ADHD-Gaming Disorder Comorbidity in Children and Adolescents: A Narrative Review

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) is a neurobiological condition characterized by developmentally inadequate levels of inattention, hyperactivity, and impulsivity, and a neurobiological disruption in brain neurotransmitters and circuitry causing abnormal responses to rewards. Playing electronic games generates a biological response that activates the neuronal circuits linked to pleasure and reward, and there is a growing attention to this type of activity, which can also turn into a mental health condition. The existence and the boundaries between the functional and the dysfunctional are still a source of debate, with the recognition of ‘Internet Gaming Disorder’ (IGD) as a condition belonging to the broader area of addiction requiring more in-depth study with respect to the DSM-5, while ‘Gaming Disorder’ (GD) was officially recognized as a new diagnosis by the World Health Organization (WHO) in the updated revision of the International Classification of Diseases (ICD-11). Notwithstanding, the suggested criteria for the diagnosis of Gaming Disorder are still debated. Since ADHD has been reported as a risk factor for developing addictions, this narrative review aims to provide the current state-of-the art of the knowledge about the comorbidity between ADHD and Gaming Disorder. For this aim, a literature search was conducted using a combination of specific keywords and the results are discussed within the R-Do-C framework and dimensions, and implications for treatment are considered.

Delayed sleep–wake phase disorder and its related sleep behaviors in the young generation

“…Second, not only patients with DSWPD but also those with GD are often complicated by neurodevelopmental disorders. Several studies have indicated that patients with GD are frequently complicated by either ADHD (142) or ASD (143). In such cases, treatment approach focusing on neurodevelopmental disorders should be included.…”

Transtorno de déficit de atenção e hiperatividade em crianças na era digital: O impacto das telas eletrônicas

“…Sabe-se que, segundo Salerno et al, (2022) no TDAH ocorrem déficits no sistema de recompensa, envolvendo o córtex cingulado anterior, córtex pré-frontal e orbitofrontal. A principal região afetada mostrou-se ser o córtex cingulado anterior, que é responsável pela modulação da atividade neuronal da rede de controle executivo, participando, assim, da tomada de decisões relativas ao sistema de recompensa, regulação das emoções e do sistema de recompensa.…”

“…Concomitantemente, outro estudo investigou a relação do TDAH ao vício em jogos digitais, e relacionou redução da conectividade funcional cerebral entre o córtex frontal e o subcorticóide, concluindo que ambos possuíam redução da funcionalidade cerebral do giro frontal médio direito para o caudado, e do cingulado esquerdo para o caudado em relação aos pacientes normais (Salerno et al, 2022).…”

“…Pesquisas demonstraram que além dos riscos associados à impulsividade em portadores de TDAH observa-se também a maior tendência à dependência da internet, devido ao maior tempo gasto com jogos e telas, e uma maior dificuldade de autocontrole (Wolraich et al, 2019) O predomínio da desatenção no Transtorno de déficit de atenção pode gerar principalmente dificuldade no desenvolvimento cognitivo e acadêmico das crianças. Tal sintoma pode se manifestar através de dificuldade em prestar atenção por muito tempo, parece não ouvir mesmo quando solicitado, dificuldade em realização de tarefas, perda de objetos constantemente, entre outros (Salerno et al, 2022).…”

Neurodevelopmental Disorders (NDDs): Beyond the Clinical Definition and Translational Approach

“…Salerno and colleagues [4] examined the state of the art related to the comorbidity between Attention Deficit Hyperactivity Disorder (ADHD) and Gaming Disorder (GD). Authors findings not only confirmed the frequent co-occurrence of ADHD and GD, but also that ADHD is associated with poor GD clinical outcomes, leading authors to state that gaming in children and adolescents with ADHD constitutes a pathological complication and not a functional coping strategy.…”