Problem gambling and obsessive-compulsive behaviors share genetic as well as behavioral links, according to a study by researchers at Yale, Veterans Affairs Medical Center and the Saint Louis University School of Medicine. These findings may help guide not only treatment development efforts but also identify biological measures underlying the conditions.

Physiological and behavioral similarities between problem gambling and substance abuse have long been noted, but gambling’s ties to obsessive-compulsive disorder are less well established.

A new study of twins, published Feb. 11 in JAMA Psychiatry, sheds new light on the relationship between problem gambling and obsessive-compulsive behaviors. The study finds that individuals with severe obsessive-compulsive behaviors — or those who demonstrate specific forms of the behavior, such as fear of germs or desire for order in the environment — are also more likely to meet diagnostic criteria for gambling disorder.

“This overlap between problem gambling and obsessive-compulsive behaviors appears to be genetic in nature,” said Dr. Marc Potenza, professor of psychiatry, child study, and neurobiology, and senior author of the study. “This common biological basis of the disorders could help inform treatment development efforts for individuals with co-occurring gambling problems and obsessive-compulsive behaviors.”

Potenza notes that the field of psychiatry has struggled with how best to classify gambling disorders. In the older diagnostic guidelines for doctors, pathological gambling was classified as an impulse control disorder, but in current guidelines, gambling disorder is classified as an addiction.

“I think the current evidence in conjunction with previously published data suggests that gambling disorder shares similarities with both addictions and obsessive-compulsive behaviors,” Potenza said.

The study was funded by the Department of Veterans Affairs Health Services Research and Development Service, the National Institute of Mental Health, and a Yale Center of Excellence in Gambling Research grant from the National Center for Responsible Gaming.

Jeffrey F. Scherrer of Veterans Affairs Medical Center at St. Louis University is first author of the study.

(Photo illustration by Michael S. Helfenbein)