Gambling is a recreational activity with many participants all over the world. However, some people, especially with certain games, loose control over their gambling behavior resulting in serious problems for the person and his or her environment. The problematic nature and the underlying psychopathology is recognized by the fact that pathological gambling is an existing diagnosis in most psychiatric classification systems. In most of these systems, pathological gambling is categorized under the group of impulse control disorders. However, in DSM5, is likely to become one of the addiction and pathological become a gambling addiction.

In this presentation, we discuss the similarities and differences between pathological gambling and substance use disorders in terms of the phenomenology, comorbidity, genetics, temperamental antecedents, neurochemistry, cognitive abnormalities, neurobiological substrates, course and response to psychological and pharmacological treatments. It is concluded that pathological gambling is more similar to substance use disorders than to impulse control disorders and that a move in the classification towards the category of addictions seems to be justified.