TABLE 1.

Studies included in the review.

References	Context	Data	Funding	Causality	Confounding factors	Treatment
Anderson et al. (55)	Estonia	Case study, psychological autopsy of a familicide-suicide	Estonian Ministry of Defense	Perpetrator suffered from pathological gambling. Did not exhibit suicidal behavior before commencing heavy gambling on EGMs.	Impulsive personality trait, HIV diagnosis resulting in marital trouble. Major depression and suicide attempt after gambling commenced.	Medication for depression
Bai et al. (57)	China (rural)	In-depth interviews with CSOs of 242 individuals who died by suicide	American Foundation for Suicide Prevention; Natural Science Foundation of Guanxi Zhuan autonomous region (China)	In one case suicide was attributed to accumulated gambling debts.	n/a	n/a
Balhara et al. (53)	India	Online media reporting on gaming-related suicide (including gambling)	None	94.8 percent of reports directly related suicide to gaming; 83.3 percent of reports linked suicide to financial loss due to gaming (of which 44 percent gambling losses, remainder in-game purhases in gaming)	Some reporting on sleep problems, academic problems, mental illness, significant life events, interpersonal problems	n/a
Bensimon et al. (63)	Israel	In-depth interviews with patrons (N = 10) and staff (N = 4) at an illegal casino	Schnitzer Foundation for Research on the Israeli Economy and Society	Attempted suicide at the casino premises after incurring heavy gambling debts.	n/a	n/a
Blaszczynski and Farrell (36)	Australia (Victoria)	Coroner’s reports on completed suicides 1990–1997 with reference to gambling (N = 44).	n/a	All the gamblers had financial difficulties prior to suicide with heavy debts and losses. In 8 cases also criminal acts to finance gambling.	Depression (32 percent), alcohol abuse (14 percent), alcohol and drug abuse (6 percent), drug abuse (4 percent). Relationship difficulties (34 percent), work problems (9 percent). Personality characteristics such as introversion and low self-esteem.	25 percent had sought help, but attendance was mostly low and appointments were not kept.
Gill et al. (61)	Global	Public records of case studies on suicide in the absence of a psychiatric disorder (N = 10)	n/a	In each case, gambling or gambling debts were identified as the cause of suicide or familicide.	None. One of the aims of the paper is to explore suicidality without mental disorder.	n/a
Jacobs (64)	United States	Case study of a 52-year old suicidal man with a history of gambling	n/a	Gambling debts described as the direct cause of suicidality. Lack of remarkable medical history.	Possibility of depression, terminal illness of a family member	Gambling addiction program
Kaggwa et al. (56)	East African community	Press reporting on gambling-related suicides (N = 18)	None	The most common identified type of suicide consisted of university students losing their tuition fees on gambling and committing suicide.	Possibly high levels of poverty.	n/a
Kausch et al. (52)	United States (Ohio)	Treatment seeking veterans with diagnosed pathological gambling (N = 111), including three detailed case reports	n/a	n/a	Selection criteria included individuals who had experienced trauma, including various types of abuse in childhood and adulthood. Also substance abuse	n/a
Kizza et al. (67)	Uganda	Qualitative psychological autopsy of men who died by suicide (N = 17)	None	In one case, gambling losses and related shame appear to have driven the individual to suicide.	Poverty and unemployment identified behind gambling as well as suicide.	n/a
Komoto (40)	Japan	Case study of a woman with a 13 year history of diagnosed pathological gambling.	The Nikkoso Foundation for Safe Society (Japan)	Gambling described as a consequence of feelings of guilt. Gambling worsened the psychological situation of the individual, resulting in a suicide attempt.	Depression and feelings of guilt	CBT as well as Naikan therapy to diminish feelings of guilt. Following treatment the patient has been able to abstain for 1 year.
Leung et al. (54)	Hong Kong	Interview study with individuals with a history of self-harm (N = 11).	n/a	Pathological gambling identified as one of the main contributing factors for self-harm.	Family problems	Preference for specialized gambling services.
Luquiens et al. (58)	France	Quantitative and qualitative observations based on contacts to gambling and gaming helpline during a 7-year period (N = 14,564)	None	Reports of contemplating suicide due to gambling debts.	Gamblers reported suicidal thoughts as a result of psychological exhaustion and lack of help.	n/a
Matthew and Volberg (65)	Singapore	In-depth interviews with CSOs of problem gamblers (N = 50)	Ministry of Community, Youth and Sports (Singapore)	Family members threaten suicide if they do not receive money from their CSOs for gambling/debts.	n/a	n/a
Miller et al. (62)	Australia	Press reporting on problem gambling in 2011–2012 (N = 339)	n/a	Twenty articles (6%) discussed suicide. Suicide was attributed to heavy gambling and related debts.	Financial debt, depression	Control on gambling availability suggested as a preventive strategy.
Oakes et al. (66)	Australia (South Australia)	Interviews with problem gamblers, CSOs and service providers (N = 54)	Flinders University Faculty of Social Sciences (Australia); Gambling Research Australia (GRA)	Shame and harms associated with gambling as a cause for suicidal thoughts for people gambling problematically. Suicide as a means to escape a desperate situation.	n/a	Suicidal thoughts as rock bottom that make the individual seek help
Reith and Dobbie (68)	UK	Interviews with a cohort of 50 gamblers interviewed three times between 2006–2009	UK Economic Social Research Council; The Responsibility of Gambling Trust (now The Responsible Gambling Trust), UK	Shame and exhaustion due to gambling identified as causes for suicidal ideation	n/a	Suicidal thoughts or attempted suicide as rock bottom that made the individual seek help and project themselves in the future.
Sharma et al. (60)	India	Case report of a diagnosed pathological gambler.	None	Heavy gambling debts, guilt, pressure by CSOs to stop gambling preceded the suicide attempt	Co-morbid depression was diagnosed, but the onset of depression
					was identified as having taking place after problematic gambling. Impulsive personality.	A failed suicide attempt made the individual seek help. CBT, Motivational enhancement therapy and medication appear to have been effective in maintaining abstinence for 3 months.
Sichali et al. (59)	Malawi	Narrative case report of a young individual who committed suicide after losing money on gambling.	Wellcome Trust (UK)	Gambling losses and subsequent conflicts identified as the main reason for the suicide	n/a	Suggested challenging the responsible gambling paradigm.
Wong et al. (28)	Hong Kong	Psychological autopsy interviews concerning gambling-related suicide cases (N = 17)	Hong Kong Jockey Club Charities Trust; The National Institute of Mental Health (NIMH), US	In each identified case, the suicide victim had unmanageable debt at the time of death.	The most common associated psychiatric disorder of suicide victims was depression. However, problematic gambling appears to have preceded depression.	n/a