Online gambling and adult mental health: A critical review with an exploratory meta-analysis of anxiety and stress
DOI:
https://doi.org/10.5281/zenodo.23113262Keywords:
Online gambling, Mental health, Anxiety, Stress, Meta-analysis.Abstract
The expansion of online betting platforms requires a distinction between recreational participation, gambling severity and psychological distress. This article examines the relationship between online gambling and mental health, with attention to sports betting, depression and suicide risk. A critical review used targeted searches in PubMed, the Virtual Health Library and the CAPES Journals Portal, supplemented by journal and repository texts. The narrative corpus comprised 18 primary studies and seven scientific syntheses. An exploratory quantitative synthesis included two cross-sectional adult studies, encompassing 6,283 participants, which reported Spearman correlations between online gambling severity and anxiety or stress. Fisher transformation, DerSimonian–Laird random effects and conservative modified Hartung–Knapp intervals were used. Pooled estimates were 0.117 for anxiety and 0.091 for stress; conservative intervals included the null. Anxiety showed substantial heterogeneity, while the stress estimate was dominated by the larger study. Depression, suicidal ideation and comparisons across gambling modes were examined narratively because their measures were incompatible. The narrative synthesis supports criticism of unrestricted betting promotion, including experimental effects of inducements on betting decisions and evidence of financial harm. The meta-analysis establishes neither causality nor platform-specific risk. Brazilian longitudinal research, product-specific measures and clinical assessments addressing financial losses, behavioural control and comorbidity are needed. The synthesis should be interpreted as exploratory rather than a comprehensive systematic review.
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