Psychiatric Comorbidity and Economic Hardship as Risk Factors for Intentional Self-Harm in Gambling Disorder—A Nationwide Register Study
(2021) In Frontiers in Psychiatry 12.- Abstract
Background: There is an increased risk of suicidality in gambling disorder (GD) and economic hardship is common in the population. Economic hardship itself is a risk factor for suicidality. This study aims to explore the risk of intentional self-harm in GD utilizing social welfare payment (SWP) as a proxy for economic hardship and exploring how economic hardship, gender, criminality, socioeconomic-, and psychiatric risk factors might contribute to intentional self-harm in GD. Methods: This is a nationwide register-based study of 848 individuals diagnosed with GD in the Swedish healthcare system during the years of 2011–2014 with an average follow up of 4.9 years. Pearson's Chi-square analyses were carried out for comparisons regarding... (More)
Background: There is an increased risk of suicidality in gambling disorder (GD) and economic hardship is common in the population. Economic hardship itself is a risk factor for suicidality. This study aims to explore the risk of intentional self-harm in GD utilizing social welfare payment (SWP) as a proxy for economic hardship and exploring how economic hardship, gender, criminality, socioeconomic-, and psychiatric risk factors might contribute to intentional self-harm in GD. Methods: This is a nationwide register-based study of 848 individuals diagnosed with GD in the Swedish healthcare system during the years of 2011–2014 with an average follow up of 4.9 years. Pearson's Chi-square analyses were carried out for comparisons regarding psychiatric comorbidity and intentional self-harm with regards to gender and SWPs. Univariable and multivariable Cox regression were utilized to analyse risk factors for intentional self-harm. Results: A large part of the study population received SWPs (45.5% with an insignificant overrepresentation of women) and psychiatric disorders were more common in these individuals (p < 0.001). Conviction for crime in general (p < 0.001) as well as intentional self-harm (p = 0.025) were also more common amongst recipients of SWPs. Criminal conviction in general was abundant (26.5%). In the stepwise multivariable regression, substance-related diagnoses as well as anxiety, depressive, and personality disorders remained risk factors for intentional self-harm and no significant results were found with regards to gender, criminal history, or SWPs. Conclusions: Social welfare payment was common among GD patients and intentional self-harm was more common amongst recipients than GD patients as a whole. Social welfare payments were however not a significant risk factor for intentional self-harm. However, attention to suicidality and self-injurious behavior should be paid from social services controlling SWPs due to the large prevalence of intentional self-harm in this group. In accordance with previous studies, comorbid psychiatric disorders such as anxiety, depression, substance use, and personality disorders increased the risk of intentional self-harm.
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- author
- Karlsson, Anna LU ; Hedén, Olivia ; Hansson, Helena LU ; Sandgren, Jenny and Håkansson, Anders LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- comorbidity, criminality, gambling disorder (GD), risk factors, self-harm, social welfare payments, suicidality, suicide attempt
- in
- Frontiers in Psychiatry
- volume
- 12
- article number
- 688285
- publisher
- Frontiers Media S. A.
- external identifiers
-
- scopus:85118341334
- pmid:34733181
- ISSN
- 1664-0640
- DOI
- 10.3389/fpsyt.2021.688285
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © Copyright © 2021 Karlsson, Hedén, Hansson, Sandgren and Håkansson.
- id
- f98ff1cd-f9bf-42f2-8812-f6b9eedde06b
- date added to LUP
- 2021-11-29 10:44:45
- date last changed
- 2024-04-06 14:19:07
@article{f98ff1cd-f9bf-42f2-8812-f6b9eedde06b, abstract = {{<p>Background: There is an increased risk of suicidality in gambling disorder (GD) and economic hardship is common in the population. Economic hardship itself is a risk factor for suicidality. This study aims to explore the risk of intentional self-harm in GD utilizing social welfare payment (SWP) as a proxy for economic hardship and exploring how economic hardship, gender, criminality, socioeconomic-, and psychiatric risk factors might contribute to intentional self-harm in GD. Methods: This is a nationwide register-based study of 848 individuals diagnosed with GD in the Swedish healthcare system during the years of 2011–2014 with an average follow up of 4.9 years. Pearson's Chi-square analyses were carried out for comparisons regarding psychiatric comorbidity and intentional self-harm with regards to gender and SWPs. Univariable and multivariable Cox regression were utilized to analyse risk factors for intentional self-harm. Results: A large part of the study population received SWPs (45.5% with an insignificant overrepresentation of women) and psychiatric disorders were more common in these individuals (p < 0.001). Conviction for crime in general (p < 0.001) as well as intentional self-harm (p = 0.025) were also more common amongst recipients of SWPs. Criminal conviction in general was abundant (26.5%). In the stepwise multivariable regression, substance-related diagnoses as well as anxiety, depressive, and personality disorders remained risk factors for intentional self-harm and no significant results were found with regards to gender, criminal history, or SWPs. Conclusions: Social welfare payment was common among GD patients and intentional self-harm was more common amongst recipients than GD patients as a whole. Social welfare payments were however not a significant risk factor for intentional self-harm. However, attention to suicidality and self-injurious behavior should be paid from social services controlling SWPs due to the large prevalence of intentional self-harm in this group. In accordance with previous studies, comorbid psychiatric disorders such as anxiety, depression, substance use, and personality disorders increased the risk of intentional self-harm.</p>}}, author = {{Karlsson, Anna and Hedén, Olivia and Hansson, Helena and Sandgren, Jenny and Håkansson, Anders}}, issn = {{1664-0640}}, keywords = {{comorbidity; criminality; gambling disorder (GD); risk factors; self-harm; social welfare payments; suicidality; suicide attempt}}, language = {{eng}}, publisher = {{Frontiers Media S. A.}}, series = {{Frontiers in Psychiatry}}, title = {{Psychiatric Comorbidity and Economic Hardship as Risk Factors for Intentional Self-Harm in Gambling Disorder—A Nationwide Register Study}}, url = {{http://dx.doi.org/10.3389/fpsyt.2021.688285}}, doi = {{10.3389/fpsyt.2021.688285}}, volume = {{12}}, year = {{2021}}, }