The high occurrence of cross-sectional studies does not allow us to clearly define the relationship’s direction between psychological distress and problem gambling. It is difficult to establish whether the former is a risk factor or an outcome of the latter. For example, it is unclear whether a high level of psychological distress is a consequence of frequent gambling or conversely whether people with psychological distress are particularly attracted to gambling. Predictably, a higher level of psychological distress was found in em linha gamblers more at risk of problem gambling than in low-risk gamblers (Gainsbury et al., 2014b; Granero et al., 2020; Hing et al., 2017; Hopley & Nicki, 2010). Anxiety and depression were the main experiences studied and reported by pathological gamblers at higher rates (Barrault & Varescon, 2013a; Barrault et al., 2017; Hopley & Nicki, 2010; Khazaal et al., 2017). In addition, mood disturbances such as hypomanic experiences and mood elevation are reported to a greater extent in the most problematic cluster (Lloyd et al.

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Several factors were identified in the review. Socioanagraphic variables are among the most studied in both comparisons. Gender, age, level of education, occupation, income and marital status are largely investigated. Being male and younger seem to be associated more with online gamblers than offline gamblers and with problematic on-line gamblers than nonproblematic gamblers. Moreover, a high level of education, income, and job status are more likely associated with on-line gamblers than offline gamblers.

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The NPB is responsible for the national monitoring of gambling services in Finland conducted through a state monopoly. As three leading gambling operators merged into one in 2017 to reduce the negative economic, social, and health effects and to support public interest in gambling at the highest level, the NPB became charged with policing the whole eco-system.

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This paper provides a synthesis of knowledge regarding the risk and protective factors of online gambling in the adult population. From the analysis carried out, several critical elements emerge, which may offer indications for future studies. Regarding the methodology used in the studies, two critical issues emerge concerning the population and the method. Most of the papers use nonrepresentative samples. For future research, it would be desirable to use representative samples of the population. In addition, most of the papers are cross-sectional studies, whereas it would be desirable to conduct longitudinal studies to achieve a greater understanding of the bdg win relationship between variables.

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Appendix B includes a table with the title, the authors, and the year of publication of the articles included in the review in chronological order from the most recent.

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