Abstract
The risk for suicidal behaviors including suicide ideations and attempts among individuals with gambling disorder (IWGDs) is high compared to the general population. Little is known about the interplay of mood disorders, alcohol use disorders, and suicidal behaviors among IWGDs. The study aimed to determine the prevalence, sociodemographic characteristics, risky behaviors, mental health disorders, and alcohol use disorders associated with suicide behaviors among IWGDs. Studies published between January 1 1995 and September 1 2022 were obtained from following databases: PubMed, Scopus, Web of Science and Cochrane Library databases. PECOS (population, exposures, comparison, outcome, and study design) criteria were used for selecting studies. The Newcastle–Ottawa Scale (NOS) was used for assessing risk of bias and rated each study in terms of exposure, outcome, and comparability. After initial assessment of 10,243 papers, a total of 39 studies met the eligibility criteria. Among IWGDs, the findings indicated a life-time pooled prevalence rate of 31% for suicide ideations (95% CI, 23–39%), 17% for suicide plans (95% CI, 0–34%), and 16% for suicide attempts (95% CI, 12–20%). Generally, suicide ideations among IWGDs were associated with having any financial debt and having chronic physical illnesses, as well as experiencing depression, mood disorders, and alcohol use disorders. Suicide attempts among IWGDs were associated with being older and having a childhood history of sexual abuse, as well as experiencing depression, mood disorders and alcohol use disorders. Interventions can help to facilitate seeking support among IWGDs by de-stigmatizing mental health disorders as well as improving the quality of care presented to individuals with psychiatric conditions.
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Data Availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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BA conceived the study. BA collected all data. BA and RM analyzed and interpreted the data. BA and EA drafted the manuscript. MDG and BA contributed to the revised paper and were responsible for all final editing. All authors commented on the drafts of the manuscript and approved the final copy of the paper for submission.
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The authors declare that there are no conflicts of interest except MDG. MDG has received research funding from Norsk Tipping (the gambling operator owned by the Norwegian government). MDG has received funding for a number of research projects in the area of gambling education for young people, social responsibility in gambling and gambling treatment from GambleAware (formerly the Responsibility in Gambling Trust), a charitable body which funds its research program based on donations from the gambling industry. MDG undertakes consultancy for various gambling companies in the area of social responsibility in gambling.
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This study was an analysis of pre-existing literature and did not use human participants.
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Supplementary Information
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Supplementary File 4. Baujat plot for pooled prevalence ratio of suicidal ideation among individuals with gambling disorders. Effects on the right part indicated studies contribute much to the heterogeneit
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Supplementary File 5. Pooled prevalence ratio of suicidal ideation after removing Mallorquí−Bagué et al., 2018 (study that had the most contribution of heterogeneity)
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Supplementary File 6. Baujat plot for pooled prevalence ratio of suicide attempts among individuals with gambling disorders. Effects on the right part indicated studies contribute much to the heterogeneity
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Supplementary File 7. Pooled prevalence ratio of suicide attempts after removing Newman & Thampson, 2007 (study that had the most contribution of heterogeneity)
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Supplementary File 8. Baujat plot for having chronic physical illnesses associated with suicidal ideation. Effects on the right part indicated studies contribute much to the heterogeneity
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Supplementary File 9. Pooled odds ratio of having chronic physical illnesses associated with suicidal ideation after removing Manning et al., 2015 (study that had the most contribution of heterogeneity)
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Supplementary File 10. Baujat plot for having depression associated with suicidal ideation. Effects on the right part indicated studies contribute much to the heterogeneity
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Supplementary File 11. Pooled odds ratio of having depression associated with suicidal ideation after removing Nower et al., 2004 (study that had the most contribution of heterogeneity)
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Supplementary File 12. Baujat plot for having chronic depression associated with suicide attempts. Effects on the right part indicated studies contribute much to the heterogeneity
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Supplementary File 13. Pooled odds ratio of having depression associated with suicide attempts after removing Wardle., 2020 and Newman & Thampson, 2003 (studies that had the most contribution of heterogeneity)
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Supplementary File 14. Baujat plot for having mood disorders associated with suicide attempts. Effects on the right part indicated studies contribute much to the heterogeneity
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Supplementary File 15. Pooled odds ratio of having mood disorders associated with suicide attempts after removing Bischof et al., 2015 and Bischof et al., 2016 (studies that had the most contribution of heterogeneity)
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Supplementary File 16. Baujat plot for having alcohol use disorders associated with suicidal ideation. Effects on the right part indicated studies contribute much to the heterogeneity
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Supplementary File 17. Pooled odds ratio of having alcohol use disorders associated with suicidal ideation after removing Slutske et al., 2022 (study that had the most contribution of heterogeneity)
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Supplementary File 18. Baujat plot for having alcohol use disorders associated with suicide attempts. Effects on the right part indicated studies contribute much to the heterogeneity
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Supplementary File 19. Pooled odds ratio of having alcohol use disorders associated with suicide attempts after removing Newman & Thampson, 2003 (study that had the most contribution of heterogeneity)
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Supplementary File 20. Subgroup analysis based on random-effect models for pooled prevalence of suicidal ideation and suicide attempts among individuals with gambling disorders
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Armoon, B., Griffiths, M.D., Mohammadi, R. et al. Suicidal Behaviors and Associated Factors Among Individuals with Gambling Disorders: A Meta-Analysis. J Gambl Stud 39, 751–777 (2023). https://doi.org/10.1007/s10899-023-10188-0
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DOI: https://doi.org/10.1007/s10899-023-10188-0