Diagnosing Gambling Addiction: Complex History, Clearer Today

Key Points 

• The DSM-5 and ICD-11 are two diagnostic tools used by professionals to diagnose mental health disorders, including gambling addiction. 

• Diagnostic tools help identify and classify disorders, along with guiding treatment plans.

• Gambling addiction treatment methods can be dependent on diagnosis and severity.

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Gambling has been around in the United States since the early 16th century, brought over from European colonists. Gambling has gone through multiple periods when it was banned in one form or another, but it seems to have always made a comeback. 

Today, gambling products are more accessible than ever before, and cases of gambling addiction have risen at alarming rates in recent years. The ways gambling addiction is diagnosed have also evolved, impacting how it is identified and treated in the medical community. Making updates to diagnostic criteria is an important part of comprehensive treatment and potential insurance reimbursement. 

How Gambling Addiction is diagnosed today

Gambling addiction can be diagnosed by a medical and clinical professional who assesses an individual for certain criteria that occur during a specific timeframe. The Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) and the International Classification of Diseases, Eleventh Revision (ICD-11) are two tools used to identify, classify and code diagnoses so that appropriate treatment can be administered.

DSM-5

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is used as a diagnostic manual by mental health professionals (both medical and clinical). It was published initially in 2013, but an update called the “DSM-5-TR” (TR = Text Revision) was released in 2022. 

This tool helps develop treatment plans and is also used for insurance billing purposes. The American Psychiatric Association (APA) is responsible for editing and reviewing updates to the DSM.  The DSM-5 diagnostic code for Gambling Disorder is F63.0. The criteria for a diagnosis of gambling disorder in the DSM-5 is a minimum of four of the following symptoms that are recurrent for a period of 12 months:

These behaviors can be classified as episodic or persistent and fall into one of three categories of mild, moderate or severe, depending on the number exhibited, as shown above.  

ICD-11

The ICD-11 was designed by the World Health Organization (WHO) and is a medical classification coding tool that is primarily used by physicians and clinicians when diagnosing conditions. In the ICD-11, Gambling Disorder is coded “6C50” with the following variations: 

• Gambling disorder, predominantly offline  (6C50.0)

• Gambling disorder, predominantly online  (6C50.1)

• Gambling disorder, unspecified  (6C50.Z)

Gambling disorder and gaming disorder (ICD-11 code 6C51) are both classified under "disorders due to addictive behaviors" in the ICD-11. Their inclusion supports clinical recognition, research and public health interventions for individuals affected by these conditions.

Diagnosis of gambling disorder in the ICD-11 requires a persistent or recurrent pattern of gambling behavior that is characterized by:

• Impaired control over gambling (difficulty limiting time or money spent)

• Increasing priority given to gambling over other interests and daily activities

• Continuation or escalation of gambling despite negative consequences (e.g., financial, social, occupational, or legal problems)

The gambling behavior must result in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning, and is typically evident over a period of at least 12 months, though a shorter duration may be sufficient if all diagnostic requirements are met and symptoms are severe. 

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History of Gambling Addiction diagnosis 

Gambling has been a part of our society for hundreds of years but has been significantly modernized over the past decade, with technological advancements increasing the accessibility of gambling products by bringing them online. With the widespread legalization of gambling in the United States over the past seven years (both sports betting and casino games), it also makes sense that there has been an increase in the prevalence of gambling addiction, which has required more research into diagnostic criteria and treatment. 

From a diagnostic standpoint, it was not until 1980 that medical and mental health professionals in the United States recognized compulsive gambling as a potential psychiatric disorder. That year, the APA formally recognized pathological gambling as a psychiatric disorder in the DSM-III, classifying it as an impulse control disorder. 

In 1994, the updated DSM-IV did not change its classification of pathological gambling, maintaining it as an impulse control disorder.

In 2013, the fifth revision of the DSM finally included gambling disorder, formerly known as “pathological gambling,” as the first non-substance behavioral addiction in the manual.

Gambling Addiction treatment methods

Standardized criteria for gambling addiction also means that a variety of treatments are available for those suffering with varying severities of gambling disorder. Treatment for gambling addiction can include inpatient rehabilitation facilities, outpatient services, support groups, medication at times or individual therapy. 

Birches Health provides individual and group therapy services virtually for individuals seeking treatment for gambling addiction. Birches has a nationwide team of therapists trained and certified in treating gambling disorder. The online care model helps reduce traditional barriers to specialized treatment, such as distance, travel logistics, availability and cost. 

You can speak with the Birches team at 833-483-3838 or email help@bircheshealth.com to connect. Or if you’re ready for care now and want to book an appointment, simply click here to schedule one right away.