Beyond the assessment score: The clinically useful meaning of withdrawal symptoms in gambling disorder

First published: 10 May 2019 | Last updated: 20 May 2019

Aims   For better understanding of the opaque gambling withdrawal symptoms in the Diagnostic and Statistical Manual diagnosis (DSM), the study provided empirical support for the association between the severity of gambling withdrawal and levels of financial hardship.

Design   35 participants with gambling disorder were recruited from two specialized gambling treatment units. A structured questionnaires study was used to assess the severity of perceived withdrawal and levels of financial hardship study.

Results   Nearly 90% of them experienced financial problem when they tried to quit their gambling; and 64% of them asked for financial help. Consistent with previous studies, majority of the participants (88.2%) experienced withdrawal symptom(s). Psychological symptoms were experienced more compared with somatic symptoms. Despite their significance in DSM, neither restlessness nor irritability was the most perceived symptom. However, feeling miserable and anxiety were severely perceived also. There was a positive correlation between level of financial hardship and withdrawal symptoms (rs = 0.306, p < 0.05). In addition, majority of participants (88% with superstition, 76 % with illusion of control) showed signs of distortion on gambling which may maintain persistent gambling.

Conclusion   Little is known on the essential features of gambling withdrawal.The findings suggest that financial hardship may contribute to the severity of the gambling withdrawal. Moreover, not limited to restlessness and irritability in DSM, both feeling miserable and anxiety are the potential signs of gambling withdrawal. The present study proposes further investigations to address the issue of specificity of gambling withdrawal that should be more efficacious and precise.


Dr. Alyson Bond Senior Lecturer, Institute of Pyshciatry, King’s College London

Conflicts of interest:

No conflict of interest

Mr Lawrence Lee