Gaming disorder – addiction to playing video games – has been officially listed by the World Health Organization (WHO) as a mental health condition. In Switzerland, there are around 70,000 “problematic” internet users – a stable number for the past five years that includes hardcore gamers.
The Geneva-based UN health agency on Monday released the 11th edition of its International Classification of Diseases (ICD) which now includes the condition gaming disorderexternal link. The ICD is used by practitioners worldwide to diagnose health conditions.
The WHO describes gaming disorder as a pattern of behaviour which is so severe that playing video games “takes precedence over other interests and daily activities”.
The health agency says studies suggest that gaming disorder affects only 2-3% of people who engage in digital- or video-gaming activities. But it warns that people who enjoy video games “should be alert to the amount of time they spend on gaming activities, particularly when it is to the exclusion of other daily activities, as well as to any changes in their physical or psychological health and social functioning” (see infobox).
Isabel Willemseexternal link, a media psychologist and psychotherapist from the Zurich University of Applied Sciences (ZHAW), welcomed the WHO’s decision to recognise gaming disorder.
“This will help a great deal as professionals will all have the same starting point and definition and know what to measure,” she said.
Swiss teens and video games
Almost all Swiss 12- to 19-year-olds (99%) own a smartphone, 76% have a PC or laptop, 45% own a portable games console and 41% own a fixed games console.
Two-thirds of 12- to 19-year-olds say they play video games occasionally (42% are girls): on average one hour 21 minutes during the week and 2 hours 38 minutes at weekends. Around 50% of 12- to 19-year-olds play every day or several times a week. Among “problematic” internet users, video games are responsible in 13% of cases.end of infobox
Public health issue
Some countries, such as South Korea, have already identified gaming disorder as a major public health issue.
In Switzerland, around 1% of the population, or 70,000 people aged 15 and over, are thought to be “problematic” internet usersexternal link. Last year, a separate Swisscom-funded study by the ZHAWexternal link found that 8.5% of 12- to 19-year-olds were “problematic” internet users. Among problematic internet users, video games are estimated to be responsible in 13% of casesexternal link.
However, despite the phenomenal growth in internet use and smartphones in Switzerland, a report published in April 2018external link, commissioned by the Federal Office of Public Healthexternal link, found that the overall internet addiction rates were fairly stable and had not increased since 2013, apart from among 20- to 24-year-olds.
Willemse felt gaming addiction was nonetheless a problem in Switzerland, partly because it is a wealthy country with extensive internet access.
Corine Kibora, spokesperson for the non-governmental organisation Addiction Switzerlandexternal link, said the WHO decision was controversial among professionals.
“We have to recognise that gaming disorder does not mean video games are bad in themselves but they can develop into excessive behaviour which can create suffering,” she noted.
Niels Weberexternal link, a Swiss psychotherapist specialised in treating teenagers suffering from internet addiction, was pleased that the new classification would give visibility and recognition to those suffering from problematic video games behaviour. But he warned about the risks of stigmatising the phenomenon.
“By choosing to classify it as an addiction and giving it a medical characteristic, you risk closing certain doors which we’d had problems opening and which had allowed gamers in difficulty to express themselves,” he said.
“We risk finding ourselves in the same situation as with cannabis, where many parents don’t want to talk about cannabis with their children as it’s a taboo subject and they fear they will try it one day. Similarly, we risk crystallising family relations over video games.”
Psychotherapists insist that the WHO diagnostic only focuses on video games, while problems with screens, social media and the internet are much wider.
Weber said he also avoided using the term “internet addiction”.
“I believe it’s more of a symptom of other problems rather than a pathology,” he said.
The updated 11th edition of the International Classification of Diseases (ICD-11)external link is a global health information standard translated into 43 languages and used in over 120 countries. The previous edition was completed in 1992.
It contains common language and codes for diseases, signs and symptoms and is used by doctors and researchers to track and diagnose disease. The 11th edition contains 10,000 revisions.
The WHO has not put daily or weekly limits on what it considers problematic gaming. But it says that for gaming disorder to be diagnosed, the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.