AbstractIntroduction: Gambling is a complex mental disorder with social and economic impacts. The lifetime prevalence rate of gambling disorder in the general U.S. population is about 0.4%–1.0%. In clinical settings the diagnosis of gambling disorder could be missed and untreated leading to worsening of functioning and impacting individuals with gambling disorder their families and the society at large.
Objectives: To summarize the diagnosis, etiology, epidemiology, the social and economic impacts and the currently available treatment interventions in gambling disorder.
Material and Methods: Data were gathered from a systematic literature review, search of the PubMed electronic database, PsycINFO and the Cochrane Systematic Review Database.
Results: The etiology of gambling disorder is complex, and not fully understood with possible genetic and environmental influences. Alteration in the cortico-striato-limbic systems and their circuits are also implicated as possible etiological factors of gambling disorder. Gambling disorder frequently co-occurs with other psychiatric conditions, particularly substance use disorders. Cognitive behavioral therapy, motivational interviewing and gambling anonymous are considered beneficial interventions in gambling disorder. Although the US Food and Drug Administration (FDA) has not approved a pharmacological intervention for the treatment of gambling disorder, limited data suggest promising beneficial effects from the use of opioid antagonists, antidepressants, mood stabilizers, antiepileptics, atypical antipsychotics, and glutaminergic agents in the treatment of gambling disorder. More and larger randomized and placebo controlled clinical trials with longerâ€term evaluation periods are still needed to confirm the effectiveness and the long-term efficacy of these pharmacological agents.
Discussion and Conclusion: Gambling is considered a complex mental disorder that affect many individuals along with their families and society at large. Its identification and diagnosis is still lacking in clinical settings Cognitive behavioral therapy, motivational interviewing and attendance of gambler anonymous are considered valuable therapeutic intervention. Pharmacological interventions are still in their early investigational stages and are not yet recommended as evidence-based treatment modalities until confirmed by the conduction of larger randomized and placebo controlled clinical trials with longerâ€term evaluation periods. Clinicians need to acquire the necessary knowledge to accurately diagnose gambling disorder as described in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
