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

Karlsson, Anna LU and Håkansson, Anders LU (2018) In Journal of Behavioral Addictions 7(4). p.1091-1099
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... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
comorbidity, gambling disorder, mortality, nationwide, standardized mortality ratios, suicide
in
Journal of Behavioral Addictions
volume
7
issue
4
pages
9 pages
publisher
Akademiai Kiado
external identifiers
  • scopus:85059270765
ISSN
2062-5871
DOI
10.1556/2006.7.2018.112
language
English
LU publication?
yes
id
3068b099-5685-4215-be08-c3c600869698
date added to LUP
2019-01-16 08:02:53
date last changed
2019-04-18 03:00:13
@article{3068b099-5685-4215-be08-c3c600869698,
  abstract     = {<p>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.</p>},
  author       = {Karlsson, Anna and Håkansson, Anders},
  issn         = {2062-5871},
  keyword      = {comorbidity,gambling disorder,mortality,nationwide,standardized mortality ratios,suicide},
  language     = {eng},
  month        = {12},
  number       = {4},
  pages        = {1091--1099},
  publisher    = {Akademiai Kiado},
  series       = {Journal of Behavioral Addictions},
  title        = {Gambling disorder, increased mortality, suicidality, and associated comorbidity : A longitudinal nationwide register study},
  url          = {http://dx.doi.org/10.1556/2006.7.2018.112},
  volume       = {7},
  year         = {2018},
}