Gambling Disorder 589
Functional Consequences  of Gambling Disorder
Areas of psychosocial, health, and mental heal th functioning may be adversely affected by
gambling disorder. Specifically, individuals with  gambling disorder may, because of their
involvement with gambling, jeopardize or lo se important relationships with family mem-
bers or friends. Such problems may occur from repeatedly lying to others to cover up the
extent of gambling or from requesting money that is used for gambling or to pay off gam-
bling debts. Employment or educational activities may likewise be adversely impacted by
gambling disorder; absenteeism or poor work or school performance can occur with gam-
bling disorder, as individuals may gamble duri ng work or school h ours or be preoccupied
with gambling or its adverse co nsequence when they should be working or studying. In-
dividuals with gambling disorder  have poor general health and utilize medical services at
high rates. 
Differential Diagnosis
Nondisordered gambling. Gambling disorder must be distinguished from professional
and social gambling. In professional gambling , risks are limited and discipline is central.
Social gambling typically occurs with friends or colleagues and lasts for a limited period of
time, with acceptable losses. Some individu als can experience problems associated with
gambling (e.g., short-term chasin g behavior and loss of control) that do not meet the full
criteria for gambling disorder. 
Manic episode. Loss of judgment and excessive gambling may occur during a manic ep-
isode. An additional diagnosis of gambling d isorder should be given only if the gambling
behavior is not better explained by manic ep isodes (e.g., a histor y of maladaptive gam-
bling behavior at times other than during a manic episode). Alternatively, an individual
with gambling disorder may, during a period of gambling, exhibit behavior that resembles