title: Suicidal events among pathological gamblers: the role of comorbidity of axis I and axis II disorders.
abstract: The risk for suicidal ideation and suicide attempts among pathological gamblers is high compared to the general population. Little is known about the interplay of Axis I and Axis II disorders, severity of gambling disorder, and suicidal ideation and suicide attempts. The study aims to address this linkage. The sampling design of the study "Pathological Gambling and Epidemiology" (PAGE) included four recruitment channels: general population, gambling locations, project telephone hotline, and in-patient treatment for pathological gambling. A total of 442 study participants with lifetime pathological gambling received a clinical interview. The multivariate analysis showed mood disorders (Relative Risk Ratio, RRR=5.14, 95%-Confidence Interval, CI=2.91-9.07), substance use disorders (RRR=1.73, CI=1.02-2.94), and early onset of gambling disorder (RRR=0.96, CI=0.93-0.99) to be associated with suicidal ideation. Suicidal attempts were associated with female sex (RRR=3.58, CI=1.56-8.19), mood disorders (RRR=11.92, CI=4.70-30.26), and Cluster B personality disorders (RRR=2.40, CI=1.13-5.10). Among study participants with suicide attempts, more had a Cluster B personality disorder than among participants with ideation solely (RRR=3.08, CI=1.48-6.40). Among this large mixed sample of pathological gamblers, high proportions of individuals with suicidal events, multi-morbidity on Axis I, and a strong linkage to Cluster B personality disorders were found.
authors.affiliation: University of Luebeck, Department of Psychiatry and Psychotherapy, Research Group S:TEP (Substance abuse and related disorders: Treatment, Epidemiology, and Prevention), Germany. Electronic address: anja.bischof@uksh.de.
authors.forename: Anja
authors.initials: A
authors.lastname: Bischof
authors.affiliation: University Medicine Greifswald, Institute of Social Medicine and Prevention, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.affiliation: University of Luebeck, Department of Psychiatry and Psychotherapy, Research Group S:TEP (Substance abuse and related disorders: Treatment, Epidemiology, and Prevention), Germany.
authors.forename: Gallus
authors.initials: G
authors.lastname: Bischof
authors.affiliation: University Medicine Greifswald, Institute of Social Medicine and Prevention, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.affiliation: Paracelsus Medical University Salzburg, Austria.
authors.forename: Friedrich Martin
authors.initials: FM
authors.lastname: Wurst
authors.affiliation: Paracelsus Medical University Salzburg, Austria.
authors.forename: Natasha
authors.initials: N
authors.lastname: Thon
authors.affiliation: University Medicine Greifswald, Clinic and Policlinic for Psychiatry and Psychotherapy at HELIOS Hanse-Hospital Stralsund, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Lucht
authors.affiliation: University Medicine Greifswald, Clinic and Policlinic for Psychiatry and Psychotherapy at HELIOS Hanse-Hospital Stralsund, Germany.
authors.forename: Hans Joergen
authors.initials: HJ
authors.lastname: Grabe
authors.affiliation: University of Luebeck, Department of Psychiatry and Psychotherapy, Research Group S:TEP (Substance abuse and related disorders: Treatment, Epidemiology, and Prevention), Germany.
authors.forename: Hans-Juergen
authors.initials: HJ
authors.lastname: Rumpf
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D005715:Gambling / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D010554:Personality Disorders / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
keywords: Comorbidity; Pathological gambling; Personality disorders; Suicidality