Charles Dickens’ The Old Curiosity Shop (1841) offers a moving and psychologically insightful portrayal of gambling disorder, long before the condition was formally recognised in medical literature. The unnamed grandfather of 13-year-old Nell Trent (Little Nell) is the proprietor of the eponymous establishment. He is a well-meaning guardian whose single-minded desire to secure his granddaughter’s future draws him into uncontrollable gambling, with devastating consequences.

His descent into the unpleasant world of gambling is fuelled neither by pleasure-seeking nor risk-taking. Instead, it is driven by a misplaced belief that an inevitable and imminent financial windfall will rescue them from poverty. As his struggles intensify, the narrative captures with striking precision the hallmarks of gambling disorder as we understand them today.

He demonstrates loss of control, gambles obsessively at night and hides his activities (at least initially) from Nell. As the disorder progresses, he neglects essential routines and responsibilities. He borrows money from unscrupulous sources, notably the sadistic Daniel Quilp, one of Dickens’ most notorious villains, and gambles irresistibly in spite of repeated losses. His behaviour is marked by ‘loss-chasing’, and he repeatedly convinces himself that his penury would be overturned by a single stroke of long-overdue luck, a classic cognitive distortion seen in gambling disorder.

The impact on Nell is profound, and, in an unfortunate instance of role reversal, she has to assume responsibilities far beyond her years, acting as his carer and protector. She endures increasing social instability and deprivation while trying to manage her grandfather’s craving. At her behest, they escape from London and wander through the English countryside, losing all former sources of community support. Nell’s premature death, from sheer exhaustion and cumulative neglect, highlights the tragic intergenerational toll of behavioural addictions, as with other mental illnesses.

Dickens, writing in the early Victorian era, is remarkably prescient in his depiction of pathological gambling not as a moral failing but as an unrestrained pattern of behaviour rooted in psychological vulnerability and false hope. The grandfather is portrayed with empathy but not granted absolution.

For psychiatrists, this character offers a compelling literary case study. It illustrates how gambling disorder may present in older adults, be motivated by protective or altruistic intentions and yet lead to severe relational, psychological and physical harm. The grandfather’s secrecy and lack of insight mirror the key obstacles faced by clinicians even today in identifying and managing this condition. This heart-rending story, within a larger one, underscores the clinical, ethical and societal challenges in addressing such problems, particularly, as in this case, far greater harm befalls the carer than the affected individual.