Pharmacological and psychosocial treatment of adults with gambling disorder: a meta-review
Abstract
BACKGROUND AND OBJECTIVES: Gambling disorder (GD) leads to impaired socioeconomical functioning and increased social costs. Although the research on GD has been rising over the years, approved treatment guidelines are currently not available. The aim of this study was to systematically review the literature on the pharmacological and psychosocial treatment of adults with GD, and to identify possible agreed-upon standards of care. METHODS: MEDLINE, PubMed, Cochrane, Web of Science, Embase, and CINAHL electronic databases were searched up to April 2019 for systematic reviews on pharmacological, psychosocial, and combined treatment of adults with GD. Twenty-six 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 subjects with comorbid bipolar disorders. Cognitive behavioral 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 weaker evidence for pharmacotherapy and SHIs. Results suggested some efficacy for MI in the short but 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, to deliver patient-tailored treatments.
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Previous studies have supported the efficacy of online interventions based on CBT.
“Previous studies have supported the efficacy of online interventions based on CBT (DiNicola et al., 2020; Jonas et al., 2020)”
From Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial (2021) · cites this paper as DiNicola et al., 2020
Section 3.4 (p. 11) reports positive results for internet-delivered therapy for gambling disorder, while section 3.2 (p. 9) reports evidence for CBT. Our copy does not establish that the effective online interventions were based on CBT, so it supports the two elements separately but not their combination. (LLM, conf=0.82)
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Frontal white and gray matter abnormality in gambling disorder: A multimodal MRI study
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The pharmacological management of gambling disorder: if, when, and how
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The Effect of Chatbot Interventions on Gambling Disorder: A Systematic Review
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Motivational telephone intervention to risk gamblers by a state-owned gambling operator in Sweden
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Motivational interviewing for cannabis use disorders: A narrative review from research to practice
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Psychopharmacotherapy in Gambling Disorder
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Pharmacothérapies des dépendances comportementales
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Addiction aux jeux de hasard et d’argent
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High-frequency rTMS as a first-line treatment for gambling disorder – A case report
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Self-Injury Mortality: Global Ascertainment and Prevention
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- Authors
- Di Nicola, M., De Crescenzo, F., D’Alò, G. L., Remondi, C., Panaccione, I., Moccia, L., Molinaro, M., Dattoli, L., Lauriola, A., Martinelli, S., Giuseppin, G., Maisto, F., Crosta, M. L., Di Pietro, S., Amato, L., & Janiri, L.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- ORCID
- Venue
- Journal of Addiction Medicine
- Published
- 2019-10-22
- Volume
- 14
- Issue
- 4
- Pages
- e15-e23
- ISSN
- 1932-0620 (ISSN-L)
- 1935-3227
- OpenAlex
- W2981816620
- Cited by
- 70
- References
- 58
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 11 · 2023: 19 · 2022: 11 · 2021: 8 · 2020: 4
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Addiction Medicine (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- gambling addiction, pharmacotherapy, psychosocial interventions, cognitive behavioral therapy, motivational interviewing, self-help intervention, opioid antagonists, mood stabilizers, lithium, bipolar disorder comorbidity, treatment guidelines, standard of care
- MeSH terms
- Systematic Reviews as Topic, Adult, Bipolar Disorder, Gambling, Humans, Cognitive Behavioral Therapy, Motivational Interviewing
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