Internet gaming: hobby or behavioral addiction?

Background: Over the last two decades, video games have become one of the most preferred sources of entertainment worldwide, with a consumer base comprising all age-groups and social status. However, concerns have emerged over its addictive potential, particularly with respect to online games. The objective of this work is to review and summarize the existing empirical data on this topic.

Methods: A research was performed on PubMed, using the terms “game”, “gaming”, “videogame”, “addiction”, “pathological gaming”, “problematic gaming” and “gaming disorder”; the resulting articles were selected based on their interest to the topic and subsequently reviewed and summarized.

Results: A growing body of literature has focused on the subject of videogame addiction over the past decade, attempting to clarify its mechanisms, clinical correlates, natural history and public health impact. Research results suggest it constitutes an important health problem, particularly among male adolescents and young adults, in relation with higher than average playing frequency and total playing time. This condition has been associated with significant distress in several life domains, including poor academic performance, diminished social “real-life” contacts, reduced involvement in other activities, self-care neglect, reduced sleep time, low self-esteem, symptoms of anxiety and depression, suicidal thoughts, as well as impulse control and attention problems, among others. Moreover, evidence of brain structural and functional alterations in this context, consistent to what has been described for addictions in general, supports its view as a behavioural addiction. Its clinical relevance has been recognized by the international medical community, with its inclusion in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (categorized as “Internet Gaming Disorder”), in a subset of conditions requiring further empirical research before being considered as a formal disorder (Section III). More recently, a “Gaming Disorder” category was introduced in the upcoming eleventh edition of the International Classification of Diseases.

Conclusions: Despite attempts to attain an international consensus, this area is still involved in much controversy. Further research is needed to establish more clearly the defining characteristics of this condition, as well as efficient treatment interventions and prevention strategies.