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Gambling Disorder

A 42-year-old man reports frequent online betting despite financial loss, borrowing money, lying to family, and irritability when trying to stop. He meets ≥5 DSM-5 criteria for gambling disorder. Outline diagnosis and management steps.

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DSM-5 gambling disorder: persistent maladaptive gambling ≥12 months with ≥4 criteria

Monitor for suicidality, relapse, and financial/legal issues

Gamblers Anonymous, financial counseling, family therapy

Consider naltrexone or SSRIs in severe/refractory cases (off-label)

First-line: cognitive behavioral therapy (CBT) and motivational interviewing

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