What this research is about
Gambling disorder occurs when a person cannot control their gambling behaviour. It can cause significant harms to the person who gambles, their family, and the society. Problem gambling is a term used when a person has some gambling problems but does not fulfill the criteria for gambling disorder.
Despite the negative consequences, only 10% of people with gambling problems seek treatment.
Gambling disorder is associated with several medical conditions, such as heart disease, and physical symptoms, such as fatigue and headaches. Patients with gambling disorder are also at higher risk of having suicidal thoughts and committing suicide.
There had been only one study on the risk of death among patients with gambling disorder. The main cause of death was reported to be suicide. This was followed by cancers and diseases of the circulatory system. This study aimed to examine the risk and cause of death in a cohort of patients treated for gambling disorder in a region in northern Italy. The study involved a 27-year follow-up from 1992 to 2019.
What the researchers did
The researchers examined the records of 826 patients who were diagnosed with gambling disorder from 1992 to 2018. Electronic data were collected from the archives of Services Dedicated to Drug Addicts
(SERDs), Community Mental Health Centres (CMHCs), and hospitals. Diagnoses of gambling disorder and any other mental health disorders were made at first admission. The follow-up period started at the first admission and lasted until December 31, 2019, or up to the date of death. Patients who were lost during follow-up were included until the date of their last known place of residence.
The researchers determined the causes of death among patients who died during follow-up. They also compared the standardized mortality ratios (SMRs) of the patients in this study to those of the general population. The SMR describes whether a specific population (i.e., patients with gambling disorder) are more, less, or equally likely to die compared to a general population. The SMRs were calculated considering specific causes of death and gender.
What the researchers found
Patients were 661 men (80%) and 165 women (20%).
The average age at first admission was 47.6 years old.
What you need to know
This study examined the risk and cause of death in a cohort of patients treated for gambling disorder in a region in north Italy. It involved 826 patients who were diagnosed with gambling disorder from 1992 to 2018. Patients were followed-up from first admission to December 31, 2019 or up to date of death. Patients who were lost during follow-up were also included until the date of their last known place of residence. Half of the patients were diagnosed with another mental health, substance use, or alcohol use disorders.
Patients with gambling disorder were at higher risk of death than the general population, especially older women aged 40 to 59 years and younger men aged 20 to 29 years. In women, the causes of death were higher for all cancers and suicide. In men, the causes of death were higher for malignant neoplasm (tumours) of liver, lung, prostate, and bladder.
A follow-up study of the risk and cause of
death among patients treated for gambling
disorder
This work is licensed under the Creative Commons Attribution-Noncommercial 4.0 International License. 2022 Thirty-nine patients died (4.7%) and eight patients
(1%) were lost during follow-up.
About 72% of the patients were admitted after 2012.
This suggested that the number of patients diagnosed with gambling disorder had been increasing over time.
Half of the patients had another diagnosis at first admission. About 41% were diagnosed with other mental health disorders. The most common were neurotic and somatoform syndromes (mental illnesses that cause bodily symptoms), personality and
behaviour disorders, and depression. About 10% were diagnosed with substance use disorders, and 8% were diagnosed with alcohol dependence.
Risk and cause of death
Of the 39 patients who died, 26 were men and 13 were women. Cancers were the main cause of 62% of all deaths. Diseases of the circulatory system were the cause of 13% of all deaths. Other causes of death included neoplasm (tumour) of liver (13%), neoplasm of bronchus and lung (8%), and suicide (5%).
Compared to the general population, the SMR was 1.16 for patients with gambling disorder. This meant patients with gambling disorder were at higher risk of death than the general population. The risk was particularly higher for older women aged 40 to 59 years and younger men aged 20 to 29 years. In women, the causes of death were higher for all cancers and suicide. In men, the causes of death were higher for malignant neoplasm of liver, of lung, of prostate, and of bladder. In addition, patients with a diagnosis of schizophrenia, personality and behaviour disorders were at higher risk of death.
The researchers found that the risk of death was higher among patients older than 60 after they considered patients’ gender, age, and other mental health and substance use disorders. Also, the risk of death was higher during the year of first admission and decreased after three years.
How you can use this research
This study can inform public health, gambling treatment and prevention services, and research.
Further follow-up studies are needed to confirm the findings of this study.
About the researchers
Raimondo Maria Pavarin, Silvia Marani, and Elsa Turino are affiliated with the Osservatorio Epidemiologico Metropolitano Dipendenze Patologiche, Dipartimento Salute Mentale e Dipendenze in Bologna, Italy. Marco Domenicali is affiliated with the Centro per lo Studio ed il Trattamento Multidisciplinare dell’Uso Inadeguato dell’Alcol “G. Fontana”, Dipartimento di Scienze Mediche e Chirurgiche at the Università degli Studi di Bologna in Bologna, Italy. Fabio Caputo is affiliated wit the Centro per lo Studio ed il Trattamento delle Patologie Alcol-Correlate, Dipartimento di Medicina Translazionale e per la Romagna at the Università degli Studi di Ferrara in Ferrara, Italy. For more information about this study, please contact Raimondo Maria Pavarin at
Citation
Pavarin, R. M., Domenicali, M., Marani, S., Turino, E.,
& Caputo, F. (2021). Mortality risk in a population of patients treated for gambling disorders: Results of a follow-up study. Annali dell’Istituto Superiore di Sanità, 57(3), 205-211.
https://doi.org/10.4415/ANN_21_03_03 Study funding
No funding was identified.
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