Psychological interventions for harmful gambling: Systematic review and network meta-analysis.
Odette Megnin-Viggars, Ifigeneia Mavranezouli, Beatrice C Downing et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and network meta-analysis compared psychological interventions for harmful gambling across 52 randomized controlled trials involving 9013 participants and 14 intervention classes. For gambling symptom severity, group cognitive behavioural therapy (CBT) ranked highest, with an SMD of -1.09 (95%CrIs -1.75 to -0.44); individual CBT followed (SMD -0.56, 95%CrIs -1.07 to -0.07). Effects of other interventions on symptom severity were uncertain. For gambling frequency, active interventions had similar effects to treatment as usual. The authors noted low or very low study quality and moderate-to-high heterogeneity for symptom severity.
Key findings
- Group CBT had the largest estimated reduction in gambling symptom severity (SMD -1.09, 95%CrIs -1.75 to -0.44).
- Individual CBT was next best for symptom severity (SMD -0.56, 95%CrIs -1.07 to -0.07).
- Waitlist was associated with greater symptom severity than no treatment (SMD 0.96, 95%CrIs 0.47 to 1.46).
- For gambling frequency, all active interventions showed similar effects to treatment as usual.
Why it matters
The findings distinguish symptom-severity outcomes from gambling frequency: CBT, particularly group CBT, had the strongest evidence for reducing severity, while frequency outcomes did not favour active interventions over usual care. This can help frame discussions of the evidence for psychological approaches, while the uncertainty and quality of the underlying studies remain important when interpreting comparative rankings.
What to keep in mind
Included studies were of low or very low quality, and the gambling symptom severity network meta-analysis had moderate-to-high heterogeneity.