Similarities and differences between pathological gambling and substance dependance: A clarification | Similitudes et différences entre le jeu pathologique et la dépendance aux substances: qu’en est-il ?

E. Bosc, M. Fatséas, J.-M. Alexandre, M. Auriacombe
L'Encéphale. 2012-10-01; 38(5): 433-439
DOI: 10.1016/j.encep.2012.02.004

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1. Encephale. 2012 Oct;38(5):433-9. doi: 10.1016/j.encep.2012.02.004. Epub 2012 Jun

[Similarities and differences between pathological gambling and substance
dependance: A clarification].

[Article in French]

Bosc E(1), Fatséas M, Alexandre JM, Auriacombe M.

Author information:
(1)Laboratoire de psychiatrie/CNRS-USR-3413-Sanpsy, université Bordeaux-Segalen,
33076 Bordeaux, France.

Similarities and differences between pathological gambling and substance
dependence: a clarification. A critical analysis of a French review of the
international literature on gambling.INTRODUCTION: The integration of
pathological gambling in the spectrum of addictive disorders modeled by substance
dependence is currently discussed.
OBJECTIVE: To perform a systematic review of the similarities and differences
between pathological gambling and substance dependence, and to classify and
analyze them, based on the data collected by a previously published French
systematic analysis of the international literature on pathological gambling.
METHOD: We established a checklist of each comparison of pathological gambling
with substance dependence within the report. Then, every entry was classified as
similarity or difference, analyzed and discussed.
RESULTS: Similarities retrieved were epidemiological characteristics (gender,
age, socio-demographic characteristics of subjects), diagnostic criteria from
DSM-IV (five criteria in common), frequent co-occurrence of pathological gambling
and substance dependence, neurobiological and genetic characteristics, cases of
spontaneous recovery, and similarities of therapeutic care. Differences retrieved
were a more elevated prevalence of mood disorders and suicide among pathological
gamblers, intrinsic risk factors related to gambling activity (delay between bid
and result, gambling device, big win), cognitive distortion of pathological
gamblers (notably chasing), specificities of cognitive behavioral therapies
focused on these cognitive distortions, and specificities of social care of
pathological gamblers.
DISCUSSION: Pathological gambling shared many similarities with substance
dependence, but also some differences. However, our critical analysis of these
elements, reported to be specific to pathological gambling, showed significant
commonalities with substance dependence. Also, the existence of key symptoms of
substance dependence such as craving and loss of control in pathological gambling
was not discussed in the review, although other data suggest a common ground.
These could be key elements to group together pathological gambling and substance
dependence within the addictive disorders.

Copyright © 2012 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights

DOI: 10.1016/j.encep.2012.02.004
PMID: 23062458 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus