Clinical and financial correlates of suicide attempts among patients with gambling disorder: a retrospective study

Abstract Background Gambling disorder (GD) is strongly associated with suicidal behavior; however, the specific clinical and financial factors associated with gambling-related suicide attempts remain insufficiently understood. This study aimed to compare the sociodemographic, clinical, and financial characteristics of individuals with GD with and without gambling-related suicide attempts and to identify independent factors associated with these attempts. Methods This retrospective, descriptive, and comparative study included 342 patients diagnosed with GD according to DSM-5 criteria at a specialized addiction outpatient clinic between September 2023 and December 2025. Sociodemographic, clinical, and financial data were obtained from medical records. Gambling severity was assessed using the South Oaks Gambling Screen (SOGS). Patients were classified according to the presence or absence of gambling-related suicide attempts identified through retrospective review of clinical records. Univariable and multivariable logistic regression analyses were performed to identify factors associated with gambling-related suicide attempts. Results The prevalence of lifetime suicide attempts in the sample was 13.2%. Traditional sociodemographic variables commonly considered protective against suicide in the general population (e.g., marriage, parenthood, social support) were not significantly associated with suicide attempts in this sample. In univariable analyses, higher gambling severity, depression, Cluster B personality disorders, history of deliberate self-harm (DSH), and financial hardship were significantly associated with gambling-related suicide attempts. After multivariable adjustment, history of DSH (OR = 15.894, 95% CI: 3.270–77.253), presence of psychiatric comorbidity (OR = 14.549, 95% CI: 1.799–117.650), and a debt-to-monthly income ratio > 30 (OR = 8.806, 95% CI: 1.777–43.625) remained independently associated with gambling-related suicide attempts. Conclusions Gambling-related suicide attempts appear to be more closely associated with disorder-specific clinical and financial characteristics than with traditional sociodemographic variables. A history of deliberate self-harm, psychiatric comorbidity, and severe relative financial burden (debt-to-income ratio > 30) emerged as independent correlates of gambling-related suicide attempts. These findings support comprehensive suicide risk assessment in gambling disorder that incorporates self-harm history, psychiatric comorbidity, and financial strain in addition to gambling severity. Clinical trial number Not applicable.