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Extreme compulsive gaming acknowledged by WHO as addiction

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Member states of the World Health Organisation (WHO) have approved the eleventh edition of the International Classification of Diseases (ICD-11), which includes gaming disorder as a psychiatric diagnosis.

The ICD is the internationally recognised guide to diagnosis of diseases, disorders, injuries, and other health conditions. It is used by both clinicians and researchers, as well as by health managers to allocate resources. The new, fully electronic ICD-11 will come into effect in January 2022.

The WHO proposed adding the diagnosis in June 2018 when it published its draft document. The approval of the ICD-11 by all 194 WHO member states means that obsessive gaming will be acknowledged as a medical condition deserving of treatment.

Gaming disorder and gambling disorders have been added to a list of ‘disorders due to addictive behaviours’: addictions to certain behaviours rather than substances like alcohol and opiates.

A gamer could not be diagnosed with this disorder if – like the vast majority of gamers – they have an enjoyable, healthy, and well-controlled relationship with gaming, even if they play the same games for hours every day. The diagnosis is only applicable if their gaming is out of control and causing harm to themselves and others. For instance, a person may be diagnosed with gaming disorder if they consistently lost control over the amount of time and money they spent gaming, put gaming ahead of other activities and interests, and struggled to control their gaming despite suffering negative consequences, such as impairment to their education, work, or social relationships.

A gamer would also need to show this extreme behaviour continuously or episodically for at least 12 months to receive the diagnosis, with exceptions for those suffering from severe symptoms.

A second diagnosis, ‘hazardous gaming’, refers to a “pattern of gaming, either online or offline, that appreciably increases the risk of harmful physical or mental health consequences to the individual or to others.”

Speaking to E&T last year, Dr Daria Kuss, an cyberpsychologist at Nottingham Trent University, explained: “The term ‘addiction’ is used in a very flippant kind of way. Just because I spend a weekend watching something on Netflix does not mean that I’m addicted to using Netflix, for example. There has to be a significant impairment and distress on behalf of the individual for a considerable amount of time where they lose control of their behaviours and they can’t help themselves anymore.”

Concerns about problem gaming are not restricted to any part of the world, but are particularly prominent in East Asia. In South Korea, for instance, up to 25 per cent of young people are estimated to play video games excessively, leading the government to ban minors from accessing online games between midnight and 6am. Meanwhile, ‘boot camps’ using military-style discipline and talking therapy to stamp out excessive gaming among young people have sprung up across China.

The private Nightingale Hospital in London became the first place in the UK to offer specialised treatments for technology-addicted patients. It was followed by a small NHS gaming addiction clinic set up by the Central and North West London NHS Trust.

The inclusion of gaming disorder in the ICD-11 is likely to pile pressure on both public and private health services to offer care for the condition.

Representatives of the video game industry across the Americas, Africa, Europe, Asia, and Oceania have objected to the WHO’s approval of the diagnosis. The Global Video Game Industry Association commented in a public statement that the inclusion of gaming disorder is not based on “sufficiently robust evidence”

“The WHO is an esteemed organisation and its guidance needs to be based on regular, inclusive, and transparent reviews backed by independent experts,” the body said.

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