Classification

In the past, this syndrome has been referred to as compulsive gambling. However, it is not a true obsessive-compulsive state but a heterogeneous group of conditions, characterized by excessive gambling resulting in disturbance for those involved. The term 'pathological gambling' is more appropriate, since it is not based on any assumptions concerning the underlying processes.(2)

ICD-10(3) describes pathological gambling as a form of behaviour under 'habit and impulse disorders'. On the other hand, DSM-IV (4) implies a homogeneous disease entity and provides criteria for its recognition under 'impulse-control disorders not elsewhere classified'. The ICD-10 approach is preferable.

A total of five varieties of pathological gambling can be recognized.(2,,5,)

1. Symptomatic gambling occurs in mental illness, usually depression, which is the primary disorder.

2. Neurotic gambling occurs as a response to an emotional problem, particularly in a disturbed relationship in marriage or during adolescence.

3. Impulsive gambling is characterized by loss of control for varying periods and is particularly liable to be associated with tolerance, craving, and dependence on the activity.

4. Psychopathic gambling is part of the generalized disturbance of behaviour that characterizes antisocial personality disorder.

5. Subcultural gambling arises out of the person's background, which is one of socially accepted heavy gambling.

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