title: Age at onset of DSM-IV pathological gambling in a non-treatment sample: Early- versus later-onset.
abstract: BACKGROUND
  Pathological gambling (PG) is a prevalent and impairing public health problem. In this study we assessed age at onset in men and women with PG and compared the demographic and clinical picture of early- vs. later-onset individuals. We also compared age at onset in PG subjects and their first-degree relatives with PG.
  
  
  METHODS
  Subjects with DSM-IV PG were recruited during the conduct of two non-treatment clinical studies. Subjects were evaluated with structured interviews and validated questionnaires. Early-onset was defined as PG starting prior to age 33years.
  
  
  RESULTS
  Age at onset of PG in the 255 subjects ranged from 8 to 80years with a mean (SD) of 34.0 (15.3) years. Men had an earlier onset than women. 84% of all subjects with PG had developed the disorder by age 50years. Early-onset subjects were more likely to be male, to prefer action games, and to have substance use disorders, antisocial personality disorder, attention deficit/hyperactivity disorder, trait impulsiveness, and social anxiety disorder. Later-onset was more common in women and was associated with a preference for slots and a history of sexual abuse.
  
  
  CONCLUSIONS
  Age at onset of PG is bimodal and differs for men and women. Early-onset PG and later-onset PG have important demographic and clinical differences. The implications of the findings are discussed.
authors.affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242. Electronic address: donald-black@uiowa.edu.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Black
authors.affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242.
authors.forename: Martha
authors.initials: M
authors.lastname: Shaw
authors.affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242.
authors.forename: William
authors.initials: W
authors.lastname: Coryell
authors.affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242.
authors.forename: Raymond
authors.initials: R
authors.lastname: Crowe
authors.affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242.
authors.forename: Brett
authors.initials: B
authors.lastname: McCormick
authors.affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242.
authors.forename: Jeff
authors.initials: J
authors.lastname: Allen
mesh_terms: D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000987:Antisocial Personality Disorder / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005190:Family / Q000523:psychology; D005260:Female; D005715:Gambling / Q000453:epidemiology*; D006801:Humans; D007175:Impulsive Behavior; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires