Are video games addictive?

The World Health Organisation recently recognised “gaming disorder” as a mental health condition. So is this based on sound science, or are we turning an everyday behaviour into a disease, or providing parents of spoilt children with an excuse? Gaming is a multi billion dollar industry with a bigger turnover than Hollywood, and it’s enjoyed by millions of children and adults. So what’s the answer? Louise Theodosiou is a Consultant Child and Adolescent Psychiatrist, working with the Royal College of Psychiatrists in the UK...

Louise - As we heard before, gambling is about a narrowing of behaviour. And what gaming disorder from the World Health Organisation talks about is about people who have a pattern of gaming where they’re losing control of their gaming. They’re giving increased priority to gaming and carrying on gaming despite negative consequences, and one of the things that WHO emphasises is the fact that, actually, there’s an impact on people’s lives. Kids are struggling with their education, they’re not maintaining enough sleep, there is an impact on how healthy they are and their social interactions in the real world are suffering. So it’s about that impact on life and about the fact that this is carrying on for over 12 months, so we’re looking to see that impact and that narrowing of behaviour.

Chris - That seems to tick most of the boxes highlighted by Amy Milton a few minutes ago on what would be classified as an addiction.

Louise - I would agree that it does. And I think one of the brilliant things about the announcement is that we’re now starting to have a clear definition that will mean that we can focus our research more clearly. As I’m sure you’re aware, the American diagnostic system has had a slightly different definition, but a very similar condition: internet gaming, as an area of concern for about five years. And if we look at the literature we can see that there has been an increasing body of literature developing for almost 20 years now. So that situation of problematic internet use, and problematic gaming use has been around and is gathering momentum and I think that’s what makes this announcement so important.

Chris - Bryan Roth, when we opened this previous part of the programme said that, for millions of people, painkillers are a wonderful thing that have helped them over a painful episode and they’re only an issue for a small minority. In my introduction to you I pointed out that millions of adults and children use gaming as a diversion, as almost therapy. It’s a stimulus, it’s a distraction, it’s a way to relax and they do it quite healthily. So can we tell who are going to be the people for whom it is going to become a problem?

Louise - I think that’s an excellent question. And just to emphasise, yes, I think gaming can be very positive. I think it can actually be something that in a very short and very controlled way can really be a socially beneficial thing for children and I think the internet overall has huge benefits for mental health practice, and it’s about finding that balance, it’s about that moderation and, as you’ve said, lots of people benefit from painkillers. Lots of people benefit from gaming but there probably are doing it in the context of lots of other experiences at the same time, and it is about that group of people who lose control of their gaming.

And yes, while we are still needing to do more research, there do seem to be some of the same brain areas that were identified in the piece about addiction, that study areas that we need to look at more in people who have gaming difficulties. And there does seem to be a connection with people who, for example, who are suffering from depression and maybe have developmental conditions such as ADHD and some of the anxiety conditions.

So the fantastic thing is that now we’ve got this definition of “gaming disorder” we can start to narrow down our studies and to identify the groups of people more clearly, and identify how we can recognise them early. Because that’s the other good thing about having this definition of gaming disorder is by having a definition of depression in that same diagnostic classification, people like myself can help teachers and other people look at kids who might be at risk of getting depression, we can start to do the same thing now with gaming disorder.

Chris - Are there any sort of broad categories that the people who are susceptible tend to fall into: more boys than girls; teenagers than younger children? Do you have any idea?

Louise - What’s interesting is that there does seem to be slightly more boys than girls. But then what’s interesting if you look at the studies, in a number of studies boys are overrepresented. What’s also interesting is that a number of the studies have concentrated on pre-teens, teens, and university students, and yet a lot of people who may be struggling with their gaming may actually be older than that. So I think that’s something else we probably need to look at overall is to check that everybody who can potentially be affected is actually included in those research studies.

Chris - If we follow up these people; say we identify someone who clearly has a big problem, how do we help them?

Louise - What we need to do is we need to, I suppose, first of all make sure that there is that opportunity to have that dialogue with people. We need there to be more information; that’s why programmes like this are so important so that families, loved ones, carers can be identifying that people maybe are at risk because of their gaming. Then what we need to do is we need to make sure that people know who to talk to - speak to your GP. What we know is because of that connection with some of the mental health needs that I was talking about before, GPs can be really useful in telling you what difficulties in terms of knowing what difficulties you might have. And we also need to remember that there’s a lot of really good practical ways of addressing all mental health problems and that those common things will apply. You know, things about thinking about your anxiety, looking at what’s actually going on, looking at other strategies, interacting with other people, leaving the house. All of these really good sense, mental health, wellbeing things that we’re doing for all sorts of other conditions can also be useful in this condition.

Chris - Do you think this is a proportional label because, strictly speaking, the number of people who die of video gaming problems is not high is it compared with other drugs?

Louise - The internet has a potential to have a huge impact on people’s lives: sleeping, reversed sleep cycles, people not attending to their basic health care needs. If you fall and break you leg while you’re playing football you’re not going to be able to carry on. People can potentially damage their health while online and might not realise it in the same way, so I do think there’s a concern that we need to understand.