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Pathological gambling

Contents of this page:

Alternative Names   

Gambling - compulsive; Compulsive gambling; Addictive gambling

Definition    Return to top

Pathological gambling is being unable to resist impulses to gamble, which can lead to severe personal or social consequences.

Causes    Return to top

Pathological gambling usually begins in early adolescence in men, and between ages 20 and 40 in women.

Pathological gambling often involves repetitive behaviors. People with this problem have a hard time resisting or controlling the impulse to gamble. Although it shares features of obsessive compulsive disorder, pathological gambling is likely a different condition.

In people who develop pathological gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems.

Symptoms    Return to top

People with pathological gambling often feel ashamed and try to avoid letting others know of their problem. The American Psychiatric Association defines pathological gambling as having five or more of the following symptoms:

Exams and Tests    Return to top

A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions can help with the diagnosis.

Treatment    Return to top

Treatment for people with pathological gambling begins with recognizing the problem. Pathological gambling is often associated with denial. People with the illness often refuse to accept that they are ill or need treatment.

Most people with pathological gambling enter treatment under pressure from others, rather than voluntarily accepting the need for treatment.

Treatment options include:

Outlook (Prognosis)    Return to top

Like alcohol or drug addiction, pathological gambling is a chronic disorder that tends to get worse without treatment. Even with treatment, it's common to start gambling again (relapse). However, people with pathological gambling can do very well with the right treatment.

Possible Complications    Return to top

Complications may include:

Getting the right treatment can help prevent many of these problems.

When to Contact a Medical Professional    Return to top

Call your health care provider or mental health professional if you believe you have symptoms of pathological gambling.

Prevention    Return to top

Exposure to gambling may increase the risk of developing pathological gambling. Limiting exposure may be helpful for people who are at risk.

Public exposure to gambling, however, continues to increase in the form of lotteries, electronic and Internet gambling, and casinos. Intervention at the earliest signs of pathological gambling may prevent the disorder from getting worse.

References    Return to top

Pathological Gambling (DSM-IV-TR #312.31). Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. St. Louis, Mo: Mosby; 2004:chap 132.

Update Date: 5/26/2008

Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathyophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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