Pathological gambling

Eric Hollander, Alison J. Buchalter, Concetta M. DeCaria

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

With increasing access to gambling facilities through casinos, the Internet, and other venues, PG is a rapidly emerging mental health concern. This impulse-control disorder tends to be comorbid with a wide range of other disorders and is reportedly associated with a high rate of suicide. For most gamblers, gambling is a form of entertainment, but for many individuals, the activity leads to far-reaching disruption of family and work. The personal and societal financial ramifications are severe, and many individuals with PG end up in the criminal justice system. An understanding of the neurobiology of PG is beginning to surface. 5-HT is linked to behavioral initiation and disinhibition, which are important in the onset of the gambling cycle and the difficulty in ceasing the behavior. Norepinephrine is associated with the arousal and risk taking in patients with PG. Dopamine is linked to positive and negative reward, the addictive component of this disorder. Effective treatment strategies for pathological gamblers are emerging. Potentially useful pharmacologic agents include SRIs (clomipramine and fluvoxamine), mood stabilizers for pathological gamblers with comorbid bipolar disorders (lithium), and naltrexone. Cognitive-behavioral psychotherapies offer promising results in the treatment of patients with this disorder. To devise prevention and early-intervention programs, research is needed to identify specific features of the individuals at risk for gambling problems. Education targeting vulnerable youth that show early signs of gambling behavior may be worthwhile and should be investigated further. Funding is necessary to support these endeavors, so perhaps a portion of tax revenues generated from the gambling industry should go toward specialized treatment facilities, educational efforts, and research into the neurobiology and treatment of PG.

Original languageEnglish (US)
Pages (from-to)629-642
Number of pages14
JournalPsychiatric Clinics of North America
Volume23
Issue number3
StatePublished - 2000
Externally publishedYes

Fingerprint

Gambling
Neurobiology
Disruptive, Impulse Control, and Conduct Disorders
Fluvoxamine
Clomipramine
Naltrexone
Criminal Law
Taxes
Cognitive Therapy
Therapeutics
Risk-Taking
Arousal
Reward
Bipolar Disorder
Lithium
Research
Internet
Suicide
Dopamine
Serotonin

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Hollander, E., Buchalter, A. J., & DeCaria, C. M. (2000). Pathological gambling. Psychiatric Clinics of North America, 23(3), 629-642.

Pathological gambling. / Hollander, Eric; Buchalter, Alison J.; DeCaria, Concetta M.

In: Psychiatric Clinics of North America, Vol. 23, No. 3, 2000, p. 629-642.

Research output: Contribution to journalArticle

Hollander, E, Buchalter, AJ & DeCaria, CM 2000, 'Pathological gambling', Psychiatric Clinics of North America, vol. 23, no. 3, pp. 629-642.
Hollander E, Buchalter AJ, DeCaria CM. Pathological gambling. Psychiatric Clinics of North America. 2000;23(3):629-642.
Hollander, Eric ; Buchalter, Alison J. ; DeCaria, Concetta M. / Pathological gambling. In: Psychiatric Clinics of North America. 2000 ; Vol. 23, No. 3. pp. 629-642.
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