Pathological Gambling & Mental Health Disorders

The Diagnostic and Statistical Manual for Mental Disorders-IV defines pathological gambling as an "impulse control disorder" characterized as "persistent and recurrent maladaptive gambling behavior." Between 1 percent and 3 percent of adults in North America fit this definition. Of these, most have some other mental health disorder.

Significance

• Social costs from loss of productivity, domestic violence, property crime and law enforcement costs can be significant, while individuals lose money, jobs and significant relationships.

Co-occurrence

• Over 96 percent of those with pathological gambling disorder suffer from at least one other mental health disorder, and 64 percent suffer from three or more.

Causality

• Causality is not well understood, but more mental illnesses seem to precede pathological gambling (PG) than proceed from PG. Panic disorder, generalized anxiety disorder and intermittent explosive disorder, for example, tend to precede PG, but do not proceed from PG.

Types of Co-occurrence

• Seventy-six percent of those who are pathological gamblers have a substance abuse disorder, while 55.6 percent have a mood disorder and 60.3 percent have an anxiety disorder. The lowest co-occurrence is with impulse-control disorders, at just over 42 percent.

Controversy

• Some argue that pathological gambling is an addictive disorder, some say it is a type of obsessive-compulsive behavior and others believe it is a stand-alone impulse control disorder.