The effect of non-pharmacologic treatments in individuals with problematic pornography use: a meta-analysis of randomized controlled trials

This study aimed to systematically review and meta-analyze the effects of non-pharmacological treatments on problematic pornography use (PPU), pornography use frequency, sexual dysfunction, psychological symptoms, and quality of life in individuals with PPU. A comprehensive literature search was conducted in PubMed/MEDLINE, Embase, PsycINFO, and Web of Science between June and July 2024. MeSH-based keywords were used to identify relevant Randomized Controlled Trials (RCTs) published in the last ten years. Five RCTs with a total of 826 participants were included. Non-pharmacological interventions significantly reduced PPU (SMD: -1.16; 95% CI: -2.10 to -0.22; p = 0.02) and pornography use frequency (SMD: -0.74; 95% CI: -1.43 to -0.05; p = 0.04) compared to control groups. No statistically significant effects were found for sexual dysfunction (SMD: -0.47; p = 0.05) or psychological symptoms (SMD: -0.42; p = 0.06), though moderate effects were observed. Risk of bias was high or unclear in terms of participant and outcome blinding. Non-pharmacological interventions appear effective in reducing PPU and use frequency. Although effects on sexual function and psychological symptoms were not significant, the findings suggest potential improvements in overall quality of life.