Description

• Internet gaming disorder (IGD) is where the “gamers” play compulsively, to the exclusion of other interests resulting in clinically significant impairment or distress.
• For gaming disorder to be diagnosed, the behavior pattern must be of sufficient severity and would be evident for at least 12 months.
• IGD is identified in section III of DSM-5 as a condition warranting more clinical research and experience before it might be considered for inclusion in the main book as a formal disorder.
• On June 18, 2018, WHO recognized gaming disorder as a mental health condition.
• Gaming disorder (digital or video) is included in ICD-11.

Epidemiology

Incidence

• Predominant age—adolescence
• Predominant sex—male

Prevalence

• Median prevalence of 2.0%
• Prevalence rates are highest in Eastern Asian countries and male adolescents aged 12 to 20 years (1).

Etiology and Pathophysiology

• On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity (2).
• On the level of neural circuitry, Internet and gaming addiction lead to neuroadaptation and structural changes that occur as a consequence of prolonged increased activity in brain areas associated with addiction (2).
• On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains (2).
• IGD shares multiple features with drug addictions, including elevated impulsivity, cognitive inflexibility, and attentional biases.

Risk Factors

The following risk factors were found to be significantly associated with IGD (3):

• Functional and dysfunctional impulsivity
• Belief self-control
• Anxiety
• Pursuit of desired appetitive goals
• Money spent on gaming
• Weekday game time
• Offline community meeting attendance
• Game community membership
• Gaming motives play a role as well.
• Gamers with psychiatric distress use it a coping strategy to improve their mood and/or attain emotional stability.
• Achievement-related motives may be related to the lack of real-life achievements that are compensated by virtual victories and successes.

Commonly Associated Conditions

• Anxiety disorder
• Mood disorder
• Autism spectrum disorder
• Attention deficit hyperactivity disorder
• Personality disorder
• Behavioral disorder