Byline: Sanju. George, Roy. Kallivayalil, T. Jaisoorya To the best of our knowledge, gambling addiction, does not occupy a place within mainstream Indian Psychiatry or even addiction psychiatry. This is the case in terms of research, strategy, and treatment provision. In our view Indian Psychiatrists, treatment services and mental health policy makers are all partly or wholly responsible for this state of affairs. As further evidence to support the above inference (about the lack of a place for gambling addiction within Indian Psychiatry), albeit a proxy measure, nevertheless "valid" in the absence of any other robust research-generated evidence, we looked at the number of papers on gambling published in the Indian Journal of Psychiatry (IJP). We used the key words "gambling" and "addiction" and searched all the issues of IJP available online. Unsurprisingly, we identified no scientific papers: There have only ever been two literary "pieces." [sup][1],[2] To explore whether gambling addiction is an issue for psychiatrists working in India or if it is a problem exclusive to the Western world, we (George 2012, unpublished) carried out a survey of 121 psychiatrists working in India. The findings of this survey (some of which will be briefly mentioned later) combined with conversations with Indian Psychiatrists have informed this paper. Here, we make the case for a wider debate about the place of gambling addiction within Indian Psychiatry. There has been no systematic research into gambling addiction in India, in terms of its prevalence, prevention or treatment. Given this, it seems a reasonable starting point to extrapolate findings from international research. Most Western countries have gambling addiction prevalence rates between 1% and 2%, respectively. [sup][3] Untreated gambling addiction can result in numerous and wide-ranging negative consequences to the addict, his/her family and the wider society. Ever increasing gambling opportunities and easier access (lotteries, gambling on the internet, etc.), and relaxed legislation can result in an increase in gambling problems and gambling-related harm, especially affecting the most vulnerable in society. This is, especially important for an emerging economy like India. In addition to those who already have a gambling problem, not to be forgotten are those who are "at risk" of developing gambling problems in the future: A national survey of the general population in Britain [sup][4] found that of those who engage in gambling activities 7.3% were "at risk." So far shrouded in nosological ambiguity, Diagnostic and Statistical Manual of Mental Disorders V (DSM V) has included "gambling disorder" in the section on addictive disorders [sup][5] alongside other substance addictions (the criterion which relates to "committing illegal acts to gamble such as forgery, fraud, theft or embezzlement" has been deleted as this on its own is rarely endorsed when other criteria are not fulfilled. The deletion of this criterion would mean that in DSM V, a diagnosis of disordered gambling can be made if four of the nine (as opposed to 5 out of 10) criteria are met). This move will help confer gambling addiction with the status of a valid psychiatric disorder and as an addictive disorder. Although there are no population prevalence studies of gambling in India, there is no doubt that Indian people gamble. Here we wish to emphasize that the vast majority of people who gamble do so without problems, and for most it remains merely a leisure activity. In terms of the size of the gambling industry (legal and illegal) in India, a precise picture is lacking. We use Kerala (a state hosting 30 million of India's 1.2 billion people) as an example, purely for the reason that accessing relevant statistics was easy. The Kerala state-run lottery (the most easily available and the most commonly engaged in gambling activity in the state) was set up in 1967, currently has "more than 35,000 authorized agents and over 100,000 retail sellers" (http://www. …