Gambling and Psychiatry

Gambling involves placing something of value, a stake, on an event with the hope of winning something else of value, a reward. The stakes can be money, merchandise, services or property. People have been engaging in gambling activities for centuries. A few examples include dice games, betting on the outcome of a horse race or political contest and collecting items such as pogs or Magic: The Gathering cards for their value. Gambling is also a part of many recreational activities such as card playing, board games, and sports, and it can be a social activity where more than one person participates.

In addition to the financial benefits of gambling, there are costs. These can be at the personal, interpersonal and societal/community levels. The costs may manifest as changes in financial situations, labor and health impacts or changes in well-being. These costs can be hard to identify and quantify. Typically, they are not included in economic impact analysis studies.

The monetary costs of gambling are usually difficult to quantify, as are the social and other non-monetary impacts. Typically, economic impact studies only look at the dollar effects of gambling and ignore these other impacts, which can be substantial and long-lasting.

Psychiatrists treat gambling disorders with cognitive-behavioral therapy, which trains people to change their thoughts and behaviors. This can help people learn to confront irrational beliefs, such as the notion that a string of losses or a near miss on a slot machine represents an imminent win. Treatment can also teach people to avoid gambling-related situations and to control their money and time.

More research is needed on the underlying biology of gambling disorder, but a growing body of scientific evidence supports the view that pathological gambling can be treated like substance-related addictions. Consequently, the DSM-5 has moved gambling disorder into the category of behavioral addictions, alongside other behavior-related disorders such as kleptomania and pyromania. This decision reflects new understanding of gambling’s brain origins, comorbidity and physiology. It has also led to the development of more effective treatments, including medications and behavioral therapies. Several of these therapies are already in clinical use. The new category of behavioral addictions has given psychiatry an important new role to play in improving the lives of people who cannot control their gambling. Moreover, it has opened the door to further research that can provide a better understanding of the causes of these disorders. This will, in turn, lead to improved prevention and intervention strategies. Ultimately, this will result in a healthier and more productive society. This is our goal at the National Council on Problem Gambling. It is why we continue to fund this crucial work.

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