DSM-IV pathological gambling in the National Comorbidity Survey Replication

Psychol Med. 2008 Sep;38(9):1351-60. doi: 10.1017/S0033291708002900. Epub 2008 Feb 7.

Abstract

Background: Little is known about the prevalence or correlates of DSM-IV pathological gambling (PG).

Method: Data from the US National Comorbidity Survey Replication (NCS-R), a nationally representative US household survey, were used to assess lifetime gambling symptoms and PG along with other DSM-IV disorders. Age of onset (AOO) of each lifetime disorder was assessed retrospectively. AOO reports were used to study associations between temporally primary disorders and the subsequent risk of secondary disorders.

Results: Most respondents (78.4%) reported lifetime gambling. Lifetime problem gambling (at least one Criterion A symptom of PG) (2.3%) and PG (0.6%) were much less common. PG was significantly associated with being young, male, and Non-Hispanic Black. People with PG reported first gambling significantly earlier than non-problem gamblers (mean age 16.7 v. 23.9 years, z=12.7, p<0.001), with gambling problems typically beginning during the mid-20s and persisting for an average of 9.4 years. During this time the largest annual gambling losses averaged US$4800. Onset and persistence of PG were predicted by a variety of prior DSM-IV anxiety, mood, impulse-control and substance use disorders. PG also predicted the subsequent onset of generalized anxiety disorder, post-traumatic stress disorder (PTSD) and substance dependence. Although none of the NCS-R respondents with PG ever received treatment for gambling problems, 49.0% were treated at some time for other mental disorders.

Conclusions: DSM-IV PG is a comparatively rare, seriously impairing, and undertreated disorder whose symptoms typically start during early adulthood and is frequently secondary to other mental or substance disorders that are associated with both PG onset and persistence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Age of Onset
  • Comorbidity
  • Data Collection / methods*
  • Data Collection / statistics & numerical data*
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Disruptive, Impulse Control, and Conduct Disorders / diagnosis
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology*
  • Disruptive, Impulse Control, and Conduct Disorders / psychology*
  • Ethnic Groups
  • Female
  • Gambling / psychology*
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Odds Ratio
  • Predictive Value of Tests
  • Prevalence
  • Retrospective Studies
  • Sex Distribution
  • Socioeconomic Factors
  • United States / epidemiology