Behavioural addictions as risk factors for incidence and reoccurrence of suicide ideation and attempts in a prospective cohort study among young swiss men

Introduction

Substance use disorder, depression and sexual minority are well documented risk factors for suicidal behaviour, far less is known about behavioural addictions.

Objectives

First, to explore associations between behavioural addictions (gaming, gambling, cybersex, internet, smartphone, work) at age 25 and the incidence and reoccurrence of suicide ideation (SID), suicide attempts (SAT), and suicide attempts among those with suicide ideation (SATID) at age 28. Second, to test whether these associations were impacted by adjusting for cannabis and alcohol use disorder, nicotine dependence, sexual orientation and depression.

Methods

Based on two waves of a prospective cohort study of 5,428 young Swiss men, nested models with and without adjustment for risk factors were used to regress SID, SAT and SATID on preceding behavioural addictions.

Results

Without adjustment, each of the behavioural addictions at age 25 significantly predicted the incidence of SID and SAT at age 28. Gambling and cybersex addiction furthermore predicted SATID. When adjusting for other risk factors, associations with behavioural addictions were reduced, whereas depression and cannabis use disorder were the most important and consistent predictors for the incidence and recurrence of SID, SAT and SATID.

Conclusions

Among young Swiss men, behavioural addictions are important predictors of SID and SAT, however a large part of their association is shared with depression and cannabis use disorder. Treatment for addictive behaviors, especially cannabis use can open the door to larger mental health screening and targeted intervention. Crisis intervention among men presenting addictive behaviours with or without substance may therefore be key to preventing suicidal behaviour.

Disclosure

No significant relationships.

Poker playing among women: Understanding factors associated with gambling problems

Poker players are at high risk of experiencing gambling problems. Despite the feminization of gambling, little is known about the problems associated with poker playing among women. This cross-sectional study aims to examine relationships between gambling problems and factors generally associated with gambling problems (gambling behaviours, substance use and mental health) among women poker players. A total of 46 women were recruited through a broader prospective cohort study from the province of Quebec, Canada. The outcome variable of interest was participants’ scores on the Problem Gambling Severity Index (PGSI); the predictive variables were gambling behaviours, alcohol and drug misuse (DEBA-Alcohol and drugs) and mental health (Beck anxiety and depression). Multiple logistic regression analyses revealed that the factors associated with gambling problems among women poker players are distinct from those of men. For women, severity of gambling problems is positively associated with Internet poker playing, playing slot machines and smoking cigarettes (p < .05). However, among these women, alcohol and drug misuse and mental health are not associated with gambling problems. Therefore, it is important to understand the risks associated with women poker players to develop preventive strategies adapted for this population and to adjust interventions accordingly.RésuméLes joueurs de poker sont une population à risque de présenter des problèmes de jeu. Malgré la féminisation des jeux de hasard et d’argent (JHA), les connaissances sont limitées quant aux problèmes liés au poker chez les femmes. Cette étude transversale vise à documenter le lien entre les problèmes de jeu et les facteurs généralement associés aux problèmes de jeu (comportements de jeu, consommation de substances et santé mentale) chez les joueuses de poker. Au total, 46 femmes ont été recrutées dans le cadre d'une étude de cohorte prospective plus large réalisée dans la province de Québec, au Canada. Le score à l'Indice Canadien du Jeu Excessif (ICJE) était la variable dépendante; les variables prédictives étaient les comportements de jeu, l'abus d'alcool et de drogues (DEBA-Alcool et Drogues) et la santé mentale (Inventaire d’anxiété et de dépression de Beck). Les analyses de régression logistique ont révélé que les facteurs associés aux problèmes de jeu chez les joueuses de poker sont distincts de ceux des hommes. Pour les femmes, la gravité des problèmes de jeu est positivement associée à jouer au poker sur Internet, à jouer aux machines à sous et à fumer des cigarettes (p < 0,05). Toutefois, chez ces femmes, ni l'abus d'alcool et de drogues, ni la santé mentale ne sont pas associés aux problèmes de jeu. Il est donc important de comprendre les risques associés aux problèmes de jeu chez les joueuses de poker afin de développer des stratégies de prévention adaptées à cette population et d'ajuster les interventions en conséquence. 

[Addictions]

This year, the actuality for addictions in this edition addresses four points. The disease model of addiction is criticized by the cognitive neurosciences which need to consider the agentivity of the persons. Regarding the societal actuality, clinical pharmacology review of cannabidiol presents an update on legal cannabis. The suicidality of excessive gamblers may be prevented specifically. Addiction and first psychotic episodes need an integrated care.

Quelle est l’influence du genre dans la recherche de soins chez les joueurs?

Cette étude vise à décrire l’influence du genre sur les différentes étapes amenant un joueur ayant des problèmes de jeu à prendre la décision de rechercher de l’aide. Le modèle de recherche d’aide de Goldsmith, Jackson et Hough (1988) a été utilisé pour conceptualiser les étapes de prise de décision menant à consulter des services d’aide pour un problème de jeu de hasard et d’argent. Au total, 83 participants, dont 45 femmes et 38 hommes adultes, y ont pris part. Les résultats indiquent que, comparativement aux hommes, les femmes sont plus nombreuses à habiter en couple, ont plus souvent de faibles revenus et subviennent moins fréquemment seules à leurs besoins, rapportent des conduites de jeu plus conséquentes, souffrent davantage de troubles anxieux au cours de leur vie et, enfin, consultent surtout des services non spécialisés. Au cours des 12 derniers mois, les femmes avaient consulté plus souvent les services médicaux de première ligne et avaient eu moins fréquemment recours aux services spécialisés que les hommes.The aim of this study was to describe the influence of gender on the various stages of the decision-making process that bring problem gamblers to seek help. The authors used the help-seeking model developed by Goldsmith, Jackson and Hough (1988) to conceptualize the different stages of the process that leads to consulting support services for a gambling problem. A total of 83 participants (45 females and 38 males) took part in the study. Results show that women are more likely to have a partner and to earn a lower income; they provide for their own needs less frequently than men; report more consistent gaming behaviours; are more prone to anxiety disorder during their lifetime; and consult primarily non-specialized services. In the previous 12 months, they had accessed front-line services more often and specialized services less frequently than men.

[Addiction]

What's new in addiction medicine in 2012? The news are presented according three axes: first, in the field of neuroscience, the process of extinction of addiction memories. Then in the clinical field, a reflexion is reported on how to treat addiction in psychiatric hospitals. At last, in the area of teaching, an e-learning development with a virtual patient shows a great interest in addiction psychiatry.