Suizidalität bei Menschen mit pathologischem Glücksspiel

Zusammenfassung

Suizidalität ist bei Menschen mit pathologischem Glücksspiel ein weit verbreitetes Phänomen. Risikofaktoren für Suizidalität sind bei Menschen mit Glücksspielproblemen in hohem Maße anzutreffen. Zudem gibt es Hinweise darauf, dass pathologisches Glücksspiel selbst einen Risikofaktor für Suizidgedanken und -versuche darstellt. Diese Übersichtsarbeit fasst die jüngsten Erkenntnisse aus der internationalen Forschung zum Zusammenhang von pathologischem Glücksspiel und Suizidalität unter Berücksichtigung von psychiatrischer Komorbidität zusammen. Internationale Studien zeigen, dass abhängig vom Erhebungssetting zwischen 19 und 62% der Teilnehmenden mit pathologischem Glücksspiel Suizidgedanken und 10 bis 26% einen Suizidversuch unternommen haben. Das Risiko von Suizidalität bei glücksspielbezogenen Problemen zeigt die Notwendigkeit einer erhöhten Sensibilität im Hilfesystem für dieses Thema und für eine Verstärkung präventiver Maßnahmen.

Abstract

Suicidality is a common phenomenon among pathological gamblers. Risk factors for suicidality are very often found in individuals with gambling related problems. Moreover, research indicates that pathological gambling itself is a high-risk factor for suicidal ideation and suicide attempts. This overview summarizes recent findings from international research on the association of pathological gambling and suicidality, taking psychiatric comorbidity into account. International studies have revealed that, dependent on the recruitment setting, between 19 and 62% of the pathological gamblers had suicidal ideation and 10 to 26% had attempted suicide. The risk of suicidality in gambling related problems shows the need for an increased sensitivity in general treatment and for intense preventive measures.

Schlüsselwörter

Suizidalität - pathologisches Glücksspiel - Komorbidität - Risikofaktoren

Key words

suicidality - pathological gambling - comorbidity - risk factors

• Literatur

• 1 American Psychiatric Association. (Hrsg.) Diagnostic and statistical manual of mental disorders, fifth edition, international version. Arlington, VA: American Psychiatric Association; 2013
• 2 Lorains FK, Cowlishaw S, Thomas SA. Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction 2011; 106: 490-498 doi:10.1111/j.1360-0443.2010.03300.x
• 3 Borges G, Nock MK, Abad JMH. et al. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. J Clin Psychiatry 2010; 71: 1617-1628 doi:10.4088/JCP.08m04967blu
• 4 Lauterbach E, Kienast T. Suizidalität. PSYCH up2date 2009; 3: 197-212
• 5 Nicoli M, Bouchez S, Nieto I. et al. Prevalence and risk factors for suicide ideation, plans and attempts in the French general population. Results from the ESEMED Study. L'Encephale 2012; 38: 296-303
• 6 Bernal M, Haro JM, Bernert S. et al. Risk factors for suicidality in Europe: Results from the ESEMED study. J Affect Disord 2007; 101: 27-34
• 7 Driessen M, Veltrup C, Weber J. et al. Psychiatric co-morbidity, suicidal behaviour and suicidal ideation in alcoholics seeking treatment. Addiction 1998; 93: 889-894. doi:10.1046/j.1360-0443.1998.93688910.x
• 8 Beautrais AL, Joyce PR, Mulder RT. et al. Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: A case-control study. American Journal of Psychiatry 1996; 153: 1009-1014
• 9 Duberstein P, Witte T. Suicide risk in personality disorders: an argument for a public health perspective. In Kleespies P. (Hrsg.) Behavioral emergencies An evidence-based resource for evaluating and managing suicidal behavior, violence, and victimization. Washington, D.C: American Psychological Association; 2009: 257-286
• 10 Dennis M, Baillon S, Brugha T. et al. The spectrum of suicidal ideation in Great Britain: Comparisons across a 16–74 years age range. Psychological Medicine 2007; 37: 795-805
• 11 Brewer JD, Potenza MN, Desai RA. Differential associations between problem and pathological gambling and psychiatric disorders in individuals with and without alcohol abuse or dependence. CNS Spectrums 2010; 15: 556-567
• 12 Petry NM, Stinson FS, Grant BF. Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2005; 66: 567-574. doi:10.4088/JCP.v66n0504
• 13 Chou KL, Afifi TO. Disordered (pathologic or problem) gambling and Axis I psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Epidemiology 2011; 173: 1289-1297
• 14 Kessler RC, Hwang I, LaBrie R. et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine 2008; 38: 1351-1360. doi:10.1017/S0033291708002900
• 15 Bischof A, Meyer C, Bischof G. et al. Comorbid Axis I-disorders among subjects with pathological, problem, or at-risk gambling recruited from the general population in Germany: Results of the PAGE study. Psychiatry Research 2013; 210: 1065-1070 doi:10.1016/j.psychres.2013.07.026
• 16 Vaddiparti K, Cottler LB. Personality disorders and pathological gambling. Curr Opin Psychiatry 2017; 30: 45-49. doi:10.1097/YCO.0000000000000300
• 17 Hakansson A, Karlsson A, Widinghoff C. Primary and Secondary Diagnoses of Gambling Disorder and Psychiatric Comorbidity in the Swedish Health Care System-A Nationwide Register Study. Front Psychiatry 2018; 9: 426 doi:10.3389/fpsyt.2018.00426
• 18 Petry NM, Kiluk BD. Suicidal ideation and suicide attempts in treatment-seeking pathological gamblers. Journal of Nervous and Mental Disease 2002; 190: 462-469. doi:10.1097/01.NMD.0000022447.27689.96
• 19 Thon N, Preuss UW, Pölzleitner A. et al. Prevalence of suicide attempts in pathological gamblers in a nation-wide Austrian treatment sample. General Hospital Psychiatry 2014; 36: 342-346. doi:10.1016/j.genhosppsych.2014.01.012
• 20 Bischof A, Meyer C, Bischof G. et al. Suicidal events among pathological gamblers: The role of comorbidity of Axis I and Axis II disorders. Psychiatry Research 2015; 225: 413-419. doi:10.1016/j.psychres.2014.11.074
• 21 Cowlishaw S, Kessler D. Problem Gambling in the UK: Implications for Health, Psychosocial Adjustment and Health Care Utilization. Eur Addict Res 2016; 22: 90-98 doi:10.1159/000437260
• 22 Guillou-Landreat M, Guilleux A, Sauvaget A. et al. Factors associated with suicidal risk among a French cohort of problem gamblers seeking treatment. Psychiatry Res 2016; 240: 11-18 doi:10.1016/j.psychres.2016.04.008
• 23 Ronzitti S, Soldini E, Smith N. et al. Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems. Addict Behav 2017; 74: 33-40. doi:10.1016/j.addbeh.2017.05.032
• 24 Ronzitti S, Kraus SW, Hoff RA. et al. Problem-gambling severity, suicidality and DSM-IV Axis II personality disorders. Addict Behav 2018; 82: 142-150. doi:10.1016/j.addbeh.2018.03.003
• 25 Pompili M, Girardi P, Ruberto A. et al. Suicide in borderline personality disorder: A meta-analysis. Nordic journal of psychiatry 2005; 59: 319-324. doi:10.1080/08039480500320025
• 26 Karlsson A, Hakansson A. Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study. J Behav Addict 2018; 7: 1091-1099. doi:10.1556/2006.7.2018.112
• 27 Mallorqui-Bague N, Mena-Moreno T, Granero R. et al. Suicidal ideation and history of suicide attempts in treatment-seeking patients with gambling disorder: The role of emotion dysregulation and high trait impulsivity. J Behav Addict 2018; 7: 1112-1121 doi:10.1556/2006.7.2018.132
• 28 Vilhjalmsson R, Kristjansdottir G, Sveinbjarnardottir E. Factors associated with suicide ideation in adults. Soc Psychiatry Psychiatr Epidemiol 1998; 33: 97-103
• 29 Newman SC, Thompson AH. A population-based study of the association between pathological gambling and attempted suicide. Suicide and Life-Threatening Behavior 2003; 33: 80-87
• 30 Hodgins DC, Mansley C, Thygesen K. Risk factors for suicide ideation and attempts among pathological gamblers. American Journal on Addictions 2006; 15: 303-310 doi:10.1080/10550490600754366
• 31 Manning V, Koh PK, Yang Y. et al. Suicidal ideation and lifetime attempts in substance and gambling disorders. Psychiatry Res 2015; 225: 706-709. doi:10.1016/j.psychres.2014.11.011
• 32 Black DW, Coryell W, Crowe R. et al. Suicide Ideations, Suicide Attempts, and Completed Suicide in Persons with Pathological Gambling and Their First-Degree Relatives. Suicide Life Threat Behav 2015; 45: 700-709 doi:10.1111/sltb.12162
• 33 Carr MM, Ellis JD, Ledgerwood DM. Suicidality among gambling helpline callers: A consideration of the role of financial stress and conflict. Am J Addict 2018; 27: 531-537 doi:10.1111/ajad.12787
• 34 Bischof A, Meyer C, Bischof G. et al. Type of gambling as an independent risk factor for suicidal events in pathological gamblers. Psychol Addict Behav 2016; 30: 263-269 doi:2016-03224-001 [pii]10.1037/adb0000152
• 35 Phillips DP, Welty WR, Smith MM. Elevated suicide levels associated with legalized gambling. Suicide Life Threat Behav 1997; 27: 373-378
• 36 Campbell F, Simmons C, Lester D. The impact of gambling on suicidal behavior in Louisiana. Omega-J Death Dying 1998; 38: 235-239
• 37 Stein GN, Pretorius A, Stein DJ. et al. The association between pathological gambling and suicidality in treatment-seeking pathological gamblers in South Africa. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists 2016; 28: 43-50
• 38 George S, Jaisoorya TS, Nair S. et al. A cross-sectional study of problem gambling and its correlates among college students in South India. BJPsych Open 2016; 2: 199-203 doi:10.1192/bjpo.bp.115.002519
• 39 Orford J, Natera G, Copello A. et al. Coping with alcohol and drug problems. The experience of family members in three contrasting cultures. London: Routledge; 2005
• 40 Hodgins DC, Shead NW, Makarchuk K. Relationship satisfaction and psychological distress among concerned significant others of pathological gamblers. Journal of Nervous and Mental Disease 2007; 195: 65-71
• 41 Hodgins DC, Toneatto T, Makarchuk K. et al. Minimal treatment approaches for concerned siginificant others of problem gamblers: A randomized controlled trial. J Gambl Stud 2007; 23: 215-230