A new research presented at the 31st annual virtual meet of the American Academy of Addiction Psychiatry (AAAP) suggested that patients diagnosed with major depressive disorder (MDD), who also gamble, have a considerably higher risk of suicide and therefore should be closely monitored.
The researchers reviewed more than 4 million patients from the National Inpatient Sample dataset spanning 11 years from2006 to 2017. They quizzed all patients, who were 18 years and above and were diagnosed with MDD. They also talked to patients with a confirmed or suspected diagnosis of gambling. Based on their interviews, the researchers concluded that those patients who were diagnosed with both MDD and gambling had a significantly higher risk of suicide compared to patients diagnosed with MDD alone. Further, patients who indulged in gambling also recorded increased alcohol use and abuse.
How the idea was born
The researchers got the idea of examining the relationship between suicide, gambling and depression when they heard about increased suicide rates during the pandemic. They realized that there were many studies that examined the relationship between MDD and gambling but none that observed the link between suicide, gambling and depression.
“The study is however observational and hypothesis-based and should serve as a basis for designing large randomized trials,” observed the chief author Dr. Chintan Trivedi, St David’s Medical Center, Austin, Texas.
Of the 4 million participants, the researchers observed that 4,021,063 patients had a diagnosis of MDD and 6,646 patients had a diagnosis of both MDD and gambling. Both the groups of patients were compared for baseline characteristics and suicide risks. They found the following results:
- Increased incidence of alcohol abuse in the group with the double diagnosis vs the group with MDD alone.
- 4 percent of the co-occurring diagnosis group recorded only suicidal ideation compared to 39.5 percent of the depressed group. Further, 7.2 percent of the gambling plus MDD population attempted suicide compared to 4.5 percent of the depressed group and 50.7 percent of the first group had a combination of suicide attempts and suicide ideation compared to 43.1 percent of the latter group.
- More patients in the MDD and gambling population were white, older and males.
- In addition to increased alcohol abuse, the gambling group also recorded a higher prevalence of obesity.
- The gambling group also showed a higher risk for suicidality in a multivariate analysis.
These findings warrant a closer look at the patients in this specific group. The researchers are of the opinion that such a group should be administered a suicide severity rating scale to assess their risk of suicide ideation and behavior so that more effective treatment interventions can be planned. They further feel that being aware of the risk can help avoid suicide in gamblers.
The findings of the study remind usthat it is important to evaluate symptoms of depression and suicide ideation in patients diagnosed with gambling. In fact, this kind of assessment should also be undertaken for patients who have a gambling history or who have a suspected gambling diagnosis, said Dr. Rebecca Payne from the University of South Carolina and Prisma Health in Columbia. Considering gambling as a factor is important as it usually gets overlooked as a problem. Dr. Payne was not a part of the study.
Seeking help for depression
The large dataset that the researchers used for this retrospective study compels researchers to consider suicide risk at the point of patient intake. In fact, adding the findings of this study to the standard suicide risk assessment can make it more comprehensive.
If you or a loved one is diagnosed with depression and have recurring thoughts of suicide, get in touch with the Florida Depression Helpline. Call our 24/7 helpline number 866-267-5177 to connect with the best depression treatment center around you. Alternatively, you can also chat online with our trained medical staff to understand the symptoms of depression and the available treatment programs for depression.