“Gambling: The sure way of getting nothing from something.” – Wilson Mizner
Who doesn’t enjoy a game of chance now and then? Trying your luck on an inexpensive lottery ticket can seem innocent enough, and might even net you considerable return. Spurred on by the lure of winning the big jackpot through television, radio, Internet, newspaper and other media ads may even prompt you to spend more than you intended. And it’s not just lottery tickets that people become hooked on but other forms of gambling as well: horse racing, slot machines, card games, sports betting. It should come as no surprise, then, that gambling use disorder (GUD) has steadily gained prominence as another form of addiction.
New research on gambling addiction and GUD is both illuminating, troubling, and promising with respect to prevention, treatment and recovery.
Gambling Officially Recognized in DSM-5 as Behavioral Addiction
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) took gambling out of the “Impulse Control Disorder” section and reclassified gambling disorder as part of the expanded section covering “Substance-related and Addictive Disorders.” With this action, gambling disorder is the first non-substance behavioral addiction. A 2016 review in Substance Abuse and Rehabilitation examined the similarities and differences between gambling disorder and substance use disorders (SUDs) and found many shared characteristics, some of which include diagnostic criteria, comorbidity, genetic and physiological factors, even approaches to treatment.
Suicide Rates Increasing Among Those with Gambling Disorder
While previous research found that gambling disorder appeared to be an independent risk factor for suicide, and few studies looked at all-cause mortality as it relates to gambling disorder, 2018 research published in the Journal of Behavioral Addictions explored both mortality and suicide rates in those with gambling disorder and the general population, as well as risk factors associated with mortality due to suicide and all causes. Their findings showed significantly elevated rates of mortality and suicide among those with gambling disorder. Furthermore, even though common comorbid mental health issues did not predict overall mortality, depression was found to predict suicide death. Researchers suggested that medical and mental health professionals pay attention to long-term risk of death in their patients with gambling disorder and promote effective interventions for mental heath and other comorbid conditions.
Personality Disorders Consistently Associated with Pathological Gambling
In 2017 review published in Current Opinion in Psychiatry, researchers found a strong association between pathological gambling and personality disorders. They noted that studies consistently showed that the presence of a personality disorder is associated with severity of gambling and early age of onset of pathological gambling. Researchers called for further research on pathological gambling that goes beyond merely estimating rates of personality disorders and instead concentrate on longitudinal research to understand both the pathways between personality disorders and the early onset and severity of pathological gambling.