Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective

Abstract

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.

The psychological and genetic factors of the addictive behaviors (PGA) study

“…Consequently, gambling is included in the subsection of “Nonsubstance‐related disorders” of the DSM‐5 (American Psychiatric Association, ), and further potentially addictive behaviors were considered (e.g., internet use disorder) although internet gaming disorder was included in the Appendix of disorders requiring more research (Griffiths, King, & Demetrovics, ; Király, Griffiths, & Demetrovics, ). In the ICD‐11 (WHO, ), gambling and gaming disorder were both included in the classification of psychiatric disorders (King et al, ; Kiraly & Demetrovics, ; Rumpf et al, ).…”

“…although internet gaming disorder was included in the Appendix of disorders requiring more research (Griffiths, King, & Demetrovics, 2014;Király, Griffiths, & Demetrovics, 2015). In the ICD-11 (WHO, 2018), gambling and gaming disorder were both included in the classification of psychiatric disorders (King et al, 2018;Rumpf et al, 2018). (Legleye et al, 2013).…”

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

“…The rationale for these recommendations is derived from in-depth scientific analysis coupled with multiprofessional clinical and public health experience, involving experts from over 25 countries; changes from the ICD-10 were debated in a series of workgroup meetings [97]. Indeed, discussion in the scientific literature has continued as emerging data suggests that, alongside the phenomenological and psychobiological overlaps between gambling and gaming disorders and disorders of substance addiction [98,99], including high levels of clinical comorbidity, overlaps are also to be found with certain impulse control disorders, such as kleptomania and compulsive sexual behaviour disorder, and obsessive-compulsive or related disorders such as trichotillomania and excoriation disorder [100,101].…”

“…While it is laudable to consider the unwanted effect of stigmatization when a diagnosis is newly introduced [105], this argument must be balanced against clinical and public health needs [97]. Treatment demand worldwide and the significant distress, functional impairment, and suffering encountered by those experiencing disorders of behavioral addiction, such as gambling and gaming disorder, underlies the pressing need for their adoption by the ICD-11.…”

Comment on the global gaming industry's statement on ICD‐11 gaming disorder: a corporate strategy to disregard harm and deflect social responsibility?

“…The industry statement does not recognize clinical and public health needs and evidence identifying the adverse impacts of problematic gaming (e.g. social isolation, displaced sleep, physical inactivity and dietary problems, decreased psychological wellbeing, academic or job interference and interpersonal conflicts) . Instead, the industry could reflect upon its strong capabilities to protect vulnerable consumers and its share of responsibility for the reduction of gaming‐related harms .…”