Internet Gaming Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the 11th Revision of the International Classification of Diseases categorize Internet gaming disorder (IGD) as an addictive disorder. An epidemiological study reported its worldwide prevalence as 3–5%. The clinical presentation of IGD is similar to that of other addictive disorders; it manifests as impaired control over gaming and results in functional impairment in daily life, such as in studies, work, and social life. Because of the high heterogeneity of IGD, its neurobiological and psychosocial etiologies remain unclear. Possible underlying mechanisms include alterations in the following: response to gaming, reaction to rewards or aversion, cognitive control, and emotional regulation. Impulsivity, hostility, depression, anxiety, social phobia, stress, social support, and family factors may be associated with IGD. IGD has high comorbidity with attention-deficit/hyperactivity disorder (ADHD), depressive disorder, generalized anxiety disorder, social anxiety disorder, and personality disorder. The bidirectional interaction between IGD and comorbidities is clinically important. Thus, comprehensive assessment of the core symptoms of IGD, as well as negative consequences, functional impairment, comorbidities, complications, and environmental factors, particularly stress and family factors, is paramount to establishing a diagnosis and formulating a personalized treatment plan. Because of the lack of effective somatic interventions, psychosocial interventions should be offered as soon as possible to patients with IGD. These interventions include motivational interviews, cognitive behavior therapy, behavior modification, harm reduction, self-discovery camps, and family interventions. Patients with IGD usually refuse to accept treatment initially; therefore, maintaining therapeutic rapport and treatment alliance is essential in initial interventions. Patients with IGD should be assessed for comorbidities, particularly ADHD and depression, and these should also be treated. More randomized control trials are required to prove the effectiveness of these interventions.