Compulsive gambling

Alternative names 
Gambling - compulsive; Pathological gambling; Addictive gambling

Definition
Compulsive gambling is the inability to resist impulses to gamble, leading to severe personal or social consequences.

Causes, incidence, and risk factors

Pathological gambling affects 1-3% of adults, men more often than women. It usually begins in adolescence in men and later in women.

This behavior usually progresses from occasional gambling to habitual gambling. The urge to gamble becomes so great that the tension can only be relieved by more gambling. Higher stakes and personal risks become involved, as well as neglect of other interests, family, and work. Severe family problems, financial ruin, and criminal behavior to support the gambling habit may result. The cause for this behavior is not known. One risk factor may be excessive alcohol use which lowers inhibitions and impairs judgment.

Symptoms

     
  • occasional gambling becomes habitual  
  • loss of control over time spent gambling  
  • gambling continues, whether winning or losing, until all money is lost or the game is terminated  
  • gambling until large debts are accumulated  
  • lack of concern for society’s expectations and laws  
  • unlawful behavior may occur to support the habit and pay debts

Signs and tests
A psychological evaluation and history reveals compulsive gambling behavior.

Treatment

Treatment for the person with compulsive gambling begins with the recognition of the problem. It is often associated with denial, allowing the person to believe there is no need for treatment. Most people affected by compulsive gambling enter treatment under pressure from others, rather than a voluntary acceptance of the need for treatment.

Treatment options include individual and group psychotherapy, and self-help support groups such as Gamblers Anonymous. This is probably the most effective treatment. It is a 12-step program similar to Alcoholics Anonymous. Abstinence principles that apply to other types of addiction, such as substance abuse and alcohol dependence, are also relevant in the treatment of compulsive gambling behavior.

Recently, medications such as antidepressants have been shown to be beneficial in combination with psychotherapy.

Expectations (prognosis)
Many people are able to gain control over their lives after undergoing treatment for compulsive gambling.

Complications

     
  • if not detected and treated early, compulsive gambling might lead to estrangement from family and friends as well as financial and legal difficulties  
  • compulsive gambling is a chronic condition: relapse after treatment is a real risk

Calling your health care provider
Call your health care provider or mental health professional if symptoms of compulsive gambling are present.

Prevention
Prevention of the urge to develop addictive behavior is challenging and may not always be possible. Counseling may benefit people who are prone to compulsive gambling or other addictive behavior. People with close relatives who are compulsive gamblers might be at higher risk and should be especially careful.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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