Gambling Addiction (cont.)

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How is a gambling addiction diagnosed?

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The first step to obtaining appropriate treatment is accurate diagnosis, which requires a complete physical and psychological evaluation to determine whether the person may have a gambling addiction. Since some medical conditions can cause an individual to develop erratic, impulsive behaviors, including problem gambling, the examining physician should rule out (exclude) these possibilities through an interview, physical examination, and applicable laboratory tests, as well as implementing a full mental-health evaluation. A thorough diagnostic evaluation includes a complete history of the patient's symptoms, during which time the practitioner might ask the following questions:

  1. How old were you when you gambled for the first time?
  2. How much time (how often and for how long each time) do you spend gambling or thinking about gambling?
  3. How much money do you lose/spend gambling?
  4. What kinds of things do you do to finance gambling?
  5. Do you have irresistible urges to gamble?

The doctor usually asks about alcohol and drug use and whether the patient has had thoughts about death or suicide. Further, the history often includes questions about whether other family members have had a gambling problem or other mental-health problems, and if treated, what treatments they received and which were effective.

A diagnostic evaluation also includes a mental-status examination to determine if the patient's speech, thought pattern, mood, or memory has been affected, as often happens in the case of a many forms of mental illness. As of today, there is no laboratory test, blood test, or X-ray that can diagnose this mental disorder.

What is the treatment for gambling addiction?

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Although there is no standardized treatment for pathological gambling, many people participate in Gamblers' Anonymous (GA). The approximately 8% one-year abstinence rate that intervention tends to produce is often improved when GA is combined with psychotherapy that is administered by a trained professional. That seems to be particularly true when cognitive behavioral treatment is the psychotherapy approach that is used by the practitioner. Medications that have been found to be helpful in decreasing either the urge to gamble or the thrill involved in doing so include antiseizure medications like carbamazepine (Tegretol) and topiramate (Topamax), mood stabilizers like lithium (Eskalith, Lithobid), medications used to address addictions like naltrexone (ReVia), and antidepressants like clomipramine (Anafranil) and fluvoxamine (Luvox). Psychotherapy appears to be more effective than any of the medications used to treat this disorder so far. Financial/debt counseling and self-help interventions may also be important aspects of the care provided to individuals with gambling addiction.

Individuals who engaged in illegal behavior in the year prior to treatment tend to have more severe symptoms of this disorder, have more gambling-related debt and to have more severe symptoms during treatment compared to people who have not engaged in illegal activity during that time period. It is therefore thought that people who engage in breaking laws in the year before treatment begins need more intensive treatment for a longer period of time, sometimes even requiring inpatient or residential treatment. Another important fact to consider in treatment for a gambling addiction is that up to 70% of people with this disorder also have another psychiatric problem. Therefore, it is not enough to just treat the gambling problem but any coexisting mental-health condition (such as alcoholism or other substance abuse problem, mood disorder, or personality disorder) should be addressed as well in order to give the person with a gambling addiction his or her best chance for recovery from both conditions. There is also a need for research about how a person's culture can play a role in the development and treatment of problem gambling.

Medically Reviewed by a Doctor on 11/26/2013

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Gambling Disorders - Causes and Risks Question: If known, what was the cause of your gambling disorder? Did you have a risk factor?
Gambling Disorders - Signs and Symptoms Question: Please discuss the signs and symptoms associated with your gambling disorder.
Gambling Disorders - Diagnosis Question: Describe the events that led to a gambling disorder diagnosis.
Gambling Disorders - Treatment Question: What kinds of treatment helped you with your gambling disorder? What medications, if any, did you use?

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