Gambling disorder: an integrative review of animal and human studies

Abstract

Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research.

Polygenic Risk Scores for Psychiatric Disorders Reveal Novel Clues About the Genetics of Disordered Gambling

“…Aberrant dopamine functioning has long been hypothesized to play a major role in the pathophysiology of SCZ (Howes, et al, 2016). Several lines of evidence also point to the involvement of dopaminergic mechanisms in DG (Nautiyal, et al, 2017, Zack & Poulos, 2009).…”

“…Starting from theory and empirical clues about possible neural mechanisms implicated in dysregulated gambling and related traits, researchers have tested associations between DG and a variety of functional candidate genes (Nautiyal, et al, 2017;Slutske, 2019). These efforts have not yet identified strong and consistent associations between selected variants and DG.…”

Cued for risk: Evidence for an incentive sensitization framework to explain the interplay between stress and anxiety, substance abuse, and reward uncertainty in disordered gambling behavior

“…It is important to note that a variety of biological, neural, genetic, and psychological/environmental factors may also constitute risk factors and contribute to the co-mordidity between gambling and substance-abuse disorder (Crockford & el-Guebaly, 1998;Nautiyal, Okuda, Hen, & Blanco, 2017;Wareham & Potenza, 2010). For example, depression, bipolar disorder, and personality disorders are also highly co-mordid with gambling and substance-abuse disorders (Bergamini et al, 2018;Edens & Rosenheck, 2011;Kennedy et al, 2010).…”

Impulse control and related disorders in Parkinson’s disease

“…This classification was revised in the DSM-5. As a function of clinical and biological similarities with substance use disorders, gambling disorder was reclassified as a behavioral addiction 5 . Compulsive sexual behavior, compulsive buying and other ICDs can also be considered addictive disorders 2,4 .…”

“…Patients experience intrusive and repetitive thoughts about gambling 5 . They spend most of their time on activities related to gambling and neglect their daily responsibilities.…”