BACKGROUND: Treatment for gaming disorder (GD) can be challenging due to comorbidities. This systematic review and meta-analysis assessed the efficacy of interventions for GD, including cognitive behavioral therapy (CBT), pharmacological, and other approaches (e.g., family therapy, mindfulness-based therapy), and extends past reviews by evaluating GD-specific trials and the role of comorbidity.

METHODS: A pre-registered systematic review identified controlled trials of GD interventions published between 2007 and 2025. Eligible studies (n = 21) used validated GD assessments, included control groups, and reported effect sizes at post-intervention and/or follow-up. The primary outcome was GD symptoms; secondary outcomes included gaming time, depression, and anxiety. Random-effects meta-analyses calculated pooled effect sizes (Hedges' g), with mixed-effects subgroup analyses by comorbidity, intervention type, age, gender, and region.

RESULTS: Across 1360 participants, interventions significantly reduced GD symptoms (g = 1.38, p<.001) and gaming time (g = 0.90, p=.002), with moderate reductions in depression (g = 0.65, p=.001) and anxiety (g = 0.66, p=.001) at post-intervention. Effects were sustained at 90-day follow-up for GD symptoms (g = 1.15, p<.001) and gaming time (g = 0.79, p=.025). CBT and other interventions demonstrated comparable efficacy. Comorbidity did not moderate outcomes. Adolescents displayed larger treatment effects than adults. Heterogeneity between studies was generally high (i.e., I>50 %).

CONCLUSIONS: The GD treatment literature has methodological limitations including inconsistent diagnostic approaches, relatively short follow-ups, and high between-studies heterogeneity. Current evidence suggests treatment can effectively reduce symptoms and gaming time, with sustained benefits at follow-up, regardless of comorbidity. High heterogeneity suggests larger, longer-term trials are needed. Pharmacological interventions require further study, alone or combined with psychological therapies.