Resembles other addictions; a strong urge to gamble even though it causes problems.
Gambling addiction is a complex disorder, the onset of which may be influenced not only by neurobiological and genetic predisposition, but also by social causes, certain personality traits and several environmental factors.
Causes shame, anxiety and depression making it more difficult to admit that there is a problem and to seek treatment.
Often associated with other mental or substance-related disorder
Treatment by psychotherapeutic methods
The dopamine agonists pramipexole and ropinirole and the dopamine modulator aripiprazole are probably associated with an increased risk of developing a gambling problem.
Background and frequency
The term gambling problem is used as an umbrella term (analogous to alcohol problem) when talking about gambling addiction and risky gambling. Gambling addiction is the most serious form of gambling problem.
Grades of severity as for other addictions: risk gambler, problem gambler, gambling addict
Gambling that is under control is often social and limited in time, and the stakes are moderate.
Symptoms may vary with time.
Risk factors
At-risk groups include, for example, young people, the elderly, prisoners and people with low socio-economic status.
Being at risk means that there are specific causes that expose these groups to gambling problems and may contribute to the development of gambling into a harmful activity.
Identification
Questions about gambling should be asked in a low threshold manner, e.g. at pupil and student health services and occupational health and age group examinations.
Systematic screening for gambling problems is warranted when a patient presents to health care with other mental health or substance abuse problems.
Even one Yes response in the Brief Biosocial Gambling Screen (BBGS) suggests a gambling problem.
During the past 12 months, have you become restless, irritable or anxious when trying to stop/cut down on gambling?
During the past 12 months, have you tried to keep your family or friends from knowing how much you gambled?
During the past 12 months did you have such financial trouble as a result of your gambling that you had to get help with living expenses from family, friends or welfare?
The patient should be examined for any other psychiatric disorders.
Bipolar disorder (in as many as 33 to 75% of people with gambling problem) Bipolar Disorder
Anxiety disorder (in 9 to 40% of people with gambling problem) Anxiety Disorder
Diagnostic criteria (ICD-10), pathological gambling (F63) used as the term
Two or more episodes of gambling per year
These episodes do not have a profitable outcome for the person, but are continued despite personal distress and interference with personal functioning in daily living.
The intense urge to gamble is difficult to control so that the patient is unable to stop gambling by an effort of will.
The person is preoccupied with thoughts or mental images of the act of gambling or the circumstances surrounding the act.
Criteria according to the ICD-11 will come into effect in the coming years.
To succeed, patients must admit the problem to themselves and their families.
Distorted thoughts associated with gambling must be put right (distorted ideas about gambling events and the chances of winning, lucky days, rituals, etc.).
Keeping things secret and lying usually make anxiety and loneliness worse and predispose to a continued spiral.
Routine pharmacotherapy with naltrexone is not recommended as first line therapy.
If pharmacotherapy is used as supportive therapy to prevent relapses, potential adverse effects should be monitored. When initiating pharmacotherapy, the patient's overall situation and any associated symptoms should be assessed.