We are presenting a retrospective study of case series of patients with a DSM IV diagnosis of pathological gambling, treated during 2006 in our institute (n=10; male=9, female=1; mean age=35 years).

The youngest patient (20 years) was addicted to video games, two were addicted to poker machines, three to betting (football) and the rest had variations of a combined addiction (card games, lotto, roulette, poker machines, betting); all subjects were addicted to nicotine. The mean duration of pathological gambling was 11.5 years, with mean onset at 23.4 years of age.

We identified 2 subgroups: early onset subgroup (<18 years); 5 subjects, mean onset at 16.6 years, mean duration 9.5 years; 3 unmarried, 2 divorced subjects; lower education level (1 primary school, 4 secondary school), 1 subject in part-time employment, 3 subjects with poly drug abuse and later onset subgroup (>18 years); 5 subjects, mean onset at 30.2 years and mean duration 13 years; 3 married, 1 divorced, 1single; education level higher (2 secondary school, 2 college); 3 fully employed, 1 in part time employment, 1 retired; 1 subject with comorbid alcohol addiction. The subgroups differed in adherence to treatment, too, with all early onset subjects dropping out from the program after few days, while the late onset subjects adhered for at least several months to up to one year.

Our results suggest that pathological gambling may represent a spectrum disorder with different clinical characteristics and prognosis.