The DSM-5 gambling disorder criteria are a list of nine signs that clinicians use to decide whether someone has gambling disorder. A person needs to show four or more of the nine signs within the same 12-month period, and the gambling must not be better explained by a manic episode. The number of criteria met also sets the severity: four to five is mild, six to seven is moderate, eight to nine is severe.
This page explains each of the nine criteria in plain words, what the thresholds mean, what changed from the older DSM-IV list, and why a questionnaire score is not the same thing as a diagnosis. Only a qualified clinician can diagnose gambling disorder. Reading this page cannot tell you whether you have it.
Written from published clinical sources. This article has not been reviewed by a clinician — see our editorial policy. Nothing here is medical advice.
What the DSM-5 is, in one paragraph
The DSM-5 is the diagnostic manual published by the American Psychiatric Association. Clinicians in the United States and many other countries use it to name and describe mental disorders. The current edition is the DSM-5-TR, a text revision published in 2022. The criteria for gambling disorder did not change in that revision. The World Health Organization publishes a separate system, the ICD-11, which is covered further down this page.
The nine DSM-5 gambling disorder criteria
These are the nine items that make up Criterion A. The wording below follows the published criteria as reproduced by state health departments, including the Connecticut Department of Mental Health and Addiction Services and the Washington State Department of Social and Health Services, and as summarised in the US National Library of Medicine’s Bookshelf.
| # | Criterion | What it means in plain words |
|---|---|---|
| 1 | Needs to gamble with increasing amounts of money in order to achieve the desired excitement. | The old stake size stops feeling like anything. Bets have to get bigger to give the same buzz. This is often called tolerance. |
| 2 | Is restless or irritable when attempting to cut down or stop gambling. | Trying to stop makes the person tense, snappy or on edge. |
| 3 | Has made repeated unsuccessful efforts to control, cut back, or stop gambling. | They have tried to stop more than once and it has not held. |
| 4 | Is often preoccupied with gambling. | Their mind keeps going back to gambling: replaying past bets, planning the next one, or working out how to get money to gamble with. |
| 5 | Often gambles when feeling distressed. | Gambling is used to cope with feeling helpless, guilty, anxious or low. |
| 6 | After losing money gambling, often returns another day to get even (“chasing” one’s losses). | Losses are followed by more gambling to win the money back. This is the pattern known as chasing. |
| 7 | Lies to conceal the extent of involvement with gambling. | They hide how much they gamble from family, friends or a therapist. |
| 8 | Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling. | Gambling has cost them something real: a relationship, a job, a course, a chance. |
| 9 | Relies on others to provide money to relieve desperate financial situations caused by gambling. | Other people have to bail them out. |
Notice what is not on the list. There is no amount of money that puts you over a line. There is no number of hours. There is no particular game. The criteria are about loss of control and about harm, not about stake size. That is why two people who gamble very different amounts can meet the same number of criteria.
How many criteria are needed, and the severity bands
Four or more of the nine, within a 12-month period. The count then sets the severity label.
| Criteria met in 12 months | What it indicates |
|---|---|
| 0 to 3 | Does not meet the threshold for a DSM-5 diagnosis. It does not mean no harm is happening. |
| 4 to 5 | Mild gambling disorder |
| 6 to 7 | Moderate gambling disorder |
| 8 to 9 | Severe gambling disorder |
The last row of that table matters. Someone can meet two or three criteria and still be in serious trouble with money, work or family. A great deal of gambling harm sits below the clinical threshold. If gambling is hurting your life, the count is not the point — getting help is.
Criterion B: the manic episode exclusion
Criterion A is the list of nine. Criterion B is a single short rule: “the gambling behavior is not better explained by a manic episode.”
Heavy, impulsive spending and risk-taking can be part of mania in bipolar disorder. If that is what is driving the gambling, the right diagnosis is the mood disorder, not gambling disorder. This is one of several reasons the criteria cannot be self-applied from a web page: sorting out which condition explains which behaviour is clinical work.
Course and remission specifiers
A clinician also records the shape of the problem over time, and whether it has eased.
- Episodic — criteria are met at more than one point in time, with months in between where symptoms ease.
- Persistent — symptoms continue without long gaps, often for years.
- In early remission — no criteria have been met for at least 3 months, but less than 12 months.
- In sustained remission — no criteria have been met for 12 months or longer.
Those remission windows are useful to know if you are in recovery. The manual itself treats three months as early, and a full year as the point where remission is described as sustained.
What changed between DSM-IV and DSM-5
Three changes arrived with DSM-5 in 2013, and they matter when you read older material.
The name and the chapter changed
DSM-IV called it “pathological gambling” and placed it with the impulse-control disorders. DSM-5 renamed it “gambling disorder” and moved it into the chapter on Substance-Related and Addictive Disorders. The American Psychiatric Association’s own fact sheet on that chapter explains why: “This new term and its location in the new manual reflect research findings that gambling disorder is similar to substance-related disorders in clinical expression, brain origin, comorbidity, physiology, and treatment.”
Gambling disorder is the only behaviour, as opposed to a substance, with full diagnostic criteria in that chapter.
The threshold dropped from five to four
DSM-IV required five or more criteria. DSM-5 requires four or more. The side-by-side comparison published by the US Substance Abuse and Mental Health Services Administration sets out both lists and both thresholds.
The illegal acts criterion was removed
DSM-IV had a tenth item about committing illegal acts such as forgery, fraud, theft or embezzlement to finance gambling. DSM-5 dropped it, which is why the list is nine items and not ten. Crime linked to gambling still happens, and still matters, but it is no longer one of the diagnostic signs.
So if you find an older page listing ten criteria with a threshold of five, it is describing DSM-IV. Our glossary of responsible gambling terms keeps the current definitions in one place.
A screening score is not a diagnosis
This is the most common mistake made with the DSM-5 criteria, and it is worth being precise about.
Most national statistics on gambling do not use the DSM-5 criteria at all. They use the Problem Gambling Severity Index (PGSI), a nine-question screening tool answered in a survey. The PGSI produces a score. It does not produce a diagnosis, and the two instruments are not interchangeable. The Gambling Commission’s own guidance on using its statistics lists “as a measure of addiction to gambling” among the ways its survey should not be used, and states plainly that “the PGSI should not be confused with a measure of gambling addiction.”
How the question is asked also changes the answer. Two British surveys illustrate it:
| Survey | Instrument | PGSI 8 or more | How it was collected |
|---|---|---|---|
| Gambling Survey for Great Britain, annual report 2025 | PGSI | 2.4% of adults (95% CI 1.9–2.8) | Push-to-web self-completion, with a postal option |
| Adult Psychiatric Morbidity Survey 2023/24 (England) | PGSI | 0.4% of adults | Self-completed within an in-home interview that an interviewer recruited |
Both figures are correct for what they measure. Neither is a count of people with gambling disorder. The gap is largely methodological: who agrees to take part, and the setting in which the questions are answered, both shift the result. The Gambling Commission says so in the 2025 annual report itself: “Estimates of gambling and its impacts vary substantially depending on survey methodology, with the GSGB typically reporting higher PGSI scores than more traditional face to face surveys.” The APMS 2023/24 gambling chapter reports the 0.4% figure and notes that its own slightly different response options may have very slightly underestimated moderate-risk gambling.
The practical rule: never take a PGSI percentage and describe it as the number of people who are addicted, and never put two survey figures side by side without saying how each was collected. The PGSI bands themselves — 0, 1 to 2, 3 to 7, and 8 or more — are set out in the Commission’s PGSI reporting. We go through the difference between the instruments in more detail in what is problem gambling.
How ICD-11 describes the same condition
Outside the United States, health systems often use the World Health Organization’s ICD-11 instead. WHO lists gambling disorder as code 6C50, under “disorders due to addictive behaviours”.
ICD-11 does not use a count of nine items. The WHO gambling fact sheet, updated on 2 December 2024, sets out three requirements: “1) impaired control over gambling; 2) increasing priority given to gambling, taking precedence over other life interests and daily activities; and 3) continuation of gambling despite negative consequences.”
The two systems describe the same condition from different angles. DSM-5 counts specific signs; ICD-11 describes a pattern. The same WHO fact sheet estimates that 1.2% of the world’s adult population has a gambling disorder, and, citing the Lancet Public Health Commission on gambling, that around 5.5% of women and 11.9% of men globally experience some level of harm from gambling.
Who can actually make the diagnosis
A diagnosis comes from a trained clinician who assesses you in person or in a proper consultation: a psychiatrist, psychologist, or another clinician qualified to use the manual. A website, a quiz and a self-scored checklist cannot do it, and this page is not trying to.
What the criteria are good for, if you are worried about yourself or someone else, is language. Reading them often gives people the words for something they had not been able to describe. That is a reasonable thing to take into a first conversation with a doctor or a helpline adviser.
- Great Britain. The National Gambling Helpline, run by GamCare, is 0808 8020 133 and is free, 24 hours a day, every day of the year. Our page on gambling help in the United Kingdom sets out the routes in order.
- NHS treatment in England. There are specialist NHS gambling services. The National Gambling Clinic takes self-referrals by form, email or on 020 7381 7722, and offers assessment, CBT, psychiatric review and support for family and friends.
- United States. The National Council on Problem Gambling’s national helpline is 1-800-MY-RESET (1-800-697-3738), by call, text or chat. The older number, 1-800-522-4700, still works.
- Anywhere. If you want to put a barrier in place while you wait for an appointment, start with our self-exclusion guide.
Four things people get wrong about these criteria
- “Four criteria means I am a severe case.” Four to five is the mild band. Eight or nine is severe.
- “Three criteria means I am fine.” It means the diagnostic threshold is not met. Harm can be heavy below it.
- “My PGSI score is my diagnosis.” It is not. Different instrument, different purpose.
- “There are ten criteria.” There were, under DSM-IV. The illegal acts item was removed in 2013.
If you want the wider picture — causes, what treatment looks like, and what recovery tends to involve — read gambling addiction explained. For the framework this whole site works within, see what is responsible gambling.
Last reviewed: 4 October 2026. Sources checked on this date.