * Treat psychiatric conditions (e.g. bipolar disorder)

Prognosis:

 * 1/3 recover without treatment