Neurocognitive functions in pathological gambling: a comparison with alcohol dependence, Tourette syndrome and normal controls.
OBJECTIVE
Neurocognitive functions in pathological gambling have relevance for the aetiology and treatment of this disorder, yet are poorly understood. This study therefore investigated neurocognitive impairments of executive functions in a group of carefully screened Diagnostic and Statistical Manual version IV (DSM-IV-TR) pathological gamblers. Performance was compared to a group of normal control participants. To study the specificity of these neurocognitive deficits, a substance dependence group (alcohol dependence) and an impulse control disorder group (Tourette syndrome) were included.


METHODS
Cross-sectional study.


METHODS
Addiction and general mental health treatment centres.


METHODS
Forty-nine pathological gamblers, 48 abstinent alcohol-dependent patients, 46 participants with Tourette syndrome and 49 normal control participants.


METHODS
A comprehensive neuropsychological battery measuring executive functions as well as basic cognitive functions.


RESULTS
Both the pathological gambling and the alcohol dependent groups were characterized by diminished performance on inhibition, time estimation, cognitive flexibility and planning tasks. The Tourette syndrome group showed deficits only on inhibition tasks. Basic cognitive functions were intact in all clinical groups. Comorbid attention deficit hyperactivity disorder, antisocial personality disorder and nicotine dependence influenced the impaired functions of the clinical groups only minimally.


CONCLUSIONS
Carefully screened groups of pathological gamblers and alcohol dependents were characterized by diminished executive functioning, suggesting a dysfunction of frontal lobe circuitry in these disorders. The resemblance between the pathological gambling group and the alcohol dependence group suggests a common neurocognitive aetiology for these disorders. Psychosocial treatment of these disorders could benefit from assessing and targeting deficits in executive functions, as they probably influence the course of these disorders negatively.
Amsterdam Institute for Addiction Research and Academic Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands. agoudriaan@gmail.com
Anna E
AE
Goudriaan
Jaap
J
Oosterlaan
Edwin
E
de Beurs
Wim
W
van den Brink
D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D016739:Behavior, Addictive / Q000523:psychology; D003072:Cognition Disorders / Q000523:psychology*; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D005879:Tourette Syndrome / Q000523:psychology*