Late-onset pathological gambling: Clinical correlates and gender differences

Jon E. Grant, Suck W Kim, Brian L. Odlaug, Stephanie N. Buchanan, Marc N. Potenza

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Age at illness onset has significant clinical implications for psychiatric disorders. Prior research has not systematically examined age at illness onset and its relationship to the clinical characteristics of pathological gambling (PG). Among a sample of 322 consecutive subjects with current DSM-IV PG, those with late-onset (at or after age 55 years) PG were compared to those with earlier onsets (at or prior to age 25, 26-54 years old) on measures of PG severity, co-occurring disorders, social and legal problems, and family history. Forty-two (13.4%) subjects reported onset of PG at or after age 55 years, 63 (19.6%) reported onset prior to age 25 years, and the majority (n = 217; 67.4%) reported onset between the ages of 26 and 54 years. The late-onset group were less likely to declare bankruptcy (p = .029) or have credit card debt attributable to gambling (p = .006). Late-onset PG subjects were significantly more likely to have an anxiety disorder (p < .001) and significantly less likely to have a father (p = .025) or a mother (p = .048) with a gambling problem. Exploratory analyses identified an age-by-gender interaction with respect to treatment-seeking, with more pronounced age-related shortening in the duration between problem onset and treatment seeking observed in men. Age at onset of PG is associated with multiple important clinical features. Long durations of PG prior to treatment-seeking indicate the need for improved prevention efforts among individuals with early PG onset. Late-onset PG is relatively common and has distinct clinical characteristics suggesting that this population might benefit from unique prevention and treatment strategies.

Original languageEnglish (US)
Pages (from-to)380-387
Number of pages8
JournalJournal of Psychiatric Research
Volume43
Issue number4
DOIs
StatePublished - Jan 2009

Bibliographical note

Funding Information:
This research was supported in part by an NIMH Career Development Award (K23 MH069754-01A1) (JEG), a Grant from NIMH (R21-MH065920) (SWK), a Grant from NIDA (R01 DA019039) (MNP), the VA VISN1 MIRECC (MNP), and unrestricted educational Grants from GlaxoSmithKline, Forest Pharmaceuticals, and BioTie Therapies. None of these funding sources had any role in this study’s design, in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Funding Information:
Dr. Grant has received research Grants from Forest Pharmaceuticals, GlaxoSmithKline, and Somaxon Pharmaceuticals. Dr. Grant has also been a consultant to Pfizer Pharmaceuticals and Somaxon Pharmaceuticals. Dr. Potenza consults for and is an advisor to Boehringer Ingelheim, receives research support from Mohegan Sun, has consulted for and has financial interests in Somaxon, and has consulted for law offices and the federal defender’s office as an expert in pathological gambling and impulse control disorders. Mr. Odlaug, Ms. Buchanan, and Dr. Kim report no competing interests.

Keywords

  • Addiction
  • Age
  • Impulse control disorders
  • Onset
  • Pathological gambling

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