Comparisons between the South Oaks Gambling Screen and a DSM-IV-based interview in a community survey of problem...

To directly compare 2 forms of assessment for determining gambling problems in a community survey, and to examine the characteristics of respondents who endorsed DSM-IV symptoms but who scored below the formal DSM-IV diagnostic cut-off for pathological gambling.

We interviewed 1489 Winnipeg adults by phone (response rate 70.5%) using th South Oaks Gambling Screen (SOGS), a DSM-IV-based instrument, and several gambling-related variables.

The lifetime prevalence of "probable pathological gambling" (according to the SOGS, having a score of > or = 5) was 2.6%. The SOGS items and DSM-IV symptoms were highly correlated (r = 0.80), but a score of 5 or more symptoms for a DSM-IV diagnosis produced lower prevalence figures. Comparisons between recreational gamblers (those with no DSM-IV symptoms), subthreshold pathological gamblers (those with 1 to 4 DSM-IV symptoms), and pathological gamblers (those with > or = 5 DSM-IV symptoms) on series of gambling-related variables (for example, high use of video lottery terminals) revealed that subthreshold individuals significantly differed from recreational gamblers and more closely approximated the characteristics displayed by pathological gamblers.

SOGS items show a high degree of association with the DSM-IV clinical symptoms of pathological gambling, but the DSM-IV cut-off of 5 symptoms is more conservative in defining gambling problems. Results support a continuum view of gambling problems in the community. DSM-IV scores of 3 or 4 represent the higher end of the group officially considered diagnostically "subthreshold" and may be important from both a clinical and public health perspective.