Late-onset pathological gambling: Clinical correlates and gender differences

Abstract

Age at illness onset has significant clinical implications for psychiatric disorders. Prior research has not systematically examined age at illness onset and its relationship to the clinical characteristics of pathological gambling (PG). Among a sample of 322 consecutive subjects with current DSM-IV PG, those with late-onset (at or after age 55 years) PG were compared to those with earlier onsets (at or prior to age 25, 26-54 years old) on measures of PG severity, co-occurring disorders, social and legal problems, and family history. Forty-two (13.4%) subjects reported onset of PG at or after age 55 years, 63 (19.6%) reported onset prior to age 25 years, and the majority (n=217; 67.4%) reported onset between the ages of 26 and 54 years. The late-onset group were less likely to declare bankruptcy (p=.029) or have credit card debt attributable to gambling (p=.006). Late-onset PG subjects were significantly more likely to have an anxiety disorder (p<.001) and significantly less likely to have a father (p=.025) or a mother (p=.048) with a gambling problem. Exploratory analyses identified an age-by-gender interaction with respect to treatment-seeking, with more pronounced age-related shortening in the duration between problem onset and treatment seeking observed in men. Age at onset of PG is associated with multiple important clinical features. Long durations of PG prior to treatment-seeking indicate the need for improved prevention efforts among individuals with early PG onset. Late-onset PG is relatively common and has distinct clinical characteristics suggesting that this population might benefit from unique prevention and treatment strategies.

Predictors of Pathological Gambling Severity Taking Gender Differences into Account

“…Also, women become dependent on gambling and substance-related disorders more quickly than men (the telescoping effect). This difference in the progress of the disorder has also been found in other studies [14,15,16,17]. …”

“…This difference in the progress of the disorder (the telescoping effect) has also been found in other studies related to gambling [14,15,16,17,21], but it is not so clear in the case of alcohol dependence [71]. The explanation of the telescoping effect is controversial.…”

Sex and gender in biomedicine

“…Another noteworthy finding is that an age-by-gender interaction regarding treatment seeking may be observed among pathological gamblers where males exhibit a more pronounced age-related shortening in the duration between problem onset and treatment seeking (95). Crisp et al (2004) characterised the help seeking female patients (46% of all help seeking pathological gamblers) in Australia as being slightly older than the male patients (39.6 vs. 36.1 years), more likely to be married (42.8% vs. 30.2%) and living with their families (78.9% vs. 61.5%) and having dependent children (48.4% vs. 35.7%).…”

Differences between early-onset pathological gambling and later-onset pathological gambling: data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

“…Studies have found that early onset of PG is associated with more social problems, greater risk of substance use disorders, higher levels of impulsivity and lower rates of treatment-seeking [12,13]. Some studies have also suggested that individuals with earlyonset PG may also be more likely than those with lateronset PG to engage in strategic forms of gambling [12,13], although the distinction between strategic and non-strategic forms of gambling can be controversial [14].…”

“…Some studies have suggested that only early-onset PG is associated with higher prevalence of psychiatric disorders [12], whereas others have found that older age at onset was associated with a higher level of depressive, paranoid and psychotic symptoms, and with specific anxiety and mood disorders [13][14][15][16][17].…”