STUDY PROTOCOL article
Front. Psychiatry
Sec. Addictive Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1658195
This article is part of the Research TopicAssessment and Management of Addictive Disorders in Sexual and Racial MinoritiesView all 6 articles
Utilizing repetitive transcranial magnetic stimulation (rTMS) in the management of gambling disorder in Indonesia: protocol for a pilot and feasibility study
Provisionally accepted
Kristiana Siste1*
Enjeline Hanafi1
Belinda Julivia Murtani1
Arnt Schellekens2,3,4
Philip Van Eijndhoven2,4
Lee Thung Sen1
Kevin Surya Kusuma1Astria Aryani1- 1Department of Psychiatry, Faculty of Medicine, University of Indonesia, Depok, Indonesia
- 2Department of Psychiatry, Radboud universitair medisch centrum, Nijmegen, Netherlands
- 3Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, Netherlands
- 4Radboud Universiteit Donders Institute for Brain Cognition and Behaviour, Nijmegen, Netherlands
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Gambling disorder (GD) has emerged as a significant concern in Indonesia, particularly due to the rise in internet-based gambling during the pandemic and the limited availability of treatment options and support services for affected individuals. This issue has had profound impacts on individuals, their families, and society as a whole. Research has demonstrated that cognitive-behavioral therapy (CBT) is an effective treatment for GD. Additionally, as a relatively novel intervention, several studies have explored the efficacy of repetitive transcranial magnetic stimulation (rTMS) in addiction management, specifically in reducing cravings. This study aims to determine the potential effectiveness and feasibility of combining these two modalities within the Indonesian population. A pilot study of 10 subjects will be conducted to evaluate the effectiveness and feasibility of multimodalistic therapy using rTMS and CBT for GD. South Oaks Gambling Screen (SOGS) will be used to determine the presence of pathological gambling, and the participants will be assessed periodically using SOGS, Gambling Symptoms Assessment Scale (G-SAS), Gambling Urge Scale (GUS), Gambling Related Cognitions Scale (GRCS), Clinical Global Impression (CGI), Self-Reporting Questionnaire-20 Item (SRQ-20), Patient Health Questionnaire-9 Item (PHQ-9), and cognitive assessment. The treatment regimen will consist of 15 sessions of rTMS and 12 sessions of CBT, administered over a 5-week period. The findings of this study will contribute to the development of an optimized rTMS protocol in combination with CBT for the treatment of GD in Indonesia.
Keywords: gambling disorder, craving, cognitive-behavioral therapy, repetitive transcranialmagnetic stimulation, multimodal therapy
Received: 02 Jul 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Siste, Hanafi, Murtani, Schellekens, Van Eijndhoven, Sen, Kusuma and Aryani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kristiana Siste, Department of Psychiatry, Faculty of Medicine, University of Indonesia, Depok, Indonesia
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