The Association Between Problem Gambling and Suicidal Ideations and Attempts: A Case Control Study in the General Swedish Population

Kristina Sundqvist,Peter Wennberg

doi:10.1007/s10899-020-09996-5

Kristina Sundqvist, Peter Wennberg

Open Access

https://doi.org/10.1007/s10899-020-09996-5

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Abstract

The association between problem gambling and suicidal behaviours is well established in treatment seeking populations, but less explored among sub-clinical problem gamblers in the general population. The aim of this study was to examine the association between problem gambling (including moderate risk gambling) and suicidal ideations/suicide attempts, in the general Swedish population. Another aim was to compare problem gamblers with and without suicide ideation/attempts. A case-control study nested in the Swelogs cohort was used. Both ideations and attempts were about twice as frequent among the cases compared to the controls. After controlling for socio-economic status and life-time mental health problems, suicidal ideation, but not attempts, remained significantly higher among the cases compared to the controls. The largest difference between attempters and non-attempters were on payment defaults and illicit drug abuse, whereas depression yielded the largest difference between ideators and non-ideators. Problem gambling severity (PGSI 8+) resulted in the smallest difference, compared to the other variables, between attempters and non-attempters. Even though no conclusion regarding the casual relationship can be drawn in this type of study, it seems like sub-clinical levels of problem gambling might have an impact on suicidal ideations whereas for suicide attempts to occur, other factors need to be present. In addition to mental health issues, financial difficulties may be such factors.

Highlights

Gambling is a leisure activity that can progress and have severe consequences
When comparing cases with and without suicide attempts/ideations, the largest difference between attempters and non-attempters were on payment defaults and illicit drug abuse, whereas depression yielded the largest difference between ideators and non-ideators
The finding that even sub-clinical levels of problematic gambling seem to increase the risk of suicidal ideations is important information that ads to the existing literature. This fact, that the groups of predominantly subclinical gamblers in this study showed an increased risk of suicidal ideations emphasize that risk gambling and problem gambling that does not fulfill the requisites for a diagnosis deserves special attention from a preventive perspective

Summary

Introduction

Gambling is a leisure activity that can progress and have severe consequences. Journal of Gambling Studies (Williams et al 2012). Problematic gambling has been associated with other psychiatric conditions, criminality and even suicide (Lorains et al 2011). There are several terms for excessive gambling behavior. In the Diagnostic and Statistical Manual of Mental Disorders, ‘gambling disorder’ is used to describe severe gambling problems (5th ed; DSM-5; American Psychiatric Association 2013). The broader term problem gambling, used in this study, is often used to include those that do not fill the criteria’s for a diagnosis but still suffer significant consequences from their gambling (Blaszczynski and Nower 2002). Recent developments in suicide theory and research have proposed the ‘ideation-toaction framework’, which suggests that the development of suicidal ideation and the progression from ideation to suicide attempts are distinct phenomena with diverse etiology (Klonsky et al 2016)

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