Pathological gambling: Clinical aspects

Introduction Pathological gambling (PG) is a psychiatric disorder characterized by persistent and recurrent maladaptive patterns of gambling behavior and by a chronic, relapsing course (Custer 1984; Hollander et al. 2000; National Opinion Research Center 1999; Rosenthal 1992). Psychosocial problems are common among pathological gamblers and include significant financial and marital problems, reduced quality of life, bankruptcy, divorce, incarceration, and impaired functioning (Blaszczynski and McConaghy 1989; Grant and Kim 2001; Petry 2005; Potenza et al. 2000; Rosenthal and Lorenz 1992; Wildman 1989). In order to fund the gambling addiction or to atone for losses resulting from past gambling, many pathological gamblers resort to illegal behavior (Blaszczynski and McConaghy 1989; Ledgerwood et al. 2007; Lesieur 1979; Meyer and Stadler, 1999; Potenza et al. 2000). Suicide attempts are also common (Ledgerwood and Petry 2004; Petry and Kiluk 2002). Diagnosis Pathological gambling was first recognized as an official psychiatric disorder in the ninth edition of the International Classification of Diseases (World Health Organization 1977). It was first included in official U.S. diagnostic coding three years later, in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) (American Psychiatric Association 1980), where it was grouped with Disorders of Impulse Control (Not Elsewhere Classified) and remains today in DSM-IV-TR (text revision) (American Psychiatric Association 2000). The diagnostic criteria for PG were modeled on those for substance dependence. The evidence supporting this choice and lending validity to the criteria selected has been reviewed by Lesieur and Rosenthal (1991).