DSM-IV pathological gambling in the National Comorbidity Survey Replication

Area of Science:

• Psychiatry
• Epidemiology
• Mental Health

Background:

• Prevalence and correlates of DSM-IV pathological gambling (PG) are not well understood.
• Limited data exists on the characteristics and associated factors of PG.

Purpose of the Study:

• To determine the prevalence and correlates of DSM-IV pathological gambling (PG) in a US population.
• To investigate the age of onset and persistence of PG.
• To examine the relationship between PG and other mental health disorders.

Main Methods:

• Utilized data from the US National Comorbidity Survey Replication (NCS-R), a nationally representative household survey.
• Assessed lifetime gambling symptoms and PG using DSM-IV criteria.
• Retrospectively assessed age of onset for PG and other disorders to study temporal relationships.

Main Results:

• Most respondents (78.4%) reported lifetime gambling; however, lifetime problem gambling (2.3%) and PG (0.6%) were less common.
• PG was associated with being young, male, and Non-Hispanic Black.
• Individuals with PG began gambling earlier (mean age 16.7 years) than non-problem gamblers (mean age 23.9 years), with problems persisting for ~9.4 years and average annual losses of $4800.
• Prior anxiety, mood, impulse-control, and substance use disorders predicted PG onset and persistence.
• PG predicted the subsequent onset of generalized anxiety disorder, PTSD, and substance dependence.
• No respondents with PG received treatment for gambling problems, though 49% were treated for other mental disorders.

Conclusions:

• DSM-IV PG is a rare but serious disorder, frequently secondary to other mental or substance use disorders.
• PG symptoms typically emerge in early adulthood and are often undertreated.
• Understanding the correlates and temporal relationships of PG is crucial for developing effective interventions.