Gambling and the enduring financial recession in Greece
Authors: Marina Economou, Lily Evagelia Peppou, Kyriakos Souliotis, Melpomeni Malliori, George N. Papadimitriou
Journal: World Psychiatry (2014)

The enduring nature of the economic crisis in Greece has already been linked to adverse health effects 1. Congruent with this, previous work from our research team has shown a gradual increase in the prevalence of major depression and suicidality in the country during the period 2008-2011 2-4. In 2013, we conducted a nationwide telephone survey, following the same methodology of previous surveys 2-4, in order to identify the general population's strategies for tackling increasing financial demands. A random and representative sample of 2,188 people were interviewed about their financial difficulties, ways of dealing with financial strain, and the presence of major depression and suicidality. A major depression diagnosis was ascertained by the pertinent module of the Structured Clinical Interview 5, while financial burden was assessed through the Index of Personal Economic Distress 2. Interestingly, 2% of the population reported that they resort to gambling in order to deal with financial distress. A series of univariate analyses were performed to identify the variables that bore a statistically significant association with gambling: they were gender, educational status, employment status, financial distress and working hours. A logistic regression analysis with the aforementioned variables entered as predictors and gambling as the outcome variable (binary: yes/no) indicated that financial distress and working hours were the only variables exerting an independent effect on gambling. In particular, for every unit increase in the Index of Personal Economic Distress, respondents were 1.12 times more likely to gamble in order to deal with financial strain (OR=1.12, 95% CI: 1.03-1.23). Furthermore, participants who reported working more than 40 hours per week were roughly 7 times more likely to gamble than those who reportedly work less (OR=7.34, 95% CI: 2.03-22.91). A non-significantly lower prevalence of major depression was found among respondents who reported they gamble as a way of dealing with financial difficulties (0.9% among those who gamble vs. 16.3% among those who do not, df 1=0.63, p>0.05). With regard to suicidality, 0% of people who reported that they gamble experienced suicidal ideation, in contrast to 2.6% among people who do not gamble: df 1=1.15, p>0.05). Although differences were not significant, these data suggest that gambling offers an alternative to the dead-end created by the grim financial reality in Greece, buffering to some extent against hopelessness, a strong risk factor for major depression, suicidality and suicide 6-8. However, the existing literature suggests that, when gambling turns into its pathological form, it progresses through four stages: winning, losing, desperation and hopelessness 9. Thus, while it seems initially to offer a solution, it may subsequently lead to the same dead-end it wishes to avoid. These data add to the growing literature 10, 11 about the impact of recession on the mental health of the Greek population and the need for actions which are tailored to the specific characteristics of each population subgroup. Marina Economou1,2, Lily Evagelia Peppou1,Kyriakos Souliotis3, Melpomeni Malliori2,George N. Papadimitriou2 1University Mental Health Research Institute, Athens, Greece; 2First Department of Psychiatry, Medical School, Athens University, Athens, Greece; 3Faculty of Social Sciences, University of Peloponnese, Corinth, Greece