Neuropsychological Performance, Impulsivity, and Comorbid Psychiatric Illness in Patients with Pathological Gambling Undergoing Treatment at the CORE Inpatient Treatment Center

Abstract

Pathologic gambling is a disorder with features that implicate abnormal functioning in brain regions involved in addiction, mood, anxiety, and impulse control disorders. Our goal was to examine brain function with neurocognitive tasks that target these brain regions in patients with pathologic gambling. Patients were evaluated for comorbid psychiatric disorders, impulsivity, and performance on reversal-learning and reward-based decision-making cognitive tasks. Patients had higher impulsivity scores and significant deficits on both cognitive tasks compared with controls. All subjects also had comorbid psychiatric disorders, including mood, anxiety, psychotic, and substance abuse. The cognitive deficits and impulsivity are consistent with abnormal activity in orbitofrontal-limbic networks. The high level of comorbidity is consistent with the overall severity in these inpatients undergoing treatment, and adds weight to the concept of a fundamental abnormality in this network.