Gaming Disorder: A New Disease Experts say is Hard to Diagnose

By Carmen Arroyo and Emily ThampoeReprint | |

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A young woman plays a video game on her phone. Credit: UN News/Elizabeth Scaffidi

UNITED NATIONS, Jun 22 2018 (IPS) - The World Health Organization (WHO) has formally added “Gaming Disorder” as a disease recognized by the International Classification of Diseases (ICD) in its 11th revision of its official collection of recognized conditions.

However, since it is a very new condition, no one is really sure about its extent, its impact or how best to treat it.

Ali M. Mattu, Professor of Medical Psychology in Psychiatry at Columbia University Clinic for Anxiety and Related Disorders, told IPS: “The vast majority of people who play video games do not become addicted, similar to how most people who use alcohol do not develop substance abuse problems”.

On the other hand, Professor Mattu said that it is still hard to make a diagnosis regarding Gaming Disorder: “However, as this is a new diagnosis, we do not know how common Gaming Disorder is. We also don’t know how much Gaming Disorder is a unique problem or how it is related to anxiety, depression, Attention Deficit Hyperactivity Disorder (ADHD), or other psychiatric problems.”

The WHO defines Gaming Disorder as “a pattern of gaming behavior characterized by impaired control over gaming, increasing priority given to gaming over other activities [..]”.

The new ailment has been included in ICD-11 based on an existing consensus of experts in different fields, who were consulted during the drafting of the document; a document that had not changed since the early 90s.

The WHO says the disorder“follows the development of treatment programmes for people with health conditions identical to those characteristic of gaming disorder in many parts of the world, and will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures”.

Some studies during previous years had already drawn attention to Gaming Disorder as a pathological disease. For example, an Oxford study conducted in 2016 showed that only 0.5% of the general population had symptoms of what is now known as Gaming Disorder, which implies that gaming is addictive.

This meant that, at the time, almost one million Americans had the possibility of suffering from Gaming Disorder, in accordance with the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders’ (DSM-5) criteria regarding addiction to online games.

Moreover, a 2016 study presented by the internet security company ESET found that around 6% of respondents spend 24 hours gaming and 10% spend between 12 and 24 hours gaming.

And finally, Professor Douglas Gentile, expert on the impact of media on youth, concluded in a 2009 Iowa State study that one every ten players is addicted to video gaming.

But none of these studies were definitive.

So, how can we diagnose it?

Given some disagreement amongst the medical community of the easiness with which this disease could be diagnosed, the WHO specified that “the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months”.

Thus, doctors should wait 12 months to diagnose patients with this disorder, although, the WHO adds, if the symptoms are evident, they can diagnose earlier.

According to Dr. Vladimir Poznyak, a member of the WHO’s Department of Mental Health and Substance Abuse, who had talked to CNN, there are three major diagnostic features that would call for a diagnosis of the mental health condition.

The first is that gaming becomes more important than other things that an individual may do, even coming to the point that activities that were once important are no longer at the forefront of the individual’s mind.

The second one is that no matter the consequences that may come with playing games, the behavior will continue or increase.

The third and final diagnostic feature shows that Gaming Disorder might cause negative sensations such as distress, irregular sleeping habits, changed dietary patterns, and impaired relationships with loved ones.

When asked to comment on the diagnostic features of Gaming Disorder, Professor Mattutold IPS: “Based on what we do know about addictions, Gaming Disorder likely occurs when individuals play video games in a self-destructive way, despite negative consequences in their life”.

“In other words, video games get in the way of school, work, personal self-care, and relationships. We are wired to experience joy, connection, and meaning in our lives. When we don’t have enough of that in our lives, some of us can seek it out from other sources, like video games. Video games are also engineered to create the psychological state of flow. During flow, experience meets the challenge of a task leading time to pass by without one’s awareness. For some, this could lead to a greater vulnerability in becoming addicted to video games”.

Specialists also argue that it is hard to separate Gaming Disorder from other diseases, and as Professor Mattu told IPS “we do not yet know what are the most effective ways to treat Gaming Disorder”.

Given this disagreement, the American psychiatric community has currently not accepted Gaming Disorder as a disease, so its coverage in American insurances will likely be limited.

When asked to comment on the possible consequences of the WHO’s decision, Professor Mattu concluded: “The ICD Gaming Disorder classification is likely to encourage more research which will lead us to have a better understanding of what this problem looks like, how common it is, and the best way to treat it. We will know much more when the next major version of the ICD is released”.