{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T10:44:45Z","timestamp":1791110685799,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["BMRPJ30"],"award-info":[{"award-number":["BMRPJ30"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG8N0881"],"award-info":[{"award-number":["CMRPG8N0881"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG8P0631"],"award-info":[{"award-number":["CMRPG8P0631"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CORPG8P0561"],"award-info":[{"award-number":["CORPG8P0561"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Gambling disorder (GD) has been linked to suicidal ideation and suicide deaths; however, evidence on all\u2010cause and cause\u2010specific mortality\u2014particularly in Asian populations\u2014remains limited. Using a retrospective cohort study based on nationwide matched and sibling cohort, we investigated all\u2010cause and cause\u2010specific mortality risk in patients with GD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was conducted using 2000\u20132022 data from Taiwan\u2019s National Health Insurance Research Database. A cohort of 961 individuals diagnosed with GD was identified. An age\u2010 and sex\u2010matched control cohort (\n                      <jats:italic>n<\/jats:italic>\n                      = 3,844) and an unaffected sibling cohort (\n                      <jats:italic>n<\/jats:italic>\n                      = 675) were constructed. Cumulative survival was illustrated using Kaplan\u2010Meier curves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Cox regression models estimated crude and adjusted hazard ratios (AHR) for all\u2010cause, natural\u2010cause and unnatural\u2010cause (accidents and suicides) mortality risks. Covariates for adjustment included sociodemographic factors, physical and psychiatric comorbidities and familial confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Over a mean follow\u2010up of 8 years, GD was associated with elevated all\u2010cause mortality risk [AHR 1.20, 95% confidence interval (CI) = 0.90\u20131.61] driven by statistically significantly elevated risk of unnatural mortality (AHR 6.15, 95% CI = 3.44\u201310.98) and especially suicide mortality (AHR 10.03, 95% CI = 4.71\u201321.33). Risk of natural mortality was statistically significantly lower in GD patients (AHR 0.66, 95% CI = 0.45\u20130.96). Sibling cohort analysis revealed a similar trend (all\u2010cause mortality: AHR 1.70, 95% CI = 0.67\u20134.28; unnatural cause mortality: AHR 8.65, 95% CI = 1.62\u201346.22; suicide mortality: AHR 7.24, 95% CI = 0.74\u201370.59; natural cause mortality: AHR 0.48, 95% CI = 0.13\u20131.73). Results remained consistent after adjustment for individual psychiatric comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gambling disorder patients in Taiwan appear to have a statistically significantly increased risk of unnatural\u2010cause 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70397","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T02:50:13Z","timestamp":1774320613000},"page":"2225-2233","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["All\u2010cause and cause\u2010specific mortality in gambling disorder: Evidence from a nation\u2010wide matched and sibling cohort study in Taiwan"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-9175","authenticated-orcid":false,"given":"Yang\u2010Chieh Brian","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences The University of Texas Health Science Center at Houston  Houston TX USA"},{"name":"Department of Psychiatry Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang\u2010Jen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-1073","authenticated-orcid":false,"given":"Mu\u2010Hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Department of Psychiatry, College of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao\u2010Hsu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine Chang Gung Memorial Hospital  Chiayi Taiwan"},{"name":"School of Traditional Chinese Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Health Information and Epidemiology Laboratory Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-5586","authenticated-orcid":false,"given":"Chih\u2010Sung","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Beitou Branch Tri\u2010Service General Hospital, National Defense Medical Center  Taipei Taiwan"},{"name":"Department of Psychiatry National Defense Medical Center  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5852-7652","authenticated-orcid":false,"given":"Edward Chia\u2010Cheng","family":"Lai","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine National Cheng Kung University  Tainan Taiwan"},{"name":"Population Health Data Center National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0099-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(24)00126-9"},{"key":"e_1_2_11_5_1","volume-title":"Problem gambling in Europe: Challenges, prevention, and 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