Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec 1;7(4):1091-1099.
doi: 10.1556/2006.7.2018.112. Epub 2018 Nov 14.

Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study

Anna Karlsson  1   2 , Anders Håkansson  1   2
Affiliations

Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study

Anna Karlsson et al. J Behav Addict. .

Erratum in

Abstract

Background and aims: Gambling disorder (GD) appears to be an independent risk factor for suicide, and all-cause mortality has been sparsely studied in patients with GD. This study aims to explore mortality and suicide rates in individuals with GD compared to the general population as well as explore risk factors associated with all-cause mortality and suicide mortality.

Methods: This is a nationwide register study on 2,099 individuals with a GD diagnosis in the Swedish inpatient and/or outpatient specialist health care system between the years of 2005-2016. Comorbid diagnoses from treatment episodes included in national registers were categorized into diagnostic groups according to the 10th revision of International Classification of Diseases, and prevalence rates (any occurrence during 2005-2016) were calculated for each diagnostic group. Multivariate Cox regression analyses on risk factors for death and suicide were performed, controlling for age, gender, and major categories of comorbidity. Standardized mortality ratios (SMRs) were calculated for men and women with regard to overall mortality and suicide compared to the general Swedish population.

Results: The population consisted of 1,625 men and 474 women ranging from 18 to 83 years of age at first GD diagnosis (mean: 36.5 years). Sixty-seven individuals passed away, among whom 21 deaths were due to suicide. SMR calculations showed a 1.8-fold increase in mortality for individuals 20-74 years old with GD compared to the general population, and a 15-fold increase in suicide mortality. All-cause mortality was predicted by higher age and any treatment episode for cardiovascular disease, whereas suicide death was predicted by depression.

Discussion and conclusions: Mortality and suicide rates are significantly elevated among individuals with GD. Although common mental health comorbidities did not predict overall mortality, depression predicted suicide death. Findings call for attention to long-term risk of death in GD patients and interventions against comorbid health problems.

Keywords: comorbidity; gambling disorder; mortality; nationwide; standardized mortality ratios; suicide.

PubMed Disclaimer

References

    1. Abbott M., Romild U., Volberg R. (2018). The prevalence, incidence, and gender and age-specific incidence of problem gambling: Results of the Swedish longitudinal gambling study (Swelogs). Addiction, 113(4), 699–707. doi:10.1111/add.14083 - DOI - PubMed
    1. Åhman A., Jerkeman A., Blomé M. A., Björkman P., Håkansson A. (2018). Mortality and causes of death among people who inject amphetamine: A long-term follow-up cohort study from a needle exchange program in Sweden. Drug and Alcohol Dependence, 188, 274–280. doi:10.1016/j.drugalcdep.2018.03.053 - DOI - PubMed
    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of psychiatric disorders. Arlington, VA: American Psychiatric Association.
    1. Bischof A., Meyer C., Bischof G., John U., Wurst F. M., Thon N., Lucht M., Grabe H. J., Rumpf H. J. (2015). Suicidal events among pathological gamblers: The role of comorbidity of axis I and axis II disorders. Psychiatry Research, 225(3), 413–419. doi:10.1016/j.psychres.2014.11.074 - DOI - PubMed
    1. Björkenstam C., Johansson L. A., Nordstrom P., Thiblin I., Fugelstad A., Hallqvist J., Ljung R. (2014). Suicide or undetermined intent? A register-based study of signs of misclassification. Population Health Metrics, 12(1), 11. doi:10.1186/1478-7954-12-11 - DOI - PMC - PubMed