Erevik Eilin K, Landrø Helene, Mattson Åse L, Kristensen Joakim H, Kaur Puneet, Pallesen Ståle
Department of Psychosocial Science, University of Bergen, Bergen, Norway.
Resource Centre on Violence, Traumatic Stress and Suicide Prevention, Haukeland University Hospital, Bergen, Norway.
Addict Behav Rep. 2022 Mar 11;15:100419. doi: 10.1016/j.abrep.2022.100419. eCollection 2022 Jun.
No studies have so far synthesised the current evidence concerning a possible relationship between problem gaming and suicidality. We therefore conducted a systematic review of the literature. Our objective was to investigate the relationship between problem gaming and suicidality. The review was funded by the Norwegian Competence Center for Gambling and Gaming Research.
The review was pre-registered in PROSPERO International prospective register of systematic reviews (CRD42021279774). Searches were conducted in Web of Science, PsycINFO, EMBASE, PubMed and Google Scholar, September 2021. Studies that reported data on the relationship between problem gaming and suicidality, published between 2000 and 2021, and written in any European language were included. Studies investigating internet addiction/problematic internet use and not problem gaming, specifically, and studies investigating mental health in general or mental health outcomes other than suicidality, were excluded. Data from the included studies were extracted independently by two coders who also evaluated for risk of bias using the Newcastle-Ottawa Quality Assessment Scale. The results from each included study were presented in a table.
A total of 12 cross-sectional studies, with in total 88,732 participants, were included in the review. In total 10 studies investigated the association between problem gaming and suicidal ideation. One of these also investigated the association between problem gaming and suicide attempts. Two studies combined suicidal ideation and suicide attempts into one variable and investigated the association between that variable and problem gaming. In total 11 of the 12 included studies found positive, crude associations between problem gaming and suicidal ideation/attempts. Five studies adjusted for possible confounding variables. Three of these still found significant associations between problem gaming and suicidal ideation, one found a positive but not statistically significant association, and the fifth found an inverse, non-significant association.
The current findings indicate that there is an association between problem gaming and suicidal ideation, and likely between problem gaming and suicide attempts. The most important limitation of the included studies is the lack of longitudinal designs. Future studies should aim to investigate the causality and mechanisms in the relationships using more stringent designs.
目前尚无研究综合有关问题游戏与自杀倾向之间可能关系的现有证据。因此，我们对文献进行了系统综述。我们的目的是调查问题游戏与自杀倾向之间的关系。该综述由挪威博彩与游戏研究能力中心资助。
该综述在国际系统综述前瞻性注册库PROSPERO（CRD42021279774）中进行了预注册。于2021年9月在科学网、心理学文摘数据库、荷兰医学文摘数据库、医学期刊数据库和谷歌学术中进行检索。纳入2000年至2021年间发表的、以任何欧洲语言撰写的、报告了问题游戏与自杀倾向之间关系数据的研究。具体而言，排除了调查网络成瘾/有问题的互联网使用而非问题游戏的研究，以及调查一般心理健康或除自杀倾向以外的心理健康结果的研究。纳入研究的数据由两名编码员独立提取，他们还使用纽卡斯尔-渥太华质量评估量表评估偏倚风险。每项纳入研究的结果都列在一张表格中。
该综述共纳入12项横断面研究，共有88732名参与者。总共有10项研究调查了问题游戏与自杀意念之间的关联。其中一项还调查了问题游戏与自杀未遂之间的关联。两项研究将自杀意念和自杀未遂合并为一个变量，并调查了该变量与问题游戏之间的关联。在纳入的12项研究中，共有11项发现问题游戏与自杀意念/未遂之间存在阳性的、粗略的关联。五项研究对可能的混杂变量进行了调整。其中三项仍然发现问题游戏与自杀意念之间存在显著关联，一项发现存在阳性但无统计学意义的关联，第五项发现存在反向的、无统计学意义的关联。
目前的研究结果表明，问题游戏与自杀意念之间存在关联，问题游戏与自杀未遂之间可能也存在关联。纳入研究的最重要局限性是缺乏纵向设计。未来的研究应旨在使用更严格的设计来调查这些关系中的因果关系和机制。
