Background: To determine the differences in clinical presentation, gambling behavior, and psychiatric comorbidity of male and female treatment-seeking pathological gamblers.

Method: Sixty-nine consecutive individuals with DSM-IV pathological gambling (47 men and 22 women) applying to a specialized outpatient treatment program were evaluated with structured interviews, self-report questionnaires, and psychological scales.

Results: Sixty-seven percent of men (N = 26) versus 25% of women (N = 5) had been exposed to gambling in adolescence. Women had a later age at first bet and a faster evolution of the disorder. Female pathological gamblers were more likely to play bingo, whereas men tended to prefer slot machines. Male and female pathological gamblers had similar gambling severity and overall rates of psychiatric comorbidity. However, male pathological gamblers had higher rates of alcohol abuse/dependence and antisocial personality disorder, whereas women had higher rates of affective disorders and history of physical abuse.

Conclusion: There are substantial gender differences in the clinical presentation and comorbidity of pathological gambling. These gender differences should be incorporated in the selection and planning of treatment for pathological gamblers.

J Clin Psychiatry 2003;64(3):295-301