Treatments of internet gaming disorder and comorbid mental disorders: A systematic review and meta-analysis

Various therapies are used in patients with internet gaming disorder (IGD), but their comparative effectiveness in reducing IGD symptoms is unknown. The present systematic review and meta-analysis evaluated the effectiveness of pharmacotherapy, psychotherapy and pharmacological-psychological combined therapy on IGD related-outcomes and its comorbid mental disorders. Following PRISMA guidelines, a search of MEDLINE, EMBASE, Ovid Emcare, PsycINFO and the Cochrane Clinical Trials Library was conducted by Aug 04, 2023. We pooled effect sizes as within-group Hedges's g and performed meta-regression using random effects models. Systematic review identified 43 studies and 32 of them with 1738 participants were included for meta-analysis. Pharmaco-, psycho- and combined therapies showed large-to-moderate effect sizes for IGD symptoms and comorbid mental disorders. Combined therapies (Hedges's g = −2.11, 95% confidence interval: −2.87 to −1.35) showed larger effect size than pharmacotherapies (Hedges's g = −1.10, −1.31 to −0.89) or psychotherapies (Hedges's g = −0.99, −1.22, −0.76) on IGD reduction at post-intervention. The effects maintained at follow-up in psycho- and combined therapies. Bupropion and cognitive behavioral therapy showed advantages over their counterparts. The three types of therapies are promising to reduce IGD symptoms and comorbidities, but cautious interpretation is required given the limitations and high heterogeneity in the existing interventions.