Late-onset pathological gambling: Clinical correlates and gender differences

• Published in: Journal of psychiatric research Vol. 43; no. 4; pp. 380 - 387
• Main Authors: Grant, Jon E, Kim, Suck Won, Odlaug, Brian L, Buchanan, Stephanie N, Potenza, Marc N
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.01.2009; Elsevier
• Subjects: Addiction; Adult; Adult and adolescent clinical studies; Age; Age differences; Age Factors; Age of Onset; Aged; Anxiety Disorders - psychology; Bankruptcy; Biological and medical sciences; Chi-Square Distribution; Diagnostic and Statistical Manual of Mental Disorders; Family Characteristics - ethnology; Female; Gambling - psychology; Gender differences; Humans; Impulse control disorders; Male; Medical sciences; Middle Aged; Miscellaneous; Onset; Outpatients; Pathological gambling; Psychiatric disorders; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk Factors; Sex Factors; Socioeconomic Factors; Young Adult; Pathological gambling; Addiction; Impulse control disorders; Age; Onset; Human; Late; Impulse control disorder; Sex; Clinical form; Age of onset; Young adult; Adult; Elderly; Comparative study
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2008.04.005

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.