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Internet Gaming Disorder and DSM-5

November 06, 2013
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By Chris Bojrab, MD
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

Just in time for the holiday season, Sony and Microsoft are preparing to launch their latest gaming consoles, PlayStation 4 and Xbox One. Both companies have taken approximately 1.5 million preorders, and analysts are predicting that they will each sell 5 to 6 million units within the first six months. Being something of an internet gamer myself, I perused the American Psychiatric Association’s recently updated Diagnostic and Statistical Manual (DSM-5) to see what it had to say about Internet gaming disorder. 

Internet gaming disorder is in Section III of the DSM-5, the section of the manual known as “Conditions for Further Study.” It describes Internet gaming disorder as a “Persistent and recurrent use of the Internet to engage in games, often with other players, leading to clinically significant impairment or distress…”

The specific criteria address:

  • preoccupation with such games
  • withdrawal symptoms of irritability, anxiety, or sadness
  • the development of tolerance
  • unsuccessful attempts to control the behavior
  • loss of interest in other activities
  • continued excessive use despite knowledge of psychosocial problems
  • deceiving others regarding the amount of time spent gaming
  • use of this behavior to escape or relieve a negative mood
  • jeopardizing/losing a significant relationship/job/educational opportunity

The APA Substance-Related Disorders Work Group’s review of this phenomenon included more than 240 articles and identified similarities between Internet gaming disorder and both gambling disorder and substance use disorders. The Work Group also visited a hospital in China, where the government has defined Internet gaming as an addiction.

Due to a lack of universally accepted criteria, the prevalence of this condition is unknown. Some literature suggests that the prevalence is highest among male adolescents ages 12 to 20 living in Asian countries (especially China and South Korea). In one study that evaluated an Asian population, the point prevalence in 15 to 19 year-olds was 8.4% for males and 4.5% for females.

As the Internet and online gaming technologies become increasingly pervasive and immersive, there are likely to be challenges in the ways in which people use and interact with this technology.

Have you seen patients who might meet criteria for Internet gaming disorder?

Chris Bojrab, MD, is the president of Indiana Health Group, the largest multidisciplinary behavioral health private practice in Indiana, established in 1987. He is a board certified psychiatrist and a Distinguished Fellow of the American Psychiatric Association who treats child, adolescent, adult, and geriatric patients. His areas of interest include psychopharmacology, sleep disorders, and gambling addiction. For more information and disclosures, visit www.chrisbojrabmd.com

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors.

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