Why Gambling Disorder May Increase Suicide Risk

During the pandemic, many Americans have distracted themselves with their smartphones, which are now a common access point to online gambling. As online gambling has become more widespread, Vishesh Agarwal, M.D., vice chair of the Department of Psychiatry, and colleagues researched the possible effects of gambling on behavioral health. The results of his research – the first study to find connections among gambling disorder, major depressive disorder and suicide risk – were published in the journal Addictive Behaviors.

What is the relationship between gambling disorder and mental illness?

We knew that gambling disorder – the only non-substance-use addiction disorder – commonly accompanies major depressive disorder. Major depressive disorder is frequent or extended depression with feelings of anxiety, distress, agitation and intense sadness.

Research has shown associations between major depressive disorder and increased suicide risk, but no one had studied major depressive disorder plus gambling disorder on suicide risk.

We looked at 12 years’ worth of inpatient data for more than four million people with major depressive disorder nationwide, including more than 6,600 people who also had gambling disorder, and found that both conditions increase suicide risk more than major depressive disorder alone.

What traits were common among people with major depressive disorder and gambling disorder?

There was significantly more alcohol use among people with this dual diagnosis. They also appear to be more significantly obese, compared to people with major depressive disorder alone. Initially, more white males had both disorders. In our research we saw that, over time, this dual disorder affected more Black and Hispanic people; this may reflect the development of casinos in areas with Black and Hispanic populations.

Why might gambling disorder increase suicide risk?

One characteristic of any addiction condition is impulsivity. There’s a higher chance of people acting on impulsive thoughts, which could be related to suicidal ideation (thoughts of suicide) or suicide attempts.

What do you recommend to people with major depressive disorder and gambling disorder or to their loved ones?

Recognize red flags, such as bank accounts being drained, conflicted relationships, increased use of alcohol, work-related problems. That tells you that it’s getting out of hand. The sooner you can get into a treatment program is of huge benefit.