Pharmacological and Psychosocial Treatment of Adults With Gambling Disorder: A Meta-Review

Abstract

BACKGROUND AND OBJECTIVES. Gambling Disorder (GD) is a major public health problem, leading to impaired socio-economical functioning and increased social costs. Although the research on this field has been rising over the years, approved treatment guidelines for GD are currently not available. The aim of this study was to systematically review the literature on the pharmacological and non-pharmacological treatment of adults with GD, to identify possible agreed-upon standards of care. METHODS. MEDLINE, PubMed, and Cochrane electronic databases were searched up to September 2018 for systematic reviews on pharmacological and nonpharmacological treatment of adults with GD. Twenty-three studies were eventually included in this meta-review. RESULTS. Studies reported promising results of opioid antagonists and mood stabilizers in reducing GD-related symptomatology. Lithium was particularly effective in gamblers with comorbid bipolar disorders. Cognitive Behavioural Therapy (CBT) was the most commonly used psychological intervention and reduced global severity, gambling frequency, and financial loss. Motivational Interviewing (MI) seemed to improve several GD domains, alone or in combination with CBT. Self Help Interventions (SHIs) showed some efficacy in promoting treatment-seeking, and in combination with other treatments. CONCLUSIONS. We found moderate evidence of effect for CBT, but lower evidence for pharmacotherapy and SHIs. Results suggested some efficacy for MI in the shortbut not in the long-term. It is likely that certain interventions might be more effective than others on specific features of GD. Further studies are needed to compare the efficacy and acceptability of individual and combined psychosocial and pharmacological interventions, in order to deliver patient-tailored treatments.

Suicide Attempt in Patients With Gambling Disorder—Associations With Comorbidity Including Substance Use Disorders

“…In addition, gambling disorder is a condition that can be treated, and where a range of support groups or evidence-based treatments are available. Most importantly, cognitive-behavioral therapy and motivational interventions are seen as efficacious (13,27,28). The findings of the present study, again underlining the gravity of gambling disorder and even more so in the presence of an alcohol or drug use disorder, call for implementation of such evidencebased treatments widely in society, and call for further research in groups with comorbidity and/or heredity for the combined conditions.…”

“…Also, with respect to evidencebased pharmacological treatment in substance use disorders, their distribution in national registers are unlikely to cover a large share of the patients receiving SUD treatment (39), and a large share of SUD treatment is likely to have occurred outside of formal treatment systems (40). Likewise, structured treatment of gambling disorder would have provided an important additional co-variate in the present analyses, as several treatment methods are available and have provided evidence in recent years' research (28). However, structured treatment has been limited throughout the study period in the present setting, and also may have occurred either within social services or in the format of voluntary peer support provided by patient organizations (4).…”

Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial

“…They offer an anonymous way to receive the treatment, with greater flexibility and time and cost reductions ( Gainsbury and Blaszczynski, 2011 ). Previous studies have supported the efficacy of online interventions based on CBT ( DiNicola et al, 2020 ; Jonas et al, 2020 ), as well as the relevance of involving significant others in the treatment to enhance adherence ( Nilsson et al, 2019 ).…”

Affected Others Responsivity to Gambling Harm: An International Taxonomy of Consumer-Derived Behaviour Change Techniques

“…It is characterized by a pattern of persistent and recurrent gambling that is associated with substantial impairment or distress [1]. Evidence suggests that the most efficacious treatment for Gambling Disorder is cognitive-behavioural therapy with weaker evidence for pharmacotherapy, self-help and motivational interviewing [2]. The negative impacts of having a gambling problem range from financial harm, emotional or psychological distress as well as relationship disruption and conflict [3].…”