The latest action by the World Health Organisation (WHO) in announcing “gaming disorder” as a new mental health condition is immensely laudable. The step is truly in keeping with the times. Gaming disorder has been included in the 11th edition of its International Classification of Diseases (ICD), released last week. While proposing the new diagnosis to WHO’s decision-making body, the World Health Assembly, Dr Vladimir Poznyak, a member of WHO’s Department of Mental Health and Substance Abuse, said, WHO has followed “the trends, the developments, which have taken place in populations and in the professional field.”
A diagnosis standard, the ICD defines the universe of diseases, disorders, injuries and other related health conditions. Researchers use it to count deaths, diseases, injuries and symptoms, and doctors and other medical practitioners use it to diagnose disease and other conditions. In many cases, healthcare companies and insurers use the ICD as a basis for reimbursement. According to Poznyak, the expectation is that the classification of gaming disorder means health professionals and systems will be more “alerted to the existence of this condition” while boosting the possibility that “people who suffer from these conditions can get appropriate help.”
He said there are three major diagnostic features or characteristics of gaming disorder. The first is that the gaming behaviour takes precedence over other activities pushing the latter to the periphery. The second feature is impaired control of these behaviours. Even when the negative consequences occur, this behaviour continues or escalates. A diagnosis of gaming disorder, then, means that a “persistent or recurrent” behaviour pattern of “sufficient severity” has emerged, according to the ICD. A third feature is that the condition leads to significant distress and impairment in personal, family, social, educational or occupational functioning. The impact may include disturbed sleep patterns.
Overall, the main characteristics are “very similar” to the diagnostic features of substance use disorders and gambling disorder, Poznyak said. Gambling disorder “is another category of clinical conditions which are not associated with a psychoactive substance use but at the same time being considered as addictive as addictions.” For a diagnosis to be made, the negative pattern of behaviour must last at least 12 months. However, exceptions can be made when the other criteria are met and symptoms are severe enough.
“Millions of gamers around the world, even when it comes to the intense gaming, would never qualify as people suffering from gaming disorder,” Poznyak said, adding that the overall prevalence of this condition is “very low.” He stressed that gaming disorder is a clinical condition, and clinical diagnosis can be made only by health professionals properly trained to do that. Poznyak noted that the ICD does not make “prescriptions” in terms of insurance coverage or the development of health services – these decisions are made by national authorities – but “prevention and treatment interventions can help people to alleviate their suffering.”
Most interventions or treatments for gaming disorder are “based on the principles and methods of cognitive behavioural therapy,” he said. Different types of support may also be provided, including “psychosocial interventions: social support, understanding of the conditions, family support.” The therapy should be based on understanding the “nature of the behaviour and what can be done in order to improve the situation.” Prevention interventions may also be needed. Ultimately, WHO hopes that inclusion of gaming disorder in the classification will stimulate debate as well as further research and international collaboration.
