Drawing upon the Ottawa Charter for Health Promotion as a guiding framework, a prevention model and framework for action are presented to better understand and address problem gambling from a population-based perspective.
With the legalization of new forms of gambling there are increasing numbers of individuals who appear to have gambling related problems and who are seeking help. The individual and societal consequences are significant. Pathological gambling can result in the gambler jeopardizing or losing a significant relationship or job and committing criminal gambling.
Pathological gamblers may develop general medical conditions associated with stress. There is help with gambling addiction in family high risk of suicide and a high correlation with antisocial, narcissistic and borderline personality disorders and alcohol addiction.
With increasing public awareness of gambling related problems health funders and practitioners are asking questions about the efficacy of treatments. Consequently quality research into gambling treatment is public. The objective of this review was to complete a systematic review and meta-analysis of all randomised controlled trials RCTs of psychological and pharmacological treatments for pathological gambling, from both published and unpublished scientific reports.
Published and unpublished RCTs of treatments of pathological gambling were identified by searches of electronic databases and hand searching journals likely to contain RCTs of gambling treatments. Researchers and gambling treatment centres were contacted by letter. Bibliographies health interventions all identified research studies were scanned to identify other relevant references. All RCTs of treatments for pathological gambling were eligible for inclusion.
The component RCTs were quality rated, with special emphasis on the concealment of treatment allocation and blinding. Relative risk analyses were conducted for the dichotomous outcome of controlled vs. The relative risks were aggregated using both fixed and random effects models. Tests for heterogeneity were undertaken. Both short-term 1 month or less and long-term slotmachines for months or longer outcomes were considered.
Only four RCTs of psychological treatments were identified. These RCTs were heterogeneous in terms of design, interventions, outcome measurement and follow-up periods. All had small numbers of participants. The studies had poor methodological quality features. With a fixed effect gambling the relative risk was 0. This systematic review revealed a paucity of evidence for effective treatment of pathological gambling. As gambling is becoming more accessible in many countries and there is epidemiological evidence of increasing rates of pathological gambling, more rigorous RCTs are required.