Do pathologic gambling and schizophrenia relate? A case report

Pathologic gambling is the recurring and maladaptive behaviour of gambling which results in negative consequences on a personal, familiar, social, and work level. It has been associated with a variety of psychiatric disorders, such as mood and anxiety disorders, as well as with substance use disorders. Its association with schizophrenia is also common but it is frequently dismissed, even though it is a potential stress factor for psychotic relapse. We present a clinical case of a 31-year-old schizophrenic male patient with pathologic gambling, which started after the onset of schizophrenia. We aim to approach the biological association between these two entities, in order to provide adequate treatment for these patients. The clinical information was obtained by interviewing the patient, his family and by reviewing past medical records. A brief literature review using PubMed and NCBI was performed, with the keywords 'schizophrenia'; 'pathologic gambling' and 'gambling addiction'. We include data from 4 case reports, 8 original articles and 2 literature reviews. Even though the various articles and case reports point towards an association between schizophrenia, there is not a clear common etiopathogenesis. Some schizophrenic symptom profiles seem to be more related to pathological gambling. Overlapping neurobiological pathways can be hypothesised, involving serotonin, dopamine, and glutamate pathways. There is clinically reported evidence supporting cognitive-behavioural intervention. Further studies are required to provide a structured and effective treatment to these patients.