CS01-01 - Pathological gambling: impulse controle disorder or addiction?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1767-1767
Author(s):  
W. van den Brink

Gambling is a recreational activity with many participants all over the world. However, some people, especially with certain games, loose control over their gambling behavior resulting in serious problems for the person and his or her environment. The problematic nature and the underlying psychopathology is recognized by the fact that pathological gambling is an existing diagnosis in most psychiatric classification systems. In most of these systems, pathological gambling is categorized under the group of impulse control disorders. However, in DSM5, is likely to become one of the addiction and pathological become a gambling addiction.In this presentation, we discuss the similarities and differences between pathological gambling and substance use disorders in terms of the phenomenology, comorbidity, genetics, temperamental antecedents, neurochemistry, cognitive abnormalities, neurobiological substrates, course and response to psychological and pharmacological treatments. It is concluded that pathological gambling is more similar to substance use disorders than to impulse control disorders and that a move in the classification towards the category of addictions seems to be justified.

Author(s):  
Gordon MacNeil ◽  
B. Michelle Brazeal

This article presents information regarding the evolving understanding of the relationships between impulse-control disorders, compulsion-related disorders, and addictions (both substance-related and behavioral). The traditional model describing the relationship between impulse-control disorders and compulsion-related disorders is now considered overly simplistic. New research suggests that this relationship is complex, and distinctions between these disorders are not as solid as previously thought. Information about this dynamic relationship also has implications for substance use disorders and behavioral addictions.


2008 ◽  
Vol 23 ◽  
pp. S75
Author(s):  
E.M. Alvarez-Moya ◽  
S. Jimenez-Murcia ◽  
Z. Aguera ◽  
L. Forcano ◽  
C. Villarejo ◽  
...  

2009 ◽  
Vol 194 (5) ◽  
pp. 411-417 ◽  
Author(s):  
S. Lee ◽  
A. Tsang ◽  
J. Breslau ◽  
S. Aguilar-Gaxiola ◽  
M. Angermeyer ◽  
...  

BackgroundStudies of the impact of mental disorders on educational attainment are rare in both high-income and low- and middle-income (LAMI) countries.AimsTo examine the association between early-onset mental disorder and subsequent termination of education.MethodSixteen countries taking part in the World Health Organization World Mental Health Survey Initiative were surveyed with the Composite International Diagnostic Interview (n=41 688). Survival models were used to estimate associations between DSM–IV mental disorders and subsequent non-attainment of educational milestones.ResultsIn high-income countries, prior substance use disorders were associated with non-completion at all stages of education (OR 1.4–15.2). Anxiety disorders (OR=1.3), mood disorders (OR=1.4) and impulse control disorders (OR=2.2) were associated with early termination of secondary education. In LAMI countries, impulse control disorders (OR=1.3) and substance use disorders (OR=1.5) were associated with early termination of secondary education.ConclusionsOnset of mental disorder and subsequent non-completion of education are consistently associated in both high-income and LAMI countries.


Author(s):  
Jon E. Grant ◽  
Marc N. Potenza

Several controlled outcome studies (Type 1 and Type 2) suggest that specific behavioral (e.g., cognitive-behavioral therapy [CBT]) and pharmacological (e.g., naltrexone, nalmefene, lithium) treatments significantly reduce the symptoms of pathological gambling in the short term compared with wait-list or placebo. Although long-term effects of manual-based CBT have been observed in several small studies, the long-term benefits of pharmacological treatment have not been adequately tested. No studies combining behavioral and pharmacological therapies have been published to date. Thus, the potential benefit of combining behavioral and drug treatments for pathological gambling remains to be investigated systematically. Although several studies (Type 1 and Type 2) suggest that CBT is effective for trichotillomania, pharmacological treatment studies for this disorder have shown mixed results. Similarly, controlled pharmacological studies (Type 1 and Type 2) of compulsive buying have demonstrated mixed results. Limited treatment studies exist for other impulse control disorders (kleptomania, intermittent explosive disorder), although various pharmacological and psychological treatments have shown promise in uncontrolled studies.


Author(s):  
Stephanie Yarnell ◽  
Ellen Edens

Chapter 20—The Prevalence and Severity of Psychiatric Comorbidities provides a summary of a landmark study in epidemiology, the The National Comorbidity Survey Replication (NCS-R). This chapter study sought to answer some fundamental questions. How common are comorbid psychiatric conditions? What are the prevalence and severity rates for comorbid anxiety, mood, impulse control, and substance use disorders? Starting with these questions, this chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


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