No Apparent Increase in Treatment Uptake for Gambling Disorder during Ten Months of the COVID-19 Pandemic—Analysis of a Regional Specialized Treatment Unit in Sweden

Abstract

The COVID-19 pandemic and its impact on society has been suspected to affect gambling behaviors. Potentially, the pandemic crisis may result in increased problem gambling, for example, due to COVID-19-related psychological distress, unemployment, and financial difficulties. In addition, the cancellation of sports in early parts of the crisis has been suspected to alter gambling behaviors. Policy makers have called for action and, in some cases, have changed regulations, and media have reported possible increases in treatment seeking. However, research data are hitherto lacking. The present study assessed the treatment uptake at a regional specialized gambling-disorder unit in the healthcare system of Region Skåne, Sweden. Number of patients, treatment contacts, and patterns of rescheduling or cancellations of appointments were quantified for each month, January–December 2020, and compared to corresponding months of 2018 and 2019. Possible trends were analyzed, using an interrupted time-series analysis. Results did not indicate an increase in treatment uptake for gambling disorder during the months of COVID-19 impact in Sweden. The proportion of digital treatment increased, but total treatment uptake was unaffected by the pandemic. In conclusion, during the first ten months of the pandemic in Sweden, no obvious increase in treatment uptake for gambling disorder could be seen. Moreover, longer follow-up may be necessary in order to see if effects of worsening socioeconomic conditions may be a possible long-term risk factor of increased gambling after COVID-19.

Gambling and the COVID-19 pandemic: A scoping review

“…The majority of the 24 studies were published in 2020 ( Auer et al, 2020 ; Czegledy, 2020 ; Frisone et al, 2020 ; Gainsbury et al, 2020 ; Griffiths et al, 2020 ; Håkansson, 2020a , Håkansson, 2020b , Håkansson, 2020c ; Håkansson et al, 2020a , Håkansson et al, 2020b ; Hunt et al, 2020 ; Lindner et al, 2020 ; Ng Yuen and Bursby, 2020 ; Price, 2020 ; Sharman, 2020 ; Turner, 2020 ; Wardle, 2020 ; Yahya and Khawaja, 2020 ), while 6 of the studies were published in 2021 ( Donati et al, 2021 ; George, 2020 , Håkansson et al, 2021 ; Lischer et al, 2021 ; Sharman et al, 2021 ; Wardle et al, 2021 ).…”

“…Nineteen studies were from Europe, including six from Sweden ( Håkansson et al, 2021 ; Håkansson, 2020a , Håkansson, 2020b , Håkansson, 2020c ; Håkansson et al, 2020b ; Lindner et al, 2020 ), eight from the UK ( Griffiths et al, 2020 ; Hunt et al, 2020 ; Sharman, 2020 ; Sharman et al, 2021 , Wardle, 2020 ; Yahya and Khawaja, 2020 ; Ng Yuen and Bursby, 2020 ), two from Italy ( Donati et al, 2021 ; Frisone et al, 2020 ), one from Switzerland ( Lischer et al, 2021 ) and two from a non-specific country or multiple countries ( Auer et al, 2020 ; Håkansson et al, 2020a ). Three articles were from North America (all from Canada; Czegledy, 2020 ; Price, 2020 ; Turner, 2020 ), one from Australia ( Gainsbury et al, 2020 ), and one from Asia (India) ( George, 2020 ).…”

“…Fourteen studies were original articles ( Auer et al, 2020 ; Donati et al, 2021 ; Frisone et al, 2020 ; Gainsbury et al, 2020 ; Håkansson, 2020a , Håkansson, 2020b , Håkansson, 2020c ; Håkansson et al, 2020b ; Håkansson et al, 2021 ; Lindner et al, 2020 ; Lischer et al, 2021 ; Price, 2020 ; Sharman et al, 2021 ; Wardle et al, 2020), eight were commentaries or editorials ( Czegledy, 2020 ; George, 2020 ; Griffiths et al, 2020 ; Håkansson et al, 2020a ; Sharman, 2020 ; Turner, 2020 ; Yahya and Khawaja, 2020 ; Ng Yuen and Bursby, 2020 ), and two were protocols ( Hunt et al, 2020 ; Wardle, 2020 ) (see Table 1 ).…”

“…Thus, chance-based online games may have remained a strong actor in the gambling market despite the COVID-19 crisis, in line with previous self-report data. A sudden increase in horse betting during the sports lockdown and its decrease when sports reopened confirm the picture of possible COVID-19-related migration between gambling types, indicating a volatility with potential impact on gambling-related public health.” “[N]ational authority data describing monthly taxations of all licensed Swedish gambling operators […] Subdivisions of the gambling market were followed monthly from before COVID-19 onset […] through June 2020” Håkansson et al (2021) No Apparent Increase in Treatment Uptake for Gambling Disorder during Ten Months of the COVID-19 Pandemic—Analysis of a Regional Specialized Treatment Unit in Sweden Europe (Sweden) Original Research “The present study assessed the treatment uptake at a regional specialized gambling-disorder unit in the healthcare system of Region Skåne, Sweden” Quantitative data analysis from 2018, 2019 and 2020 (number of patients treated at a Gambling Disorder Unit) N/A (data analysis of the number of patients) “[D]uring the first 10 months of the pandemic in Sweden, no obvious increase in treatment uptake for gambling disorder could be seen. Moreover, longer follow-up may be necessary in order to see if effects of worsening socioeconomic conditions may be a possible long-term risk factor of increased gambling after COVID-19.” Håkansson et al (2020a) Gambling During the COVID-19 Crisis – A Cause for Concern Europe (not specific) Commentary “[D]escribe observations suggesting that the current crisis and its sequelae may worsen problem gambling […] [because it] may impact financial and psychological well-being […]” N/A N/A “In summary, when facing an unforeseen situation with confinement, fear of disease and financial uncertainty for the future, problem gambling may be an important health hazard to monitor and prevent during and following the COVID-19 crisis, especially given current online gambling availability.…”

Self-Exclusion from Gambling—A Measure of COVID-19 Impact on Gambling in a Highly Online-Based Gambling Market?

“…Likewise, in previous survey studies in the present setting, the subgroup of gamblers who reported a decrease in gambling during COVID-19 was, in size, comparable to the proportion reporting an increase. Thus, the absence of dramatic changes in treatment seeking [ 21 ] or self-exclusion may be a result of counter-acting changes in different subgroups of gamblers, reflecting the mixed picture of COVID-19’s impact on gambling as either concerning or, paradoxically, relieving [ 20 ].…”