赌博问题严重程度的变化和随后的自杀企图：2018-20 年英国青年的纵向调查。
Changes in severity of problem gambling and subsequent suicide attempts: a longitudinal survey of young adults in Great Britain, 2018-20.
机构信息
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 Social and Political Sciences, University of Glasgow, Glasgow, UK.
出版信息
Lancet Public Health. 2023 Mar;8(3):e217-e225. doi: 10.1016/S2468-2667(23)00008-7.
BACKGROUND
Cross-sectional studies identify problem gambling as a risk factor for suicidality. Using an online longitudinal survey, we aimed to examine the association between changes in severity of gambling behaviour and attempted suicide.
METHODS
The Emerging Adults Gambling Survey is a longitudinal survey of people in England, Scotland, and Wales, aged 16-24 years interviewed online between June 25 and Aug 16, 2019 (wave 1) and 1 year later between July 13 and Oct 8, 2020 (wave 2). The Problem Gambling Severity Index (PGSI) was administered at both waves. Multivariable logistic regression models examined wave 1 PGSI score and between-wave change in PGSI score as risk factors for suicide attempts at wave 2, unadjusted and with adjustment for wellbeing, anxiousness, impulsivity, perceived loneliness, and suicide attempts at wave 1.
FINDINGS
3549 participants were interviewed in wave 1 and 2094 were interviewed in wave 2, of whom 1941 were included in this analysis (749 [39%] men; 1192 women [61%]). Prevalence of attempted suicide did not change between waves (wave 1: 3·7% [95% CI 2·9-4·8], n=75; wave 2: 3·3% [2·5-4·3], n=65). 78·9% (95% CI 76·7-80·9, n=1575) of participants had stable PGSI scores between the two waves, 13·7% (11·9-15·6, n=233) of participants had a decrease in PGSI score by 1 or more, and 7·5% (6·2-8·9, n=133) had an increase in PGSI score by 1 or more. An increase in PGSI scores over time was associated with suicide attempt at wave 2, even with adjustment for baseline PGSI score and other factors (adjusted odds ratio 2·74 [95% CI 1·20-6·27]). Wave 1 PGSI score alone was not associated with suicide attempt at wave 2 in fully adjusted models.
INTERPRETATION
Repeated routine screening for changes in gambling harm could be embedded in health, social care, and public service settings to allow effective identification and suicide prevention activities among young adults.
FUNDING
Wellcome Trust.
背景
横断面研究将赌博问题确定为自杀倾向的一个风险因素。我们采用在线纵向调查，旨在研究赌博行为严重程度的变化与自杀未遂之间的关联。
方法
《青年成人赌博调查》是一项对英格兰、苏格兰和威尔士 16-24 岁人群进行的纵向调查，于 2019 年 6 月 25 日至 8 月 16 日（第 1 波）和 1 年后的 2020 年 7 月 13 日至 10 月 8 日（第 2 波）期间通过网络进行访谈。在两波调查中均采用问题赌博严重程度指数（PGSI）进行评估。多变量逻辑回归模型分别在未调整和调整幸福感、焦虑、冲动、孤独感和第 1 波自杀未遂等因素后，分析第 1 波 PGSI 评分和两波间 PGSI 评分变化作为第 2 波自杀未遂的风险因素。
结果
在第 1 波调查中对 3549 人进行了访谈，在第 2 波调查中对 2094 人进行了访谈，其中 1941 人纳入了本分析（男性 749 人[39%]；女性 1192 人[61%]）。自杀未遂的发生率在两波之间没有变化（第 1 波：3.7%[95%CI 2.9-4.8]，n=75；第 2 波：3.3%[2.5-4.3]，n=65）。78.9%（95%CI 76.7-80.9，n=1575）的参与者两波间 PGSI 评分稳定，13.7%（11.9-15.6，n=233）的参与者 PGSI 评分下降 1 个或更多单位，7.5%（6.2-8.9，n=133）的参与者 PGSI 评分升高 1 个或更多单位。随着时间的推移，PGSI 评分升高与第 2 波的自杀未遂相关，即使在调整基线 PGSI 评分和其他因素后也是如此（调整后的比值比 2.74[95%CI 1.20-6.27]）。在完全调整后的模型中，第 1 波 PGSI 评分单独与第 2 波自杀未遂无关。
解释
在卫生、社会保健和公共服务场所中反复进行常规的赌博伤害变化筛查，可能有助于在年轻人中有效地识别和预防自杀。
资金来源
惠康信托基金会。
Zotero 插件