Effects of a depression-focused internet intervention in slot machine gamblers: A randomized controlled trial

PLoS One. 2018 Jun 8;13(6):e0198859. doi: 10.1371/journal.pone.0198859. eCollection 2018.


Background: Problematic and pathological gambling have been linked to depression. Despite a high demand for treatment and negative financial consequences, only a small fraction of problematic and pathological gamblers seek professional help. The existing treatment gap could be narrowed by providing low-threshold, anonymous internet-based interventions. The aim of the present study was to examine the acceptance and efficacy of an online-intervention for depression ("Deprexis") in a sample of problematic and pathological slot-machine gamblers. We hypothesized that the intervention group would show a greater reduction in both depressive and gambling-related symptoms compared to a wait-list control group.

Method: A total of 140 individuals with self-reported gambling and mood problems were randomly allocated either to the intervention group or to a wait-list control group. After 8 weeks, all participants were invited for re-assessment. The Patient Health Questionnaire - 9 (PHQ-9) served as the primary outcome assessment. Problematic gambling was measured with the Pathological Gambling Adaptation of Yale-Brown Obsessive Compulsive Scale (PG-YBOCS) and the South Oaks Gambling Screen (SOGS). The trial is registered with the German Registry for Clinical Studies (DRKS00013888).

Results: ITT analyses showed that the intervention led to a significant reduction in depressive symptoms as well as gambling-related symptoms compared to the control group, with moderate to strong effect sizes. PP analyses failed to yield significant results due to high rates of non-completion and limited statistical power. Moderator analyses indicated that Deprexis was particularly beneficial in reducing problematic gambling for those scoring high on baseline gambling-related symptoms and for those who gamble due to loneliness.

Discussion: Results of the present study suggest that Deprexis might be a useful adjunct to traditional interventions for the treatment of problematic gambling. The potential of internet-based interventions that are more targeted at issues specific to gambling should be evaluated in future studies.

Trial registration: German Registry for Clinical Studies DRKS00013888.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Depression / psychology
  • Depression / therapy*
  • Female
  • Gambling / psychology
  • Gambling / therapy*
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Psychotherapy / methods*
  • Self Report
  • Telemedicine / methods*
  • Treatment Outcome
  • Young Adult

Associated data

  • DRKS/DRKS0001388

Grant support

The study was funded by the Gauselmann AG, a German gaming and gambling company. The declaration of the German Interstate Gambling Treaty claims that the gambling industry is required to spend money on the prevention of pathological gambling. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.