Internet Gaming Disorder: Symptoms, Diagnosis, Treatment – Verywell Health

Alison Yarp, MD, MPH, is a medical professional with experience in both clinical and non-clinical medicine, especially in the areas of mental health and public health.
Internet gaming disorder, sometimes referred to as IGD, is an emerging diagnosis. The internet is an integral part of people’s lives worldwide for business, education, and leisure. However, for some, it has gone beyond typical use to what some people view as addictive behavior, especially in the realm of online gaming.
As a result, IGD is being discussed progressively more often in research articles and studies as its understanding grows. Learn more about what is currently known about this disorder from this overview.

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IGD is being discussed and studied both at the national and international levels. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which contains the formal guidelines used by healthcare professionals to diagnose mental health disorders, lists IGD in Section III, describing it as being a condition needing further research and experience.
The general idea of IGD is the continued use of internet gaming to the extent that it causes distress and affects daily life and functioning. Furthermore, it is being described separately from excessive use of the internet, social media, or online gambling.
The World Health Organization (WHO) has also listed IGD in the International Classification of Diseases (ICD-11), the standard for diagnosing and categorizing diseases worldwide.
IGD is “a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”

It must be present for 12 months and be severe enough to affect functioning in other areas of life such as personal, family, social, education, and occupation.
The proposed DSM-5 criteria for IGD require ongoing and recurrent internet gaming causing clinically significant impairment or distress. It needs to be noticeable by at least five of the following signs in the past 12 months:
People who are said to have this condition typically spend eight to 10 hours per day on internet gaming and at least 30 hours per week. It has been listed separately from gambling disorder because there is no money at risk.

While there is still not much known about IGD, there is some research that has looked into the causes, risk factors, and other conditions that may be associated with it. Some risk factors observed include impulsiveness, lower social competence, and amounts of time spent on gaming. Some conditions observed along with IGD include depression, anxiety, and ADHD.
One study looked at how those affected by IGD may think about and view their gaming psychologically. It proposed that patient’s beliefs may be categorized into four main factors:
Since this disorder is still being researched and debated, it is possible the criteria for diagnosing it will change. However, if someone is concerned about potentially having IGD, it is important to tell their doctor or mental health professional.
They will perform a thorough history, asking questions about internet gaming and any effects it may have had. If they are not a psychiatrist themselves, they might provide a referral to a psychiatrist as well, as they have further training in diagnosing and treating mental illness.

While there have been studies performed on treatment options for IGD, there are not any formal recommendations. The number of studies conducted has increased over the past decade, primarily since the DSM-5 was published. However, there is no established evidence of the effectiveness of any specific treatment. 
The treatments that could be used in the future include both medications and therapy. The medications studied so far are typically used to treat depression, including escitalopram (Lexapro) and bupropion (Wellbutrin), or ADHD, including methylphenidate (Ritalin) and atomoxetine (Strattera). The therapy methods studied have been primarily based on cognitive behavioral therapy (CBT) and can be done as an individual or in a group.

It is essential to understand that while many people engage in online gaming, studies have shown that the actual number of people affected by internet gaming disorder is only a small proportion. However, if you feel like your or a loved one’s gaming is beginning to affect your or their daily life and functioning, seek advice and help from a healthcare professional or mental health provider. Even though this diagnosis is still being studied, they can provide support and potentially treatment.

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American Psychiatric Association. Internet Gaming. Updated June 2018.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. Fifth Edition. American Psychiatric Association; 2013.
World Health Organization. Addictive behaviors: gaming disorder. Updated September 14, 2018.
Gentile DA, Bailey K, Bavelier D, et al. Internet gaming disorder in children and adolescents. Pediatrics. 2017;140(Supplement 2):S81-S85. doi:10.1542/peds.2016-1758H
King DL, Delfabbro PH. The cognitive psychology of Internet gaming disorder. Clinical Psychology Review. 2014;34(4):298-308. doi:10.1016/j.cpr.2014.03.006
Zajac K, Ginley MK, Chang R. Treatments of internet gaming disorder: a systematic review of the evidence. Expert Review of Neurotherapeutics. 2020;20(1):85-93. doi:10.1080/14737175.2020.1671824

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