Addiction. 2026 Mar 23. doi: 10.1111/add.70397. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: Gambling disorder (GD) has been linked to suicidal ideation and suicide deaths; however, evidence on all-cause and cause-specific mortality-particularly in Asian populations-remains limited. Using a retrospective cohort study based on nationwide matched and sibling cohort, we investigated all-cause and cause-specific mortality risk in patients with GD.
DESIGN, SETTING AND PARTICIPANTS: A retrospective cohort study was conducted using 2000-2022 data from Taiwan’s National Health Insurance Research Database. A cohort of 961 individuals diagnosed with GD was identified. An age- and sex-matched control cohort (n = 3,844) and an unaffected sibling cohort (n = 675) were constructed. Cumulative survival was illustrated using Kaplan-Meier curves.
MEASUREMENTS: Cox regression models estimated crude and adjusted hazard ratios (AHR) for all-cause, natural-cause and unnatural-cause (accidents and suicides) mortality risks. Covariates for adjustment included sociodemographic factors, physical and psychiatric comorbidities and familial confounding.
FINDINGS: Over a mean follow-up of 8 years, GD was associated with elevated all-cause mortality risk [AHR 1.20, 95% confidence interval (CI) = 0.90-1.61] driven by statistically significantly elevated risk of unnatural mortality (AHR 6.15, 95% CI = 3.44-10.98) and especially suicide mortality (AHR 10.03, 95% CI = 4.71-21.33). Risk of natural mortality was statistically significantly lower in GD patients (AHR 0.66, 95% CI = 0.45-0.96). Sibling cohort analysis revealed a similar trend (all-cause mortality: AHR 1.70, 95% CI = 0.67-4.28; unnatural cause mortality: AHR 8.65, 95% CI = 1.62-46.22; suicide mortality: AHR 7.24, 95% CI = 0.74-70.59; natural cause mortality: AHR 0.48, 95% CI = 0.13-1.73). Results remained consistent after adjustment for individual psychiatric comorbidities.
CONCLUSIONS: Gambling disorder patients in Taiwan appear to have a statistically significantly increased risk of unnatural-cause mortality and especially suicide mortality compared with matched controls. Policies and clinical interventions for treating GD patients should focus on suicide prevention to reduce mortality in this population.
PMID:41872026 | DOI:10.1111/add.70397
