Diagnosis, neurobiology, and treatment of pathological gambling.
Pathological gambling is a disabling disorder that affects at least 2 1/2 million Americans and their families. Although pathological gambling has been characterized as an impulse control disorder, it has also been associated with compulsivity. Essential features of pathological gambling include constantly recurring gambling behavior that is maladaptive, in that personal, familial, and/or vocational endeavors are disrupted. Affective disorders and substance abuse often co-occur. Incidence of suicidality is extremely high. Despite the fact that this disorder is a widespread public health problem, few controlled studies of causes or treatment have been conducted. Preliminary neurobiological studies implicate serotonergic dysfunction in pathological gamblers. Treatment with serotonin reuptake inhibitors, such as clomipramine and fluvoxamine, may be effective in treating this disorder. Well-defined and controlled clinical trials in large samples of pathological gamblers are needed.
DeCaria
C M
CM
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
Hollander
E
E
Grossman
R
R
Wong
C M
CM
Mosovich
S A
SA
Cherkasky
S
S
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003192:Compulsive Behavior / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use; D005715:Gambling / Q000523:psychology*; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D015990:Placebo Effect; D011613:Psychotherapy; D012657:Self-Help Groups; D012701:Serotonin / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome
D016666:Fluvoxamine; D016651:Lithium Carbonate; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors