Swedish Study Finds Link Between Gambling Disorder & Long-Term Work Leave

According to new research out of Sweden, those with gambling addiction have an increased risk of requiring long-term sick leave in the years before and after a problem gambling diagnosis.

Published in Psychological Medicine, the study suggests swift detection of gambling addiction can minimize gambling harms. It bears the title: The risk and development of work disability among individuals with gambling disorder: a longitudinal case-cohort study in Sweden.

Essentially, researchers found the earlier gambling problems are detected, the better.

Individuals with gambling disorder have an increased risk of work disability which may add financial and social pressure and is an additional incentive for earlier detection and prevention of gambling disorder.

Researchers also found that comorbidities play a role in individual risk factors.

The study also shows that comorbid anxiety, depression, and ADHD, prior use of psychotropic medication (e.g., antidepressants), female sex, and having fewer years of education increase the risk of work disability among individuals with gambling disorder.

These findings highlight the importance of early detection and prevention.

Study Sought to Investigate PG, Long-Term Leave

As a psychiatric condition, science classifies gambling disorder (GD) as prolonged and problematic gambling, leading to adverse social, health, and financial consequences.

Gambling addiction has long been considered a “hidden addiction” that creates havoc for sufferers in the shadows.

In Sweden, approximately 1.3% of the population, or 105,000, are either at risk of or experience gambling harm.

According to the National Council on Problem Gambling (NCPG), most adults who gamble in the US do so without experiencing harm. However, 2 million adults (1% of the population) meet the criteria for severe gambling problems. Another 2-3% (4-6 million) exhibit mild-to-moderate risk on the problem gambling (PG) scale.

For this longitudinal study, researchers aimed to investigate the association between gambling disorder and “work disability.” They also set out to classify individuals with GD into subgroups based on absenteeism tallied pre and post-gambling disorder diagnosis.

To complete its research, the team relied on several of Sweden’s interlinked national registers to identify and study 2,830 participants between 19 and 62. Researchers followed each individual’s history for six years, three on either side of their initial diagnosis. They then compared results against a comparison cohort of 28,300 without a gambling addiction diagnosis.

One of the study’s authors, Yasmina Molero, noted the extensive data sources offered researchers valuable controls

In a release detailing the findings, Molero, a researcher at Sweden’s Karolinska Institute, said:

Thanks to the extensive data in the different registers, we were also able to control for a range of factors that are linked to both gambling addiction and sickness absence, including physical and mental health, gender, age, length of education, and how densely populated area the individual lives in.

Gambling Addiction Requires More Sick Leave

Notably, with those controls, researchers found individuals with gambling addiction had a higher risk of requiring long-term sick leave (more than 90 days per year).

Researchers identified the finding as particularly worrying due to mental health comorbidities that often benefit from work satisfaction.

As lead author Viktor Månsson, also of the Karolinska Institute, said in the release:

This is particularly worrying as this group often has a history of mental health problems, and the ability to work is important for mental and financial recovery.

The study shows that we need to detect gambling problems at an earlier stage in health care and at workplaces and increase access to help for affected people so that they can break negative trajectories earlier. Gambling addiction risks going unnoticed, and the problems can become extensive before they are noticed and diagnosed in health care, something that this study shows.   

Importantly, the study also found that for those with gambling disorder, the risk of long-term work absences is uneven. It found being female, having lower education levels, and rural living associated with a higher risk of extended sick leave.

Researchers noted the findings are significant because they contribute to a lack of existing knowledge of the long-term consequences of gambling disorder. Results like this only highlight how the condition impacts health, employability, financial stability, and social participation through work.

The findings also spotlight potential prevention efforts, researchers explained:

For individuals with GD unable to work due to anxiety or depression, it could be essential to include preventive actions directed at gambling while on sick leave.

Long periods away from work can imply more unstructured time, less social contact, and increased opportunities to gamble. Therefore, preventive efforts at the selected level via the healthcare system could be improved by early detection of GD among individuals in treatment for depressive symptoms or being on sick leave due to anxiety or mood disorders.

Researchers Suggest ‘Systematic’ Workplace Screening

Given the absence of widespread, systematic screening, researchers argue that recognition of the increased GD risk among specific individuals should lead to screening within psychiatry.

Researchers also suggest that “systematic” screening should occur in the workplace.

Since prevention and treatment directed at the workplace suffer from the same obstacles as approaching healthcare for treatment – e.g., stigma, embarrassment, and not wanting to disclose the reason for being absent are reasons cited for not seeking help, systematic screening via health check-ups regularly conducted at the workplace could increase early detection.

The next step, explained Molero, is to develop earlier problem gambling detection methods while educating health professionals. It’s also critical to follow participants for even longer time frames.

As gambling addiction is often a long-term problem, it will also be important to follow people over an even longer period, for example up to 10 years, to find out more about the long-term consequences for those affected and their environment.

About the Author

Robyn McNeil

Robyn McNeil

Robyn McNeil is a Nova Scotia-based writer and editor. She lives in Halifax in an empty nest with a mischievous cat and a penchant for good stories, strong tea, cheeseburgers, yoga, graveyards, hammocks, gardening, games, herb, adventure, and hoppy beer.
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