Gender- and age-stratified analyses of gambling disorder in Finland between 2011 and 2020 based on administrative registers

Aim: Prevalence studies on gambling have largely relied on survey samples. Little is known about the diagnosed prevalence of gambling disorder (GD) based on register data. This study examines the annual prevalence rate of GD between 2011 and 2020 among Finns by gender and age. Methods: Aggregated data on the diagnosis of GD (corresponding to pathological gambling, code F63.0 in the ICD-10) were retrieved from the following national registers: Register of Primary Health Care Visits, and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient Care Register for Social Welfare. Primary and secondary diagnoses of adults were included. Average population during a calendar year (4,282,714-4,460,177 individuals) was utilised to calculate annual prevalence. Results: The annual prevalence of diagnosed GD in the population increased from 0.005% (n = 196) to 0.018% (n = 804) within nine years. In 2011, the annual prevalence rate was 0.006% for men and 0.003% for women, compared to rates in 2020 of 0.025% and 0.011%. Gender discrepancy was relatively stable across years: 27.2-33.8% of the diagnoses were for women. The prevalence of GD varied between age groups within genders. GD was most prevalent among 18-44-year-olds. The prevalence rates increased the most among 30-44-year-old women. Conclusion: The extremely low prevalence rate of GD implies that the problem remains under-diagnosed, yet, it has increased among all age groups across genders, except for women aged 60 years or older. Active efforts are needed to increase awareness of GD among both primary and specialised healthcare professionals and the public for better recognition and early detection.Peer reviewe

Canadian Lower Risk Gambling Guidelines: Investigating Feasibility of the Guidelines in a Finnish Cultural Context

ABSTRACT At-risk and problem gambling is a significant public health concern globally, and it causes harm not only to the gamblers but also to their significant others as well as the society at large. This study evaluates the feasibility of the Lower-Risk Gambling Guidelines (LRGG), developed by the Canadian Centre of Substance Use and Addiction (CCSA), in a Finnish cultural context. The LRGG was developed to lessen the harms related to gambling in Canada, using gambling data from eight countries, including Finland. We use both qualitative and quantitative methods to find out whether the established guidelines of: 1) Gamble no more than 1 % of household income, and 2) Gamble no more than 4 days per month, and 3) Avoid regularly gambling at more than 2 types of games apply to the Finns as they are or do they need cultural modifications. We will present and discuss preliminary results of the quantitative online survey results (n = 500–800) and the qualitative focus group interviews (n = 44–70). IMPLICATIONS The goal of our study is to establish culturally sensitive safer gambling guidelines in Finland, which would help Finns to make informed decisions about their gambling. The guidelines also support the implementation of the programs aimed at reducing gambling-related harms and promoting public health. In addition, these programs can provide consistent evidence-informed advice about how to gamble in a lower-risk manner

Gender- and age-stratified analyses of gambling disorder in Finland between 2011 and 2020 based on administrative registers

Aim: Prevalence studies on gambling have largely relied on survey samples. Little is known about the diagnosed prevalence of gambling disorder (GD) based on register data. This study examines the annual prevalence rate of GD between 2011 and 2020 among Finns by gender and age. Methods: Aggregated data on the diagnosis of GD (corresponding to pathological gambling, code F63.0 in the ICD-10) were retrieved from the following national registers: Register of Primary Health Care Visits, and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient Care Register for Social Welfare. Primary and secondary diagnoses of adults were included. Average population during a calendar year (4,282,714-4,460,177 individuals) was utilised to calculate annual prevalence. Results: The annual prevalence of diagnosed GD in the population increased from 0.005% (n = 196) to 0.018% (n = 804) within nine years. In 2011, the annual prevalence rate was 0.006% for men and 0.003% for women, compared to rates in 2020 of 0.025% and 0.011%. Gender discrepancy was relatively stable across years: 27.2-33.8% of the diagnoses were for women. The prevalence of GD varied between age groups within genders. GD was most prevalent among 18-44-year-olds. The prevalence rates increased the most among 30-44-year-old women. Conclusion: The extremely low prevalence rate of GD implies that the problem remains under-diagnosed, yet, it has increased among all age groups across genders, except for women aged 60 years or older. Active efforts are needed to increase awareness of GD among both primary and specialised healthcare professionals and the public for better recognition and early detection.</p

Role of Nicotine Dependence in the Association between the Dopamine Receptor Gene DRD3 and Major Depressive Disorder

Peer reviewe

Somatic comorbidity among persons with diagnosed gambling disorder: a Finnish nationwide register study

Previous register-based studies on comorbidity have mainly focused on gambling disorder (GD) and psychiatric disorders. However, knowledge on somatic health of persons with GD is also needed. This nationwide register-based study aims to examine the gender-specific prevalence rates of chronic diseases and conditions among Finnish adults with GD. This study utilises aggregated data of persons aged 18 and over with GD diagnosis (ICD-10; F63.0) in 2011–2020 (n=2,617). The data were retrieved from the Finnish nationwide primary and secondary health care registers. All diagnostic groups were included. Age-adjusted corresponding figures for the total population with same age range are presented as references. The most common comorbid somatic disorders among persons with GD were (persons with GD vs the general population): musculoskeletal diseases (61.6% vs 48.7%), digestive diseases (30.2% vs 20.5%), cardiovascular diseases (25.3% vs 21.5%), and nervous system diseases (23.9% vs 14.2%). Among persons with GD, comorbid disorders were more prevalent among women than among men. All the somatic disorders were more prevalent among persons with GD than among the general population. These findings highlight the need for health and social care professionals to recognize that persons with GD may additionally have somatic disorders that need attention

Social disadvantage and gambling severity: a population-based study with register-linkage.

BACKGROUND Studies have found an association between problem gambling and poverty. However, there is relatively little research on social inequalities and problem gambling using population representative data. METHODS A population-representative self-report web-based and postal survey with register-based linkage was conducted in the three geographical areas of Finland. Participants (n = 7186, aged 18 or older) were randomly selected from the population register. Sociodemographic factors and social welfare benefits were studied among gambling groups and their statistical difference were examined by χ2 test. Seven logistic regression models were calculated, where unemployment, social security benefits and low income were treated as dependent variables and where sex, age, family structure and education were controlled as covariates. The results were presented as odds ratios (OR) with 95% confidence intervals (CIs). RESULTS Problem and at-risk gambling (ARG) was more common among people who were unemployed [PG: χ2=6.4 (1), P < 0.01, ARG: χ2=12.4 (1), P < 0.001] or had received social security benefits [PG: χ2=41.6 (1), P < 0.001, ARG: χ2=22.9 (1), P < 0.001]. The OR for problem gambling was high as 5.6 (CI: 3.22-9.61) among respondents who had received social assistance even when covariates were taking into count. Almost a third of those experiencing problem or at-risk gambling received at least one form of social security benefit. CONCLUSIONS The most important task of gambling policy should be reducing gambling-related harms and diminishing social inequality. However, even in government organized system where gambling profits are used for common good, profits come from the most socially disadvantaged people thereby exacerbating inequality

Somatic and psychiatric comorbidity in people with diagnosed gambling disorder: A Finnish nation‐wide register study

Background and aimsThis is the first nation-wide register study based on a total population sample measuring the gender-specific incidences of chronic diseases and conditions among adults diagnosed with gambling disorder (GD).Design, setting and participantsThe study used aggregated data for 2011–22 retrieved from the Register of Primary Health Care visits, Care Register for Health Care and Care Register for Social Welfare, including specialized outpatient and inpatient health care, inpatient social care and institutional care and housing services with 24-hour or part-time assistance, set in mainland Finland. Participants comprised people aged 18–90+ years with GD diagnosis [corresponding to pathological gambling, International Classification of Diseases 10th revision (ICD-10) code F63.0, n = 3605; men n = 2574, women n = 1031] and the general population (n = 4 374 192).MeasurementsIncidences of somatic diseases and psychiatric disorders were calculated for the people with diagnosed GD and for the general population, separately for women and men.FindingsAfter standardizing for age, the incidence of each diagnostic group was systematically higher for people with GD compared with the general population, except for cancer. The highest standardized incidence ratio (SIR) values were for psychiatric disorders [SIR = 234.2; 95% confidence interval (CI) = 226.1–242.4], memory disorders (SIR = 172.1; 95% CI = 119.1–234.8), nervous system diseases (SIR = 162.8; 95% CI = 152.8–173.1), chronic respiratory diseases (SIR = 150.6; 95% CI = 137.6–164.2), diabetes (SIR = 141.4; 95% CI = 127.9–155.5) and digestive diseases (SIR = 134.5; 95% CI = 127.1–142.2).ConclusionsIn Finland, the incidence of chronic diseases and conditions among people with gambling disorder is higher compared with the general population, apart from cancer

Psychiatric comorbidity was linked with diagnosed gambling disorder in Finland – A study based on a total population sample

Only few studies have evaluated gambling disorder (GD) based on total population samples. The prevalence rates of diagnosed GD are low in Finland; however, they increased among all age groups across genders, except for the women aged 60 or more in 2011-2020. This study examines the psychiatric comorbidity and main causes of death among person with diagnosed GD in Finland based on a total population sample. Aggregated data on adults with diagnosed GD (ICD-10: code F63.0) were retrieved from the following Finnish national registers: Register of Primary Health Care visits, and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient social care. Primary and secondary diagnoses in 2011-2020 were included. Further, data on other psychiatric diagnoses (F00–F99), and causes of death were retrieved. Of persons with GD, 87.7 percent had been diagnosed with at least one additional psychiatric disorder. Comorbid psychiatric disorders were more prevalent among women with GD (92.1%) compared to men with GD (85.9%). Overall, mood disorders, anxiety disorders, and substance use disorders were most common types of comorbid disorders. Out of the 2,617 persons with GD in 2011-2020, 54 persons (2.1%) had died. Every third death was a suicide death. The potential presence of comorbidity and increased risk for suicide death should be acknowledged by health and social care professionals when working with persons with addictive disorders including GD. Furthermore, interventions are needed to increase awareness of GD among both primary and specialized health care professionals and the public