Gambling Disorder and Work Disability: A National Registry Study in Sweden

Background: Having the ability to work is an important part of everyday life and personal finances. If individuals with Gambling Disorder(GD) have an increased risk for work disablity have not been investigated previoulsy with register data. This longitudinal study aimed to investigate the association between GD and work disability and to map work disability in subgroups of individuals with GD, three years before and three years after recieving a diagnosis from healthcare.

Methods: We included individuals aged 19–62 with a diagnosis of GD in Swedish helathccare regsiters between 2005 and 2018 (n = 2830; 71.1% men, mean age: 35.1) and a matched comparison cohort (n = 28 300). Work disability was operationalized as the aggregated net days of sickness absence and disability pension extracted from the Swedish Social Insurance Agency. Generalized estimating equation models were used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the risk of long-term work disability (>90 days of work disability/year). Secondly, we conducted Group-based Trajectory Models on days of work disability amng individuals with GD to map subgroups of developmental pathways.

Results: Individuals with GD showed a four-year increased risk of long-term work disability compared to the matched cohort, peaking at the time of diagnosis (AOR = 1.89; CI 1.67–2.13). Four trajectory groups of work disability days were identified: constant low (60.3%, 5.6–11.2 days), low and increasing (11.4%, 11.8–152.5 days), medium–high and decreasing (11.1%, 65.1–110 days), and constant high (17.1%, 264–331 days). Individuals who were females, older, with prior psychiatric diagnosis, and had been dispensed a psychotropic medication, particularly antidepressants, were more likely to be assigned to groups other than the constant low.

Conclusion: Individuals with GD 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 GD. In addition, the burden of work disability is unevenly distributed; females, individual with fewer years of education, living in more rural areas were at higher risk of work disability.