School of Social and Political Sciences, University of Glasgow, Glasgow, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
School of Health Sciences, City, University of London, London, UK.
Lancet Public Health. 2021 Jan;6(1):e39-e49. doi: 10.1016/S2468-2667(20)30232-2.
Suicide rates in young people have increased in England and Wales since 2010. There are a range of possible explanations for this increase, and problem gambling has been suggested as a potential risk factor. We aimed to examine the association between suicidality (suicidal thoughts and suicide attempts) and problem gambling specifically for young adults in Great Britain, where gambling has become more widely available and normalised in the past two decades.
We analysed data from the Emerging Adults Gambling Survey: a cross-sectional, online, non-probability sample survey of young adults aged 16-24 years living in Great Britain, who were selected from a YouGov online panel. Participants were eligible if they had not taken part in any other YouGov survey on gambling in the past year. We examined associations between problem gambling (defined as a score of 8 or higher on the Problem Gambling Severity Index [PGSI]) and suicidal thoughts and suicide attempts in the year before survey completion in a series of regression models, with and without adjustment for sociodemographic factors, alcohol use, video gaming, anxiety, loneliness, and impulsivity.
3549 eligible participants completed the survey between June 25 and Aug 16, 2019. 24 (37·0% [95% CI 25·6-50·2]) of 62 men who had attempted suicide in the past year had survey scores that were indicative of problem gambling, compared with 38 (3·6% [2·6-5·0]) of 1077 men who had not attempted suicide or had suicidal thoughts in the past year. 13 (14·5% [8·5-23·6]) of 85 women who had attempted suicide in the past year had survey scores that were indicative of problem gambling, compared with 25 (2·0% [1·4-3·0]) of 1184 women who had not attempted suicide or had suicidal thoughts in the past year. The adjusted odds ratio for attempted suicide was 9·0 (4·1-19·7) in men with scores that indicated problem gambling and 4·9 (2·0-12·0) in women with scores that indicated problem gambling, compared with participants of the same gender with PGSI scores of 0.
Problem gambling appears to be associated with suicide attempts in both young men and young women. This association persisted after adjusting for anxiety, impulsivity, life satisfaction, and other factors, which suggests that other mechanisms, such as the severity and multiplicity of harms experienced, or gambling to cope with life stressors, might underpin this relationship. Young people with problem-gambling behaviours should be considered at risk for suicidality.
Wellcome Trust.
自 2010 年以来，英格兰和威尔士年轻人的自杀率有所上升。对于这种上升，有很多可能的解释，而赌博问题已被认为是一个潜在的风险因素。我们的目的是专门研究英国青年中与自杀意念（自杀念头和自杀企图）和赌博问题之间的关联，在过去二十年中，赌博在英国变得更加普遍和正常化。
我们分析了“新兴成年人赌博调查”的数据：这是一项针对 16-24 岁生活在英国的年轻人的横断面、在线、非概率样本调查，他们是从 YouGov 在线小组中选出的。如果参与者在过去一年中没有参加过任何其他有关赌博的 YouGov 调查，则符合条件。我们在一系列回归模型中，检查了在完成调查前一年中，赌博问题（根据问题赌博严重程度指数[PGSI]得分为 8 或更高）与自杀念头和自杀企图之间的关联，这些模型既包括也不包括社会人口因素、酒精使用、视频游戏、焦虑、孤独和冲动的调整。
2019 年 6 月 25 日至 8 月 16 日期间，有 3549 名合格参与者完成了调查。在过去一年中有自杀企图的 62 名男性中，有 24 名（37.0%[25.6-50.2]）的调查分数表明存在赌博问题，而在过去一年中没有自杀企图或有自杀念头的 1077 名男性中，只有 38 名（3.6%[2.6-5.0]）。在过去一年中有自杀企图的 85 名女性中，有 13 名（14.5%[8.5-23.6]）的调查分数表明存在赌博问题，而在过去一年中没有自杀企图或有自杀念头的 1184 名女性中，只有 25 名（2.0%[1.4-3.0]）。在有调查分数表明存在赌博问题的男性中，自杀企图的调整后比值比为 9.0（4.1-19.7），在有调查分数表明存在赌博问题的女性中，自杀企图的调整后比值比为 4.9（2.0-12.0），与具有相同性别且 PGSI 分数为 0 的参与者相比。
赌博问题似乎与年轻男性和女性的自杀企图有关。在调整了焦虑、冲动、生活满意度和其他因素后，这种关联仍然存在，这表明其他机制，例如经历的伤害的严重程度和多发性，或赌博以应对生活压力源，可能是这种关系的基础。有赌博行为问题的年轻人应被视为有自杀倾向的风险人群。
惠康信托基金会。
