DSM-5 gambling disorder: prevalence and characteristics in a substance use disorder sample.

Lior Rennert, Cécile Denis, Kyle Peer, Kevin G. Lynch, Joel Gelernter, Henry R. Kranzler
Experimental and Clinical Psychopharmacology. 2014-02-01; 22(1): 50-56
DOI: 10.1037/a0034518

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Rennert L(1), Denis C(1), Peer K(1), Lynch KG(1), Gelernter J(2), Kranzler HR(1).

Author information:
(1)Center for Studies of Addiction.
(2)Department of Psychiatry (Division of Human Genetics).

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) replaced the fourth edition’s (DSM-IV) diagnosis of Pathological Gambling
(PG) with Gambling Disorder (GD). GD differs from PG in that it requires 4 rather
than 5 criteria for diagnosis and excludes the « Illegal Acts » criterion. We
examined the prevalence of GD and its characteristics and validity in a
substance-use disorder (SUD) sample. Participants (N = 6,613) in genetic studies
of substance dependence underwent a semistructured psychiatric interview.
Individuals who reported ever having gambled $10 at least monthly (n = 1,507)
were the focus of the analyses. Approximately one third of acknowledged gamblers
(n = 563; 8.5% of the total sample) received PG (DSM-IV) and GD (DSM-5) diagnoses
and 678 (10.3% of the total) received only a DSM-5 diagnosis, representing an
increase of 20.4% relative to DSM-IV. Although the 3 groups were comparable
demographically, the DSM-5-Only group was intermediate between the other 2 groups
on the prevalence of comorbid SUDs, the distribution of DSM-IV PG criteria
endorsed, and the types of gambling reported. Multinomial logistic regression
analysis showed that the DSM-5-Only group was more likely than the No-Diagnosis
group and less likely than the Both-Diagnoses group to acknowledge a gambling
problem. In conclusion, there was a high prevalence of PG in this SUD sample.
Analysis of non-DSM variables suggested that the increased sensitivity of the
DSM-5 GD diagnosis successfully identifies a broader set of individuals with
clinically significant gambling-related problems. Prospective studies of
individuals with GD are needed to validate this finding.

DOI: 10.1037/a0034518
PMCID: PMC4019046
PMID: 24490711 [Indexed for MEDLINE]

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