Gambling and completed suicide in Hong Kong: a review of coroner court files.

BACKGROUND: Previous studies have established a positive relationship between gambling and suicidal ideation and suicide attempts. Limited studies have investigated the role of gambling in completed suicide. This study aimed to determine the prevalence of gambling behavior among suicides and to compare the correlates of nongambling and gambling with and without related debt suicides.
METHOD: The death records from the coroner's court files of suicides (N = 1,201) in Hong Kong in 2003 were reviewed. Logistic regression models were used to investigate relevant correlates in suicides with gambling behavior and debt due to gambling compared to suicides with gambling behavior but no debt and nongamblers.
RESULTS: Of the suicide victims, 233 (19.4%) showed evidence of gambling behavior prior to death; 110 of the 233 gambling suicides (47.2%) involved individuals who were indebted due to gambling. In comparison with the other 2 groups, the gambling with debt suicide victims were more likely to be male, aged 30-49 years old, married, and employed and to have died by charcoal burning (carbon monoxide poisoning). These individuals also had fewer recorded medical and psychiatric problems in the past year and lifetime. When comparing suicides with gambling behavior with and without gambling-related debt, the indebted victims were more likely to also have had debt problems not attributed to gambling (OR = 149.66, P < .001) and to have been disturbed by loan sharks prior to death (OR = 28.14, P < .001) but were less likely to have recorded psychiatric disorders during their lifetime (OR = 0.41, P < .05) and at the time of death (OR = 0.26, P < .05).
CONCLUSIONS: Gambling and indebted suicides have a distinct profile and may be difficult to predict using standard risk factors as references. This finding suggests the need for improved detection and suicide prevention efforts related to gambling in individuals with gambling-related debt.