In ICD-11, the World Health Organization’s global disease classification, gambling disorder has the code 6C50. It sits in a group called “disorders due to addictive behaviours”. That is the change. ICD-10, the version most health systems used before, called the same condition “pathological gambling” and coded it F63.0, and it had no group for addictive behaviours at all. So the name changed, the code changed, and the company the diagnosis keeps changed.
ICD-11 was adopted by the World Health Assembly in 2019 and came into effect on 1 January 2022. This page explains what the ICD-11 gambling disorder entry says, what it replaced, why the World Health Organization (WHO) made the move, and what the code does not mean.
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 ICD-11 gambling disorder entry says
WHO’s gambling fact sheet sets out three things that mark the disorder:
- “impaired control over gambling”
- “increasing priority given to gambling, taking precedence over other life interests and daily activities”
- “continuation of gambling despite negative consequences”
The Lancet Public Health Commission on gambling (2024), whose authors include a WHO staff member, quotes the ICD-11 wording more fully. Impaired control covers when gambling starts, how often it happens, how intense it is, how long it lasts, when it stops and where it happens. The pattern can be continuous, or it can come and go. And it has to cause real distress, or real damage to personal, family, social, educational or working life.
Two details matter here. First, ICD-11 describes a pattern rather than a checklist: there is no number of symptoms to count. Second, the diagnosis is about a sustained pattern, not one bad weekend. WHO’s full clinical requirements, including how long the pattern should normally have been going on, are in the manual it published in March 2024, Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders. Gambling disorder appears on page 506 of that manual, according to the record held by Ireland’s Health Research Board library.
Only a trained clinician can make this diagnosis. If you want the plain-language version of what the condition looks like day to day, read gambling addiction explained.
What changed from ICD-10
| ICD-10 | ICD-11 | |
|---|---|---|
| Name | Pathological gambling | Gambling disorder |
| Code | F63.0 | 6C50 |
| Grouped with | No category for behavioural addictions existed | Disorders due to addictive behaviours, alongside gaming disorder |
| A separate, non-disorder code | Plain “gambling” indexed at Z72.6 | QE21, hazardous gambling or betting |
| Status | Being phased out | Adopted 2019, in force since 1 January 2022 |
The grouping is the real news. In ICD-10 and in the DSM-IV, “a diagnostic category for non-substance-related behavioural (or process) addictions did not exist”, as a 2017 review in European Psychiatry put it. Gambling had to be filed somewhere else. ICD-11 created the category, and put gambling disorder and gaming disorder in it.
Why WHO moved it
The short answer: the evidence came to look more like addiction than like a one-off impulse problem.
The American Psychiatric Association moved first. In 2013 the DSM-5 took gambling out of the chapter on impulse-control disorders — it “was reclassified from the ‘Impulse Control Disorders Not Elsewhere Classified’ category”, as a 2023 editorial in Frontiers in Psychiatry describes it — and placed it with substance-related and addictive disorders. ICD-11 then did something similar, and the same editorial notes that in ICD-11 “both gaming disorder and gambling disorder were classified in the ‘Disorders due to addictive behaviors’ category”.
WHO’s own fact sheet now describes gambling disorder as classified alongside substance use disorders in both systems. The reasoning is that the behaviour behaves like an addiction: control slips, the activity crowds out everything else, and it carries on even when the costs are plain. That is not a claim that gambling is chemically identical to a drug. It is a claim about the shape of the problem and how to treat it.
WHO is still working on the measuring tools. It has a project to build clinician-administered diagnostic interviews and screeners for gambling and gaming disorder, and says instruments that reflect the ICD-11 guidelines “would be highly useful”. In other words, the classification arrived before the standard questionnaires caught up.
ICD-11 also names gambling that is not a disorder
This is the part most summaries skip. ICD-11 has a second gambling entry, QE21, hazardous gambling or betting, listed on page 516 of WHO’s clinical manual. It is not a mental disorder. The Lancet Commission describes it as “a pattern of gambling that appreciably increases the risk of harmful physical or mental health consequences” — something a health professional should notice and advise on, even when no diagnosis fits.
That second entry matters because most gambling harm is not sitting inside the diagnosis. WHO’s fact sheet states plainly that “gambling harm also occurs well below clinical thresholds”, and the Lancet Commission found that “a substantial proportion of harm is suffered by those individuals who fall below the threshold” for a disorder.
Numbers on how common the disorder is should be read with care. WHO’s 2024 fact sheet says estimates suggest 1.2% of the world’s adult population has a gambling disorder, while noting on the same page that standardised global estimation has been limited. The Lancet Commission reports that estimates of disordered gambling “vary across regional studies”, from 0.1% to 5.8%, because different countries use different surveys, different instruments and different ways of asking. Our page on why gambling prevalence surveys disagree explains how much of that gap is method rather than behaviour.
ICD-11 and the DSM-5 side by side
Clinicians in Europe and much of the world code with ICD. In the United States, and in most published research, the DSM-5 is the reference. They agree on the big move and differ on the mechanics.
| ICD-11 (WHO) | DSM-5 (American Psychiatric Association) | |
|---|---|---|
| Name and code | Gambling disorder, 6C50 | Gambling disorder, 312.31 |
| How it is defined | Three features describing a pattern | Nine criteria, counted |
| Threshold | No symptom count given | “four (or more) of the following in a 12-month period” |
| Main exclusion | Clinical judgement | “The gambling behavior is not better explained by a manic episode” |
| Non-disorder companion code | QE21 hazardous gambling or betting | None |
The DSM-5 wording above is taken from the criteria published by the Washington State Health Care Authority. We go through each of the nine in the 9 DSM-5 criteria for gambling disorder, and compare both systems with the screening questionnaires in what is problem gambling.
A questionnaire score is not a diagnosis
Most figures you read about “problem gambling” come from a screening questionnaire filled in by people at home, not from a clinical assessment. The most common one is the Problem Gambling Severity Index (PGSI). Britain’s Gambling Commission, which runs the survey that uses it, says the PGSI “was specifically developed for use among the general population rather than within a clinical context”, and that as with any screening instrument there are caveats to keep in mind.
Its guidance on using those statistics is blunter still. The figures should not be used “as a measure of addiction to gambling”, and “the PGSI should not be confused with a measure of gambling addiction”. The same guidance warns against using them “to provide direct comparisons with results from other gambling or health surveys”, “because differences in survey design, methodology, and sampling can lead to misleading comparisons”.
So what is a PGSI score good for?
It is a flag, not a verdict. A high score is a reason to talk to someone, and the Gambling Commission notes that follow-up studies find some people with low or moderate scores go on to develop problems and some do not. Only an assessment by a clinician produces an ICD-11 or DSM-5 diagnosis.
Why a code matters at all
A classification code can feel like paperwork. It is not. WHO describes ICD as the basis for “the systematic recording, analysis, interpretation and comparison of mortality and morbidity data” between countries and over time, and says that “clinical terms coded with ICD are the main basis for health recording and statistics on disease”. It also underpins “decision support, resource allocation, reimbursement, guidelines and more”.
So where a condition sits decides a lot of practical things: whether a health system counts it, which service is expected to treat it, how research is grouped, and in some countries whether treatment is funded. Moving gambling in with the addictions makes the case for addiction services treating it, instead of nobody owning it.
The switch is still in progress. WHO reported in May 2024 that 132 member states and areas were “at various phases of implementing the new classification system”, with 14 having begun collecting or reporting data using ICD-11 codes. So you may still meet F63.0 on an older record, and ICD-10 codes are still in daily use in many places.
What ICD-11 does not say
- It does not say gambling is a disease you either have or do not have. QE21 exists precisely because risk and harm run along a range.
- It does not turn survey percentages into counts of “addicts”. The screening questionnaires those percentages come from were not built to do that.
- It does not say a person needs a diagnosis before they deserve help. Support services, blocking tools and self-exclusion are open to anyone who wants them.
- It does not replace clinical judgement. The code is a label for something a clinician has assessed.
If you recognise yourself in this
You do not need a code, a score or a label to ask for help, and you do not have to decide first whether what you have “counts”. Our step-by-step guide to getting help sets out the order most people find useful: stop the money moving, block access, then talk to someone trained. A doctor can refer you for an assessment if you want one.
If you are worried about someone else, the same guide covers that. And if you want the wider context for how gambling is meant to be made safer, start with what is responsible gambling.
Last reviewed: 13 October 2026. Sources checked on this date.