A new study out of Denmark found that people experiencing gambling disorder are more likely to have physical and mental health problems and to have been convicted of a crime. The research also showed that the indirect costs to society of gambling disorder are much larger than one would estimate looking only at its direct impacts.
Undertaken by academics from Aarhus University, Aarhus University Hospital, and the University of Southern Denmark, the authors say the study’s results point to an opportunity to minimize the personal and societal costs of disordered gambling.
Study Relied on Treatment and Health Records
As the study shows, gambling disorder affects millions annually around the globe. There are often severe consequences to the individual, those around them, and society at large. Yet, only a fraction of those experiencing harm seek treatment or assistance.
Making matters worse, gambling disorder is a notoriously hard problem to study. Studies over recent decades have estimated the prevalence of gambling disorder in developed countries at anywhere between 0.02% and 3.4%. That is, the high and low estimates differ by a factor of 170.
One reason for this is that much of the available research has relied on self-reported survey data.
A recent Danish study estimated that in 2021, 0.7% of adults in Denmark exhibited a severe gambling issue, which is in the middle of the range. Concerningly, that represents a three-fold jump over Denmark’s 2016 findings and four times higher than 2006 results.
Gambling disorder often occurs in combination with other forms of harm:
- Mental health issues
- Criminality
- Illness and associated healthcare costs
- Unhealthy lifestyle habits
This study considered 1381 Danish patients who had been diagnosed with gambling disorder at Danish hospitals or specialized treatment centers between 2013 and 2017. The researchers examined each participant’s registry-recorded mental and somatic (physical) comorbidities, medication use, criminality, and illness costs.
The study controlled for the age and sex of the participants to create an apples-to-apples demographic comparison with the general population.
Researchers used individual-level healthcare and socioeconomic registries to characterize participants’ history of mental and physical ailments, medication use, and criminality.
A Deeper Understanding of Gambling Disorder’s Toll
In previous studies based on self-reported data, those diagnosed with gambling disorder frequently exhibited simultaneous mental health issues (73%) and unhealthy lifestyle habits. Additionally, criminality was higher among Danish individuals with a self-reported gambling problem (23%) than those without (10%)
Despite this, researchers noted the connection between gambling addiction and the risk of lifestyle-related illness remains unaddressed.
Additionally, European studies have estimated the annual public costs of problem gambling in the billions, with indirect costs accounting for most of the expense. However, those results were only partly based on individual data. In other UK and Australian cases, researchers determined societal costs based on extrapolation of averages.
For these reasons, the team behind this study, led by research academic and doctor Søren Viborg Vestergaard, recognized a need for individual-level data beyond self-reporting.
According to the published research, the team planned to better understand gambling disorder’s individual and social tolls.
We aimed to estimate the occurrence of individuals seeking specialized treatment and describe their psychiatric and somatic comorbidities, criminal records, and cost of welfare services and lost productivity.
Mental, Physical Disorders, Criminality Prove Common
Young men made up the bulk of the study participants at 87% and the group’s median age was 34.
Reflecting previous studies, people diagnosed or in treatment for gambling disorder had “hospital-recorded comorbidity.”
Specifically, researchers found a higher rate of chronic pulmonary disease in those with gambling disorder (14.7%) than an equivalent demographic in the general population (9.1%). Other conditions including myocardial infarction and diabetes without end-organ damage were also more common by a similar margin, albeit starting from a lower base rate.
Multiple studies have linked gambling disorder to other types of addiction and compulsive behavior. The Danish study corroborated this, finding rates of alcohol and drug abuse that were four to six times higher among those with gambling disorder.
Even more striking were differences in psychiatric diagnoses between the two groups. Almost a third of the gambling disorder sample had anxiety diagnoses versus 11% in the control sample.
A similar pattern was found for other psychiatric diagnoses. Bipolar disorder was more than ten times more common in the study group than in the general population. The same was true of other conditions, each occurring several more times as often among those with gambling disorder:
- Depression
- Developmental and behavioral disorders
- Personality disorders
- Schizophrenia spectrum disorders
- Sleep disorders
Correspondingly, the study group filled more prescriptions in the five years leading up to their gambling diagnosis.
Relative to the comparison group, people with gambling disorder were between 20% and 55% more likely to use pharmaceuticals to treat infections or for issues relating to the digestive tract and metabolism, nervous system, or respiratory system.
Avenues for Further Research
In addition to the increase in mental and physical disorders, those with gambling disorder were seven times more likely to have criminal convictions than the control.
Specifically, the study found that among those with gambling disorder, 7.6% had received a conviction in the past five years, though many of these were suspended or partially-suspended sentences.
Fraud (3.3%), burglary (2.1%), and common assault (1.9%) were the most common crimes represented.
The study assessed that the attributable direct costs of gambling disorder averaged out to €4,036 (US$4,266) per person. However, it estimated the indirect attributable costs were €17,623 (US$18,630), more than four times higher.
However, researchers emphasized that this study analyzed the occurrence of diagnosed or treated gambling disorder, not problem gambling generally. Because of the suspected prevalence of undiagnosed or subclinical problem gambling, they expect the total costs associated with problem gambling on Danish individuals and society to be much higher than a straightforward reading of the study would suggest.
Despite having assembled the largest gambling disorder study cohort in Denmark to date, the team resists drawing firm conclusions on the disorder’s occurrence and total costs.
Even so, they argue that their high-quality data reveals a high burden in individuals with gambling disorder, after factoring in mental and physical comorbidity and criminality.
As is typical for gambling studies, the team concluded that more research is needed, especially into the causal relationships between the correlations they found:
With the increasing burden of gambling disorder, there is an urgent need for establishing a research infrastructure to address the associated health and criminality issues on both individual and societal level.
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