{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T18:38:31Z","timestamp":1772217511691,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The COVID-19 pandemic and its impact on society has been suspected to affect gambling behaviors. Potentially, the pandemic crisis may result in increased problem gambling, for example, due to COVID-19-related psychological distress, unemployment, and financial difficulties. In addition, the cancellation of sports in early parts of the crisis has been suspected to alter gambling behaviors. Policy makers have called for action and, in some cases, have changed regulations, and media have reported possible increases in treatment seeking. However, research data are hitherto lacking. The present study assessed the treatment uptake at a regional specialized gambling-disorder unit in the healthcare system of Region Sk\u00e5ne, Sweden. Number of patients, treatment contacts, and patterns of rescheduling or cancellations of appointments were quantified for each month, January\u2013December 2020, and compared to corresponding months of 2018 and 2019. Possible trends were analyzed, using an interrupted time-series analysis. Results did not indicate an increase in treatment uptake for gambling disorder during the months of COVID-19 impact in Sweden. The proportion of digital treatment increased, but total treatment uptake was unaffected by the pandemic. In conclusion, during the first ten months of the pandemic in Sweden, no obvious increase in treatment uptake for gambling disorder could be seen. Moreover, longer follow-up may be necessary in order to see if effects of worsening socioeconomic conditions may be a possible long-term risk factor of increased gambling after COVID-19.<\/jats:p>","DOI":"10.3390\/ijerph18041918","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T04:49:01Z","timestamp":1613537341000},"page":"1918","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["No Apparent Increase in Treatment Uptake for Gambling Disorder during Ten Months of the COVID-19 Pandemic\u2014Analysis of a Regional Specialized Treatment Unit in Sweden"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5800-8975","authenticated-orcid":false,"given":"Anders","family":"H\u00e5kansson","sequence":"first","affiliation":[{"name":"Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 221 85 Lund, Sweden"},{"name":"Gambling Disorder Unit, Malm\u00f6 Addiction Center, Region Sk\u00e5ne, 205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunny","family":"\u00c5kesson","sequence":"additional","affiliation":[{"name":"Gambling Disorder Unit, Malm\u00f6 Addiction Center, Region Sk\u00e5ne, 205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6648-0236","authenticated-orcid":false,"given":"C\u00e9cile","family":"Grudet","sequence":"additional","affiliation":[{"name":"Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 221 85 Lund, Sweden"},{"name":"Gambling Disorder Unit, Malm\u00f6 Addiction Center, Region Sk\u00e5ne, 205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niroshani","family":"Broman","sequence":"additional","affiliation":[{"name":"Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 221 85 Lund, Sweden"},{"name":"Gambling Disorder Unit, Malm\u00f6 Addiction Center, Region Sk\u00e5ne, 205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1177\/0020764020915212","article-title":"The outbreak of COVID-19 coronavirus and its impact on global mental health","volume":"66","author":"Torales","year":"2020","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1111\/add.15080","article-title":"Mitigating and learning from the impact of COVID-19 infection on addictive disorders","volume":"115","author":"Marsden","year":"2020","journal-title":"Addiction"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1556\/2006.2020.00016","article-title":"Problematic online gaming and the COVID-19 pandemic","volume":"9","author":"King","year":"2020","journal-title":"J. Behav. Addict."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1097\/ADM.0000000000000690","article-title":"Gambling During the COVID-19 Crisis\u2014A Cause for Concern","volume":"14","author":"Potenza","year":"2020","journal-title":"J. Addict. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1038\/s41572-019-0099-7","article-title":"Gambling disorder","volume":"5","author":"Potenza","year":"2019","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_7","unstructured":"SBC News (2020, December 10). Spain Order \u2018Social Shield\u2019 to Fast Track Gambling Advertising Window. SBC News, Available online: https:\/\/sbcnews.co.uk\/europe\/2020\/04\/01\/spain-orders-social-shield-to-fast-track-gambling-advertising-window\/."},{"key":"ref_8","unstructured":"The Guardian (2020, December 10). Coronavirus: Gambling Firms Urged to Impose Betting Cap of L50 a Day. The Guardian, Available online: https:\/\/www.theguardian.com\/sport\/2020\/mar\/22\/coronavirus-gambling-firms-urged-to-impose-betting-cap-of-50-a-day."},{"key":"ref_9","unstructured":"Reuters (2020, December 10). Sweden to Limit Online Betting during Coronavirus Outbreak. Reuters, Available online: https:\/\/www.reuters.com\/article\/us-health-coronavirus-sweden-gambling\/sweden-to-limit-online-betting-during-coronavirus-outbreak-idUSKCN2251WC."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"H\u00e5kansson, A. (2020). Changes in gambling behavior during the COVID-19 pandemic\u2014A web survey study in Sweden. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17114013"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"568543","DOI":"10.3389\/fpsyg.2020.568543","article-title":"Impact of COVID-19 on online gambling\u2014A general population survey during the pandemic","volume":"11","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Price, A. (2020). Online Gambling in the Midst of COVID-19: A Nexus of Mental Health Concerns, Substance Use and Financial Stress. Int. J. Ment. Health Addict., 1\u201318.","DOI":"10.1007\/s11469-020-00366-1"},{"key":"ref_13","unstructured":"Financial Times (2020, December 10). Gamblers Bet on Marbles and Trotting as Pandemic Hits Sport. Financial Times, Available online: https:\/\/www.ft.com\/content\/71aa11ad-cf3e-47b3-8cfe-9233c436ea32."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Brown, R., Hickman, A., and Changes in Online Gambling during the COVID-19 Pandemic (2020, December 10). Statistical Bulletin 25, Available online: https:\/\/www.aic.gov.au\/publications\/sb\/sb25.","DOI":"10.52922\/sb04527"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Auer, M., Malischnig, D., and Griffiths, M.D. (2020). Gambling before and during the COVID-19 pandemic among European regular sports bettors: An impirical study using behavioral tracking data. Int. J. Ment. Health Addict., 1\u20138.","DOI":"10.1007\/s11469-020-00327-8"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"554542","DOI":"10.3389\/fpubh.2020.554542","article-title":"Transitioning between online gambling modalities and decrease in total gambling activity, but no indication of increases in problematic online gambling intensity during the first phase of the COVID-19 outbreak in Sweden: A time series forecast study","volume":"8","author":"Lindner","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_17","unstructured":"Sveriges Television [Swedish Television] (2020, December 10). Fler S\u00f6ker St\u00f6d f\u00f6r Spelberoende Under Coronapandemin. [More People Seek Support for Gambling Problems during the Corona Pandemic]. Available online: https:\/\/www.svt.se\/nyheter\/lokalt\/skane\/fler-soker-stod-for-spelberoende-under-coronapandemin."},{"key":"ref_18","unstructured":"Sveriges Television [Swedish Television] (2020, December 10). Kraftig \u00d6kning av Spelberoende Som S\u00f6ker Hj\u00e4lp. [Large Increase in Number of Individuals Addicted to Gambling Who Seek Help]. Available online: https:\/\/www.svt.se\/nyheter\/lokalt\/vast\/paskhelg-och-coronapandemi-farlig-tid-for-spelberoende."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"108180","DOI":"10.1016\/j.jsat.2020.108180","article-title":"COVID-19-related treatment service disruptions among people with single- and polysubstance use concerns","volume":"121","author":"Mellis","year":"2021","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1017\/ipm.2020.47","article-title":"Addiction psychiatry and COVID-19: Impact on patients and service provision","volume":"37","author":"Columb","year":"2020","journal-title":"Ir. J. Psychol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1080\/08897077.2020.1822489","article-title":"Identifying #addiction concerns on twitter during the COVID-19 pandemic: A text mining analysis","volume":"42","author":"Glowacki","year":"2021","journal-title":"Subst. Abus."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3389\/fpsyt.2017.00255","article-title":"Who seeks treatment when medicine opens the door to gambling disorder patients\u2014Psychiatric co-morbidity and heavy predominance of online gambling","volume":"8","author":"Zaar","year":"2017","journal-title":"Front. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"426","DOI":"10.3389\/fpsyt.2018.00426","article-title":"Primary and secondary diagnoses of gambling disorder and psychiatric comorbidity in the Swedish health care system\u2014A nationwide register study","volume":"9","author":"Karlsson","year":"2018","journal-title":"Front. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s12954-020-00423-x","article-title":"Who chooses to enroll in a new national gambling self-exclusion system? A general population survey in Sweden","volume":"17","author":"Henzel","year":"2020","journal-title":"Harm Reduct. J."},{"key":"ref_25","first-page":"100182","article-title":"Television gambling advertisements: Extent and content of gambling advertisements with a focus on potential high-risk commercial messages","volume":"9","author":"Widinghoff","year":"2019","journal-title":"Addict. Behav. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1111\/add.14083","article-title":"The prevalence, incidence, and gender and age-specific incidence of problem gambling: Results of the Swedish longitudinal gambling study (Swelogs)","volume":"113","author":"Abbott","year":"2018","journal-title":"Addiction"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s10899-009-9129-9","article-title":"Barriers to Seeking Help for Gambling Problems: A Review of the Empirical Literature","volume":"25","author":"Suurvali","year":"2009","journal-title":"J. Gambl. Stud."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Donati, M.A., Cabrini, S., Capitanucci, D., Primi, C., Smaniotto, R., Avanzi, M., Quadrelli, E., Bielli, G., Casini, A., and Roaro, A. (2021). Being a gambler during the COVID-19 pandemic: A study with Italian patients and the effects of reduced explosion. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18020424"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.addbeh.2018.06.001","article-title":"Gamblers seeking online help are active help-seekers: Time to support autonomy and competence","volume":"87","author":"Rodda","year":"2018","journal-title":"Addict. Behav."},{"key":"ref_30","unstructured":"Berman, A. (2020, December 10). Hasardspelberoende\u2014Hur Hanterar Vi Problematiskt Spelande under Corona-Krisen? Oral Presentation. Uppsala University, U-FOLD. Available online: https:\/\/www.ufold.uu.se\/evenemang\/seminarier\/hasardspelberoende-under-corona\/."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Cross, M., Ng, S.-K., and Scuffham, P. (2020). Trading health for wealth: The effect of COVID-19 response stringency. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17238725"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"563397","DOI":"10.3389\/fpubh.2020.563397","article-title":"Lessons from Italy\u2019s and Sweden\u2019s policies in fighting COVID-19: The contribution of biomedical and social competences","volume":"8","author":"Farina","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.annepidem.2020.11.005","article-title":"Leveraging epidemiological principles to evaluate Sweden\u2019s COVID-19 response","volume":"54","author":"Baral","year":"2020","journal-title":"Ann. Epidemiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1918\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:25:05Z","timestamp":1760160305000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["ijerph18041918"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18041918","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,17]]}}}