Treatment Approaches for Problematic Pornography Use: A Systematic Review

Area of Science:

• Psychiatry
• Psychology
• Sexual Health

Background:

• Problematic pornography use (PPU) is an emerging condition linked to adverse psychological and sexual health outcomes.
• A systematic review is needed to evaluate current treatment approaches for PPU.

Approach:

• Searched multiple databases (PubMed/MEDLINE, Embase, PsycINFO, Web of Science) up to April 1, 2023.
• Assessed evidence quality using Joanna Briggs Institute checklists, Cochrane risk-of-bias tools, and the GRADE approach.
• Included 28 studies (500 participants) comprising case reports, case series, quasi-experimental, and randomized clinical trials.

Key Points:

• The majority of reviewed studies exhibited low quality and significant risk of bias, with interventions rated as low or very low certainty.
• Psychological interventions, particularly cognitive behavioral therapy (CBT) variants, were most frequently investigated.
• Pharmacological options included opioid antagonists (e.g., naltrexone) and antidepressants; one study explored repetitive transcranial magnetic stimulation (rTMS).

Conclusions:

• While some psychological and pharmacological interventions show potential for treating PPU, the current literature is limited by low-quality evidence.
• Treatment adherence was a concern for online and self-help interventions.
• Further high-quality research is essential to establish definitive conclusions on PPU treatment efficacy.