When Does Gambling Become a Disorder? DSM-5 and ICD-11 Criteria
Liking to gamble and having gambling disorder are different things. The second is a formal diagnosis. DSM-5 lists nine signs and requires at least four within a twelve-month period; ICD-11 describes three core features.
The nine DSM-5 signs
- Needing to gamble with more money to get the same excitement
- Restlessness or irritability when trying to cut down or stop
- Repeated unsuccessful attempts to control, cut back or stop
- Frequent preoccupation with gambling
- Gambling when feeling distressed
- Returning another day to get even after losing money
- Lying to conceal how involved one is
- Jeopardising or losing a relationship, job or educational opportunity
- Relying on others for money to relieve a desperate financial situation
Four or five signs is classed as mild, six or seven as moderate, eight or nine as severe. The American Psychiatric Association explains the diagnosis on its patient information page.
The three ICD-11 features
ICD-11 codes gambling disorder as 6C50 and centres on three things: impaired control over gambling; gambling taking increasing priority over other interests and daily activities; and continuing or escalating despite negative consequences. The pattern is normally evident over at least twelve months. The wording is in the ICD-11 browser.
How to use a list like this
These criteria exist for clinicians. Reading them against your own behaviour is reasonable; reaching a verdict alone is not. The two signals that matter most are wanting to stop and not managing to, and gambling that has started to affect the rest of life. If both are present, it is worth talking to someone without waiting to count four.