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The Impact of Comorbidity on the Management of Pathological Gambling

Published online by Cambridge University Press:  07 November 2014

Abstract

A 30-year-old woman with severe pathological gambling and cyclothymia presented to our program with no previous history of pharmacologic or psychotherapeutic treatment. Pathological gambling is an impulse-control disorder not otherwise specified (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) in which comorbidity is common, particularly with substance abuse, obsessive-compulsive disorder and mood disorders. As described in this case, pathological gamblers with bipolar comorbidity may be effectively treated with mood stabilizers such as lithium. After receiving 10 weeks of lithium treatment, the patient showed improvement in both gambling behavior and affective instability. The identification of specific subtypes among patients with pathological gambling may be relevant to the choice of pharmacologic treatment.

Type
Case Report
Copyright
Copyright © Cambridge University Press 2005

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References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text rev. Washington, DC: American Psychiatric Association; 2000.Google Scholar
2.Shaffer, HJ, Hall, MN, Vander Bilt, J. Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis. Am J Public Health. 1999;89:13691376.Google Scholar
3.Hollander, E, Buchalter, AJ, DeCaria, CM. Pathological gambling. Psychiatr Clin North Am. 2000;23:629642.CrossRefGoogle ScholarPubMed
4.National Research Council. Pathological Gambling: A Critical Review. Washington, DC: National Academy Press; 1999.Google Scholar
5.Hollander, E, Frenkel, M, Decaria, C, Trungold, S, Stein, DJ. Treatment of pathological gambling with clomipramine. Am J Psychiatry. 1992;149:710711.Google ScholarPubMed
6.Hollander, E, DeCaria, CM, Mari, E, et al.Short-term single-blind fluvoxamine treatment of pathological gambling. Am J Psychiatry. 1998;155:17811783.Google Scholar
7.Hollander, E, DeCaria, CM, Finkell, JN, Begaz, T, Wong, CM, Cartwright, C. A randomized double-blind fluvoxamine/placebo crossover trial in pathological gambling. Biol Psychiatry. 2000;47:813817.Google Scholar
8.Zimmerman, M, Breen, RB, Posternak, MA. An open-label study of citalopram in the treatment of pathological gambling. J Clin Psychiatry. 2002;63:4448.CrossRefGoogle ScholarPubMed
9.Kim, SW, Grant, JE, Adson, DE, et al.A double-blind placebo-controlled study of the efficacy and safety of paroxetine in the treatment of pathological gambling. J Clin Psychiatry. 2002;63:501507.Google Scholar
10.Blanco, C, Petkova, E, Ibanez, A, Saiz-Ruiz, J. A pilot placebo-controlled study of fluvoxamine for pathological gambling. Ann Clin Psychiatry. 2002;14:915.CrossRefGoogle ScholarPubMed
11.DeCaria, CM, Hollander, E, Begaz, T, et al.Reliability and validity of a pathological gambling modification of the Yale-Brown Obsessive-Compulsive Scale (PGYBOCS): preliminary findings. In: Proceedings of the 12th National Conference on Problem Gambling. Washington, DC: National Council on Problem Gambling; 1998.Google Scholar
12.Guy, W, ed. ECDEU Assessment Manual of Psychopharmacology. Washington, DC; US Department of Health, Education, and Welfare; 1976:218222. Publication ADM 76-338.Google Scholar
13.DeCaria, CM, Hollander, E, Grossman, R, Wong, CM, Mosovich, SA, Cherkasky, S. Diagnosis, neurobiology, and treatment of pathological gambling. J Clin Psychiatry. 1996;57:8083.Google ScholarPubMed
14.Linden, RD, Pope, HG, Jonas, JM. Pathological gambling and major affective disorders: preliminary findings. J Clin Psychiatry. 1986;47:201203.Google Scholar
15.Hollander, E. Obsessive-Compulsive Related Disorders. Washington, DC: American Psychiatric Press; 1993.Google Scholar
16.McElroy, SL, Pope, HG Jr, Keck, PE Jr, Hudson, JI, Phillips, KA, Strakowski, SM. Are impulse-control disorders related to bipolar disorders? Compr Psychiatry. 1996;37:229240.CrossRefGoogle Scholar
17.Haller, R, Hinterhuber, H. Treatment of pathological gambling with carbamazepine. Pharmacopsychiatry. 1994;27:129.Google Scholar
18.Pallanti, S, Quercioli, L, Sood, E, Hollander, E. Lithium and valproate treatment of pathological gambling: a randomized single-blind study. J Clin Psychiatry. 2002;63:559564.Google Scholar
19.Hollander, E, Pallanti, S, Allen, A, Sood, E, Baldini Rossi, N. Does sustained-release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders? Am J Psychiatry. 2005;162:137145.CrossRefGoogle ScholarPubMed
20.Winters, KC, Kushner, MG. Treatment issues pertaining to pathological gamblers with a comorbid disorder. J Gambl Stud. 2003;19:261267.CrossRefGoogle ScholarPubMed