Gambling addiction may increase the risk of long-term sick leave

Gambling addiction can increase the risk of long-term sick leave for several years, according to a new study published in Psychological Medicine. Researchers from Karolinska Institutet behind the study point to the need to detect people with gambling addiction in time to avoid financial and health problems.  

Gambling addiction is a psychiatric condition characterized by prolonged and problematic gambling that leads to negative financial, health and social consequences. 1.3 percent of the Swedish population, corresponding to 105,000 Swedes, have gambling problems or an increased risk of gambling problems, but the number of unreported cases is believed to be much higher. The condition has been described as a "hidden addiction" that can go on without the knowledge of the environment.  

The research team, with expertise in addiction, gambling, epidemiology, and sickness absence, used several linked national registers to study 2,830 working-age individuals between 19 and 62 who had been diagnosed with gambling addiction and examined their sickness absence over six years. They then compared these data to an equivalent group of 28 300 people without a gambling addiction diagnosis.  

 "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," says the study's last author Yasmina Molero, researcher at the Department of Clinical Neuroscience, Karolinska Institutet.

The researchers found that people with gambling addiction had an 89% higher risk of being on long-term sick leave, which means more than 90 days per year during the year they were diagnosed.   

"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," says the study's first author Viktor Månsson, researcher at the same department.

The study also shows that the risk is unevenly distributed. Being female, having less education and living in less densely populated areas were linked to a higher risk of long-term sick leave.  

According to the researchers, the results are important because there is a lack of knowledge about the consequences of gambling addiction over time and how they can affect the individual in terms of health and workability, and ultimately financial stability and participation in society through work.  

“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," says Viktor Månsson.   

The next step in the research is to continue to develop methods for earlier detection of gambling addiction and to educate healthcare professionals about the problem, Yasmina Molero explains.   

“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 ten years, to find out more about the long-term consequences for those affected and their environment.”

The research was mainly funded by Region Stockholm and Forte. The researchers declare that there is no conflict of interest.   

Publication: "The risk and development of work disability among individuals with gambling disorder: a longitudinal case-cohort study in Sweden", Viktor Månsson, Emma Pettersson, Ellenor Mittendorfer- Rutz, Joar Guterstam, Anne H Berman, Nitya Jayaram Lindström, Yasmina Molero, Psychological Medicine, online November 20, 2023, doi: 10.1017/S0033291723003288