Gambling Disorder in the DSM-5: Opportunities to Improve Diagnosis and Treatment Especially in Substance Use and Homeless Populations.

In the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), gambling disorder (GD) underwent several changes. This paper reviews recent research related to the revisions, including the elimination of the illegal acts criterion and the newly lowered diagnostic threshold. These studies suggest the removal of the illegal acts criterion has little impact in terms of prevalence or loss of diagnostic status among gamblers, especially when considered in combination with the newly lowered diagnostic threshold. Overall prevalence rates will increase modestly with the lowered threshold in community samples of gamblers. However, increases in GD prevalence rates may be more notable in settings that serve individuals at higher risk for gambling problems (e.g., substance abuse treatment clinics and homeless persons). GD is now aligned more closely with substance use addictions in DSM-5. This re-categorization, along with the lower threshold for diagnosis under DSM-5 diagnostic criteria, may lead to increased recognition of gambling problems, particularly in settings that serve high risk populations. These changes also may necessitate the training of more clinicians in the delivery of efficacious gambling treatments.