Suicidal Ideation and Suicide Attempts in Treatment-Seeking Pathological Gamblers

Abstract

This study assessed rates and correlates of suicidal ideation and suicide attempts in individuals seeking treatment for pathological gambling. At intake to gambling treatment programs, 342 pathological gamblers completed the Addiction Severity Index and the South Oaks Gambling Screen. Participants were categorized into three groups: no suicidal ideation (N = 175, 51%), suicidal ideation alone (N = 109, 32%), and suicide attempters (N = 58, 17%). After controlling for gender, age, treatment site, and substance abuse treatment histories, differences among the groups emerged in terms of severity of psychiatric, social/family, and gambling problems. Compared with nonsuicidal gamblers, those with suicidal ideation suffered from more psychiatric symptoms, were less satisfied with their living situations, and experienced more days of conflict in the month before entering gambling treatment. Compared with pathological gamblers with no history of suicidal ideation, those with suicidal ideation spent more money gambling in the month before entering treatment, reported greater cravings for gambling, and had higher South Oaks Gambling Screen scores. These data confirm other reports of high rates of suicidality in pathological gamblers and may suggest the need for more intensive and focused treatments in pathological gamblers with suicidality.Pathological gambling is characterized by loss of control over gambling, financial debt, family and social difficulties, legal and employment problems, and psychological distress. A meta-analysis of prevalence surveys (Shaffer et al., 1999) indicates that the lifetime prevalence rate of pathological gambling in the adult population is approximately 1.8%.In epidemiological studies, disordered gambling seems to be associated with depression and suicidality. For example, Cunningham-Williams et al. (1998) and Bland et al. (1993) found that disordered gamblers identified in general population surveys were more likely to meet criteria for affective disorders than respondents with no gambling problems. In a survey of college students, Ladouceur et al. (1994) found that 27% of those identified as pathological gamblers had attempted suicide, compared with 7% of students without gambling problems. Phillips et al. (1997) reviewed mortality data between the years 1969 and 1991 from three major gambling areas. Compared with other metropolitan areas, they found elevated rates of suicide among resident and nonresident visitors in these gambling venues.Studies of treatment-seeking pathological gamblers likewise point to a relationship among gambling, depression, and suicide. In studies that used structured diagnostic instruments in (Linden et al., 1986;McCormick et al., 1984;Taber et al., 1987;Ramirez et al., 1983;Roy et al., 1988) rates of major depression ranged from 32% to 76%. Specker et al. (1996) found that gamblers seeking outpatient treatment had much higher rates of major depression (35% current, 70% lifetime) compared with control subjects (5% current, 23% lifetime).High rates of sui...

Response Perseveration and Ventral Prefrontal Sensitivity to Reward and Punishment in Male Problem Gamblers and Smokers

“…It is associated with psychosocial problems (Lejoyeux et al, 2002), criminal offences (Rosenthal and Lorenz, 1992), and sometimes even suicide (Petry and Kiluk, 2002). Although classified as an impulse control disorder (American Psychiatric Association, 1994), PG is often considered a behavioral addiction (Petry, 2006;Potenza, 2006;Tamminga and Nestler, 2006) and shares many clinical characteristics with substance dependence, such as psychiatric comorbidity (Petry et al, 2005), genetic vulnerability (Eisen et al, 2001;Ibanez et al, 2003), and responsiveness to specific pharmacological treatments (Eisen et al, 2001;Grant and Kim, 2006;Hollander et al, 2005b;Ibanez et al, 2003).…”

A Baseline Study of Past-Year Problem Gambling Prevalence Among Ohioans

“…Prevention activities should be directed toward groups that are at greatest risk for problem gambling, including African Americans, unemployed and retired persons, unmarried or widowed persons, persons with low educational attainment, and persons with substance use disorders. The higher rate of depression among at-risk and problem gamblers compared with other groups is concerning, and the rates indirectly support the link between suicidal ideation and gambling (Newman & Thompson, 2003;Petry & Kiluk 2002). Clinicians should screen all persons being treated for gambling disorder for depression and refer them to the appropriate treatment centres as needed.…”

La crise chez les joueurs de jeux de hasard et d’argent : au-delà de l’appel de détresse, les services novateurs qui y répondent

“…En outre, l'étude d'une relation causale entre le jeu et les comportements suicidaires présentent plusieurs défis méthodo-logiques notamment la présence potentielle de facteurs confondants tels la dépression (Wager, 2005). Néanmoins, plusieurs études établissent un lien entre le jeu pathologique et les comportements suicidaires (Frank, Lester et Wexler, 1991 ;Hodgins et coll., 2006 ;Maccallum et Blaszczynski, 2003 Thompson, 2003 ;2007 ;Petry et Kiluk, 2002 ;Phillips, Welty et Smith, 1997). Ainsi, une vaste étude épidémiologique canadienne indique que les tentatives de suicide dans la dernière année sont significativement plus fréquentes chez les joueurs que dans la population géné-rale (Newman et Thompson, 2007).…”

“…Bien qu'il soit impossible d'établir avec précision si ce sont les problèmes de jeu qui ont précipité les tentatives de suicide, les joueurs présenteraient 3 à 4 fois plus de risque de faire une tentative de suicide que la population générale (Newman et Thompson, 2007). De même, chez les joueurs en traitement, il n'est pas rare d'observer une très forte prévalence d'idéations suicidaires (35 %-81 %) et de tentatives suicidaires (4 %-40 %) (Battersby et coll., 2006 ;Beaudoin et Cox, 1999 ;Kausch, 2003 ;Ladouceur et coll., 2004 ;Ledgerwood et Petry, 2004 ;Maccallum et Blaszczynki, 2003 ;Petry et Kiluk, 2002). Ces comportements suicidaires semblent notamment en lien avec la sévérité des problèmes de jeu, la présence de dettes, les problèmes de consommation et la dépression (Battersby et coll., 2006).…”