In 2024, centralized cryptocurrency exchanges reported approximately USD 18.4 trillion in trading activity, with Binance constituting a significant forty percent (~USD 7.7 trillion) of this total. The overall number of cryptocurrency holders surpassed 600 million worldwide, yet active traders (those involved in high-frequency or substantial trading) seem to be restricted to thirty to sixty million monthly users. Epidemiological studies reveal that these traders tend to be predominantly male (≈sixty-one percent), mainly falling within the 25 to 34 age bracket (thirty-four percent of owners), with a predominant share of trading volume concentrated in Asia (forty percent), followed by North America (thirty percent) and Europe (twenty percent).
This swift rise in cryptocurrency trading has given rise to a new socio-economic subculture referred to as “crypto-bros.” Frequently depicted in the media as speculative risk-takers with extravagant lifestyles, emerging empirical findings indicate that this demographic might possess unique psychological characteristics and display health-related vulnerabilities that could affect clinical practice, especially for emergency physicians and surgeons who treat acute care pathways. Due to the volatility and around-the-clock accessibility of cryptocurrency markets, one might anticipate an uptick in acute visits to emergency departments (EDs) associated with the psychological and physical effects of such trading practices.
A study published in PLOS ONE involving over 2,000 U.S. adults revealed a significant correlation between cryptocurrency ownership and heightened levels of the so-called “Dark Tetrad” personality traits (narcissism, Machiavellianism, psychopathy, and sadism), alongside conspiratorial beliefs and consumption of unregulated media. These personality aspects have been connected to high-risk decision-making, impulsivity, and a preference for immediate rewards, all of which may exacerbate compulsive trading behavior. Further research has refined this understanding, indicating that while Dark Triad traits (excluding sadism) are more prevalent among crypto holders, they account for only part of the behavioral trends, with cultural, social, and economic factors also being crucial.
From a mental health standpoint, cryptocurrency trading may resemble the dynamics of gambling addiction. A recent scoping review highlighted considerable psychological distress among traders, including increased rates of anxiety, depression, and mood variation. Similarities with gambling disorder encompass an obsession with market activities, “chasing losses,” and neglecting other life aspects. The United Kingdom’s National Health Service has reported a noticeable increase in young men seeking assistance for compulsive cryptocurrency trading, with repercussions that vary from financial devastation to relationship failures.
Physical consequences are increasingly documented in scholarly work. A cross-sectional study of 437 university academics in Turkey found that cryptocurrency traders experienced significantly diminished sleep quality, elevated stress levels, and lower overall quality of life. Such challenges are likely influenced by extended screen time, irregular sleep patterns governed by market changes, and sustained physiological excitement in reaction to volatile financial fluctuations. Chronic stress of this nature is recognized to heighten the risk of cardiovascular issues, immune dysfunction, and gastrointestinal disorders.
Physiological effects related to stress can appear as acute abdominal pain, exacerbations of peptic ulcers, or even functional gastrointestinal crises that resemble surgical emergencies. Traders under high stress can present for surgical care with perforated peptic ulcers or pain similar to acute appendicitis without any identifiable organic pathology. They may also exhibit symptoms akin to ischemic bowel caused by vascular spasms. Hence, it is crucial to recognize the emerging profile and incorporate psychosocial evaluation when assessing acute abdominal presentations.
The relevance to emergency medicine becomes clear when reflecting on parallels with established data regarding stress in financial markets. A 2024 study in Nature Mental Health indicated that downturns in the stock market correlated with measurable rises in ED visits for cardiovascular disease and mental health issues. Given the considerably higher volatility of cryptocurrency markets, which operate continuously, it is reasonable to expect an increased incidence of acute stress-related presentations in the ED (ranging from chest pain and palpitations to panic attacks and hypertensive crises), particularly during market downturns. Furthermore, a recent analysis discovered that crypto investors are more than twice as likely to disregard necessary medical care, including doctor visits and prescription refills, thereby raising the likelihood of preventable acute complications that necessitate emergency intervention.
Aristomenis Exadaktylos is an emergency physician. Suhaib J. S. Ahmad is a surgeon in the United Kingdom. Thomas Mueller is a medical director.