Extreme cases of compulsive gambling may pass to the realm of mental disorders. In the DSM-III, pathological gambling was recognized as a psychiatric disorder. For the DSM-IV the criteria were significantly reworked based on statistical methods and large-scale studies. Pathological gambling is now defined as persistent and recurrent maladaptive gambling behavior that meets at least five of the following criteria, unless these behaviors are better explained by a manic episode:
- The subject experiences tolerance. He requires larger or more frequent wagers to experience the same excitement.
- The subject has frequent thoughts about past, future, or fantasy gambling experiences.
- The subject gambles to improve his mood or escape from his problems.
- The subject gambles in attempt to recover gambling losses.
- The subject attempts to hide his extent, lying to family, friends, or therapists.
- The subject has attempted to reduce gambling, but his attempts were unsuccessful.
- The subject experiences irritability or restlessness associated with attempts to stop or reduce gambling.
- Gambling endangers the subjects serious relationship, job or other opportunity, but he continues gambling.
- The subject has broken the law to obtain money for gambling or recover gambling losses.
- Subject turns to family, friends, or another third party for financial assistance as a result of gambling.
This definition of pathological gambling is widely accepted and internationally used as a basis for clinical practice and research.
In the United States, incidence of compulsive gambling is 2-3 percent and pathological gambling is 1 percent, though this statistics may vary by country. 86 percent of Americans have gambled in their lives and 60 percent gamble in a given year.
