Natural recovery and treatment-seeking in pathological gambling: results of two U.S. national surveys.
OBJECTIVE
Pathological gambling is described in DSM-IV as a chronic and persisting disorder, but recent community-based longitudinal studies that have highlighted the transitory nature of gambling-related problems have called into question whether this is an accurate characterization. This emerging evidence of high rates of recovery coupled with low rates of treatment-seeking for pathological gambling suggests that natural recovery might be common. The purpose of the present study was to document the rates of recovery, treatment-seeking, and natural recovery among individuals with DSM-IV pathological gambling disorder in two large and representative U.S. national surveys.


METHODS
Prevalences of recovery, treatment-seeking, and natural recovery were estimated among individuals from the Gambling Impact and Behavior Study (N=2,417) and the National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093) who reported a lifetime history of DSM-IV pathological gambling disorder (N=21 and N=185, respectively).


RESULTS
Among individuals with a lifetime history of DSM-IV pathological gambling, 36%-39% did not experience any gambling-related problems in the past year, even though only 7%-12% had ever sought either formal treatment or attended meetings of Gamblers Anonymous. About one-third of the individuals with pathological gambling disorder in these two nationally representative U.S. samples were characterized by natural recovery.


CONCLUSIONS
Pathological gambling may not always follow a chronic and persisting course. A substantial portion of individuals with a history of pathological gambling eventually recover, most without formal treatment. The results of large epidemiological surveys of pathological gambling may eventually overturn the established wisdom about pathological gambling disorder.
Slutske
Wendy S
WS
Department of Psychological Sciences, University of Missouri-Columbia, 210 McAlester Hall, Columbia, MO 65211, USA. slutskew@missouri.edu
D000328:Adult; D016739:Behavior, Addictive / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005715:Gambling / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology