Suicide attempts among veterans seeking treatment for pathological gambling

Background: There is little information in the scientific literature regarding the suicide attempts of pathological gamblers, even though studies of problem gamblers have found that completed suicide, suicide attempts, and suicidal ideation are common outcomes related to gambling behavior. There has been no attempt in previous studies to identify the contributions of comorbid conditions, such as substance abuse, to the suicide attempts of pathological gamblers. Method: A retrospective chart review was completed for all consecutive admissions (N = 114) to the Gambling Treatment Program of the Louis Stokes VA Medical Center over a 12-month period (September 2000-September 2001). All subjects met DSM-IV criteria for pathological gambling. Relevant information was obtained from the admission history and physical examination, as well as a variety of self-report questionnaires and structured instruments. Results: Forty-five patients (39.5%) reported that they had made a suicide attempt at some time in their lives. The most common method was overdose. Sixty-four percent of attempters reported that their most recent attempt was related to gambling. Forty-two percent of gamblers with a history of alcohol dependence and 58.8% of those with a history of drug dependence had a history of suicide attempts. Mean impulsivity scores differentiated suicide attempters from nonattempters among gamblers with a history of drug and/or alcohol dependence. Severity of psychiatric symptoms and family problems on admission was related to a history of suicide attempts. Conclusion: Pathological gamblers have high rates of attempted suicide. They are highly impulsive and suffer from high rates of comorbid psychiatric conditions as well as social disruptions. A combination of these risk factors very likely contributes to their potential for suicidal behavior.