Men and women, under the age of 25, with problem gambling are at increased risk of trying to take their own lives, a UK study has found.

Data were analysed from 3,549 participants in the Emerging Adults Gambling Survey during 2019.

The survey is a cross-sectional, online, non-probability sample survey aimed at young adults, resident in Great Britain, with an online panel of more than one million members. Invitations to participate in the survey were sent by email from YouGov to a random selection of panel members, aged 16-24 years. Invitations were stratified by region.

The survey included items on gambling, video gaming, social media, and health-related behaviours. Problem gambling was assessed using the Problem Gambling Severity Index (PGSI), with a score ≥ 8 indicating problem gambling.

A total of 85 out of 1,922 (4.3%) female participants and 62 of 1,627 (3.8%) male participants reported attempting suicide in the previous year, with 735 women (38.4%) and 546 men (34.1%) respectively reporting suicidal thoughts in the previous year.

Overall, 730 men (45·5%) and 766 women (39·4%) had gambled in the previous year. The most common forms were scratch cards, 365 women (19·3%) and 297 men (18·8%) and lotteries, 354 women (17·7%) and 275 men (17·4%). Among men, online betting on sports events was the next most prevalent form of gambling, 260 (16·2%), whereas among women, bingo was the next most common form, 142 (7·0%), although 122 women (6·0%) also engaged in online betting. Eighty men (4·9%) and 51 women (2·6%) had PGSI scores indicating problem gambling.

For men, unadjusted regression analysis suggested that problem gambling was not associated with suicidal thoughts, and this relationship was at the margins of significance for women (P = 0·041).

However, there was a strong association between problem gambling and suicide attempts for both men and women.

The unadjusted odds ratio (OR) for attempted suicide for those who had PGSI scores ≥ 8 compared with those who had PGSI scores of 0 to 7 was OR 15·1 (95% CI: 8·2-27·9) in men and OR 8·0 (95% CI: 4·0-16·0) in women.

For both women and men, impulsivity, perceived loneliness, low life satisfaction, and anxiety were all associated with suicide attempts.

However, the strong association between problem gambling and suicide attempts remained when data were fully adjusted for sociodemographic factors, alcohol use, video gaming, anxiety, loneliness, and impulsivity. The adjusted ORs for attempted suicide for those who had PGSI scores  ≥ 8 compared with those who had scores of 0 to 7 were OR 9.0 (95% CI: 4.1-19.7) in men and OR 4.9 (95% CI: 2·0-12·0) in women.

Associations between problem gambling and suicidality have been documented for adults, but few studies have examined any potential association for young adults.

Furthermore, most of these studies were performed before the advent of online betting and gambling became more normalised and easily accessible in the UK.

The study authors conclude: ‘Problem gambling could be a substantial risk factor for suicide attempts among both young men and young women. Though this association might be explained in part by a common aetiology such as impulsive or risk-taking personality type, the association persisted even after adjusting for these factors.

‘It is plausible that the severity and multiplicity of harms to relationships, health, and financial security experienced by some who gamble might prompt them to attempt to take their own lives.’

Though the extent to which comorbid mental health problems and the potential for suicide attempts are caused by harmful gambling, or vice versa, is not entirely clear, young people with problem gambling behaviours should be considered at increased risk for suicidality.

Dr Jez Thompson