Pathological gambling: prevalence, diagnosis, comorbidity, and intervention in Germany

The number of pathological gamblers seeking treatment has risen continuously till the present, and the trend shows no sign of reversal. Estimates of the number of pathological gamblers in Germany range from 103,000 to 290,000, corresponding to 0.2% to 0.6% of the population. Pathological gambling often accompanies other mental disturbances. Doctors who learn that their patients suffer from such disturbances should ask targeted questions about gambling behavior to increase the chance that this problem will be detected early on.

This article is based on an analysis of secondary data obtained from the German Statutory Pension Insurance Scheme and the Federal Statistical Office and on a selective review of the literature on comorbidities and available interventions.

The rate of inpatient treatment for pathological gambling tripled from 2000 to 2010. Most pathological gamblers are men (70%-80%). More than 90% of the patients suffer from more than one mental disturbance; 40% of them carry five different psychiatric diagnoses. Simple screening instruments for pathological gambling are easy to use in routine practice and facilitate the diagnosis.

As with alcoholics, only a small fraction of pathological gamblers receives the appropriate support and treatment. Educational seminars to raise awareness among physicians and targeted measures for early detection might result in more of the affected persons getting suitable help.