Pathological gambling and obsessive-compulsive disorder: towards a spectrum of disorders of volition

Abstract

Pathological gambling and obsessive-compulsive disorder: towards a spectrum of disorders of volition Jogo patológico e transtorno obsessivo-compulsivo: rumo a um espectro de transtornos da volição A b s t r a c t Objective: Pathological gambling is proposed as a participant of an impulsive-compulsive spectrum related to obsessive-compulsive disorder. This study aims to contrast pathological gambling and obsessive-compulsive disorder regarding course, comorbidity, and personality, hence testing the validity of the impulsive-compulsive spectrum. Method: 40 pathological gambling and 40 obsessivecompulsive disorder subjects matched to 40 healthy volunteers according to gender, age, and education were assessed with the Temperament Personality Questionnaire and the Barratt Impulsiveness Scale. Psychiatric patients were also assessed for course and comorbidity data. Results: Obsessive-compulsive disorder presented an earlier onset, but the full syndrome took longer to evolve. Pathological gambling had higher comorbidity with substance-related disorders, and obsessive-compulsive disorder higher comorbidity with somatoform disorders. Gamblers scored higher than controls on the sub-factors Impulsiveness, Extravagance, Disorderliness, and Fear of Uncertainty. Obsessive-compulsive patients scored higher than controls on Fear of Uncertai-nty. Impulsiveness, Extravagance, and Disorderliness significantly correlated with the Barratt Impulsiveness Scale total score, Fear of Uncertainty did not. Discussion: The course and comorbidity profiles of pathological gambling resemble an addiction and differ from obsessive-compulsive disorder. Pathological gambling combines impulsive and compulsive traits. Impulsivity and compulsivity should be regarded as orthogonal constructs, and as drives implicated in volition aspects of behavioral syndromes.

Obsessive-Compulsive Spectrum Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

“…Our cluster analysis study of comorbid OCSDs in OCD patients found that the reward-focused behaviors of pathological gambling and hypersexual disorder clustered together in a 'reward deficiency' cluster [36] . Although the phenomenology and psychobiology of OCD and the behavioral addictions appear rather different [5,[56][57][58] , there is interesting literature exploring certain overlaps. For example, a number of studies have studied the commonalities (and differences) in the clinical, phenomenological, and psychobiological features between impulse-control disorders (such as compulsive shopping [59] , pathological gambling [5] ) and OCD, and described an inability to resist repetitive behaviors that may be harmful to the self or others as the overarching construct that unifies these conditions.…”

Neurobiological bases for impulsive and compulsive behaviour: Implications for pharmacological and psychological interventions

“…Patološko kockanje kombinuje impulsivne i kompulzivne karakteristike. Prvobitno ulaganje može biti radi postizanja zadovoljstva, ali "jurenje dobitka" u cilju smanjenja negativnih finansijskih posledica ima više kompulzivan karakter, koji nije izraz slobodne volje [8]. Poremećaj prejedanja npr.…”

Effect of amphetamine on behavioral patterns of obsessive-compulsive and addictive gambling in a rat marble test

“…Игровую зависимость (pathological gambling) и обсессивно-компульсивное расстройство (ОКР) может объединять повышенная компульсивность [25,28]. Исходя из этого игровую зависимость (ИЗ) классификационно можно включить в число рас-стройств обсессивно-компульсивного ряда [14].…”

“…Дофаминергическая система моз-га, являющаяся мишенью действия фенамина, как показано в работе, вовлекается в реализацию об-сессивно-компульсивного поведения. Поскольку игровая зависимость может быть классифицирова-на как расстройство обсессивно-компульсивного ряда [14,25,28], исследование дофаминергиче-ских механизмов будет способствовать выявлению и уточнению внутримозговых механизмов взаимо-связи игровой зависимости и обсессивно-ком-пульсивного поведения.…”