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Meta-Analysis
. 2023 Jul 14;12(3):613-630.
doi: 10.1556/2006.2023.00034. Print 2023 Oct 5.

Psychological intervention for gambling disorder: A systematic review and meta-analysis

Jakob W Eriksen  1 , Anne Fiskaali  1 , Robert Zachariae  2   3 , Kaare B Wellnitz  4   5 , Eva Oernboel  4   5 , Anna W Stenbro  1 , Thomas Marcussen  1 , Marie W Petersen  4   5
Affiliations
Meta-Analysis

Psychological intervention for gambling disorder: A systematic review and meta-analysis

Jakob W Eriksen et al. J Behav Addict. .

Abstract

Background and aims: Increasingly, gambling features migrate into non-gambling platforms (e.g., online gaming) making gambling exposure and problems more likely. Therefore, exploring how to best treat gambling disorder (GD) remains important. Our aim was to review systematically and quantitatively synthesize the available evidence on psychological intervention for GD.

Methods: Records were identified through searches for randomized controlled trials (RCTs) evaluating psychological intervention for GD via six academic databases without date restrictions until February 3, 2023. Study quality was assessed with the revised Cochrane risk-of-bias tool for randomized trials (RoB2). Primary outcomes were GD symptom severity and remission of GD, summarized as Hedges' g and odds ratios, respectively. The study was preregistered in PROSPERO (#CRD42021284550).

Results: Of 5,541 records, 29 RCTs (3,083 participants analyzed) were included for meta-analysis of the primary outcomes. The efficacy of psychological intervention across modality, format and mode of delivery corresponded to a medium effect on gambling severity (g = -0.71) and a small effect on remission (OR = 0.47). Generally, risk of bias was high, particularly amongst early face-to-face interventions studies.

Discussion and conclusions: The results indicate that psychological intervention is efficacious in treating GD, with face-to-face delivered intervention producing the largest effects and with strongest evidence for cognitive behavioral therapy. Much remains to be known about the long-term effects, and investigating a broader range of treatment modalities and digital interventions is a priority if we are to improve clinical practice for this heterogeneous patient group.

Keywords: gambling disorder; meta-analysis; pathological gambling; psychological intervention; psychotherapy; systematic review.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Fig. 1.
Fig. 1.
Study selection Database search was conducted at October 12, 2021 and again on July 8, 2022 and February 3, 2023 to ensure that recently published records would be identified. See Supplemetary Material 1 Tabel S1 for more information
Fig. 2.
Fig. 2.
Efficacy of psychological intervention overall Forest plot displaying the efficacy of psychological intervention at the end of treatment as measured by gambling disorder symptom severity across 28 studies. See Supplementary Material 1 Figs S2 – S30 for forest plots on remaining outcomes
See this image and copyright information in PMC

References

    1. * Abbott, M., Hodgins, D. C., Bellringer, M., Vandal, A. C., Palmer Du Preez, K., Landon, J., … Feigin, V. (2017). Brief telephone interventions for problem gambling: A randomized controlled trial. Addiction, 113(5), 883–895. 10.1111/add.14149. - DOI - PubMed
    1. Adam, C., & Raschzok, A. (2014). Explaining trends in addictive behaviour policy-The role of policy coherence. International Journal of Drug Policy, 25(3), 494–501. 10.1016/j.drugpo.2014.02.013. - DOI - PubMed
    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA.
    1. Ariss, T., & Fairbairn, C. E. (2020). The effect of significant other involvement in treatment for substance use disorders: A meta-analysis. Journal of Consulting and Clinical Psychology, 88(6), 526–540. 10.1037/ccp0000495. - DOI - PMC - PubMed
    1. Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97(5), 487–499. 10.1046/j.1360-0443.2002.00015.x. - DOI - PubMed