Commentary: Why excessive gaming is a mental health condition

Commentary: Why excessive gaming is a mental health condition

The World Health Organisation's recognition of gaming disorder as a mental health disorder paves the way for other Internet-related disorders to become recognised as distinct health disorders, says Financial Times' Anjana Ahuja.

LONDON: Death and disease has come a long way since the time of Jacques Bertillon. 

In the late 19th century, the French statistician and demographer started compiling the Bertillon Classification of Causes of Death, an exhaustive litany of maladies including scarlet fever, cholera and syphilis.

Bertillon’s morbid opus eventually became the International Classification of Diseases (ICD), the comprehensive global encyclopedia of fatal and non-fatal diseases that defines healthcare today. And what a difference a century makes: Gaming disorder has been added to the ICD’s 11th edition, released this week.

This follows years of controversy about whether excessive game-playing (usually online) qualifies as a mental health condition.

Being listed is the route to clinical legitimacy: Inclusion in the ICD, which is published by the World Health Organisation (WHO), can kick-start programmes for prevention, diagnosis and treatment. 

The move is likely to pave the way for other internet-related disorders, such as an addiction to social media, to become recognised as distinct health problems.


Gaming disorder is not simply about hours spent in front of a screen, despite the concerns among parents whose children play the online shooter game Fortnite.

gaming keyboard
(Photo: Unsplash/Aidan Granberry)

The WHO says the pathological behaviour “must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning”.

Skipping homework to stay online doesn’t count — but dropping out of school or a job to keep firing virtual bullets does.

The issue has received prominent attention in China, where several people have died after playing nonstop for several days. Some wear nappies to avoid toilet breaks. Frightened parents are said to be sending children to digital detox camps.

Between one and four per cent of players are at risk of developing gaming disorder, according to Mark Griffiths of Nottingham Trent University. He was on WHO’s working group and began researching internet addiction, as it was then called, in the 1990s.

Prof Griffiths is delighted that gaming disorder is now officially recognised by both the WHO and the American Psychiatric Association.

“The two most important medical bodies in the world now have gaming disorder in their manuals,” he says.

Anyone worried about a player’s behaviour is advised to see a family doctor, who can make an appropriate referral.

Prof Griffiths points out that the WHO did not use the term gaming addiction, even though many in the field use the words disorder and addiction interchangeably.

There remains disagreement about whether an addiction to a video game can be usefully compared to a substance addiction, which involves physiological withdrawal symptoms, such as the shakes. (Gaming disorder is grouped with gambling disorder.)

Gaming disorder
In 2014, a 27-year-old Chinese woman suffered sudden death after playing video games for more than 10 consecutive hours. (Photo: AFP/Chandan Khanna)


He thinks that social media addiction, or disorder, will eventually find its way into the manuals, too.

He co-authored a 2017 study showing that, in Hungary, about 4 per cent of 16-year-olds showed “problematic use” of social media.

His research shows that social media is awash with psychological hooks. These include unpredictable rewards (your next notification might be from a supercool influencer); social affirmation through “likes”; Fomo (the fear of missing out); smartphone sounds, which lure people back online; and reciprocity (you “like” my selfies, and I’ll “like” yours).

Adolescents, with their still-maturing brains, are particularly vulnerable.

Snapchat “streaks”, which reward continuing conversations, are one way platforms encourage us to sink time into certain activities and stay online. But what bodes well for Snapchat et al does not necessarily bode well for the individual — as future editions of the ICD might bear out.

© 2018 The Financial Times Ltd. All rights reserved. Please do not copy and paste FT articles and redistribute by email or post to the web.

Source: Financial Times/nr