Excessive playing of computer games – a nightmare for the parent!

Game-related (computer) disorders are a new mental disorder that will be introduced into the new classification of diseases (ICD-11) of the World Health Organisation (WHO) in 2018. As a child psychiatrist, I have experienced this problem many times and many times together with a child psychologist we have tried to solve a moral dilemma or treat something that has not been defined as a disorder, and even more so a disease! Introducing such a diagnosis into the ICD-11 resolves a longstanding dispute on this issue, but it does not dispel doubts. Millions of people around the world will meet the criteria for gambling disorders; in the direct translation of gambling disorders and in the free translation of gambling addiction.
The latter name appears to be the most appropriate because the criteria for the new disorder are similar to those for other addictions.

The first steps to classify the excessive use of computer games were taken by child psychiatry during the update of the DSM-IV classification to DSM-5 (2013). This classification is a classification and diagnostic tool of the American Psychiatric Association (APA). In the DSM-5 the above-mentioned disturbances have not been placed in the main part, but in the supplement, in which the disturbances are placed, the placement of which in the main section requires further research. It also means that the APA continues to observe the behavior associated with overplaying computer games and officially still does not consider the proposed diagnosis to be a mental disorder in the strict sense of the term.

Furthermore, the diagnosis proposed by DSM-5 concerns mainly online games and does not cover all other types of video games. However, it rightly excludes online gambling from this category and leaves it in the gambling addiction group. The new WHO classification is intended to cover both online and offline games, but at the same time overlap to a large extent with DSM-5. A new ICD-11 classification has not yet been published and is expected to do so in early 2018. As a child psychiatrist, like my child psychologists, we look forward to seeing you… Child psychiatry is waiting!

The criteria proposed by the World Health Organisation for diagnosing gambling disorders include:

Characterized by a persistent or recurrent pattern of game-related behavior (‘digital games’ or ‘video games’), which may be either online (i.e. via the Internet) or offline and manifested:

limited control of the game (e.g. start, frequency, intensity, duration, end, context);
increasing the priority of gaming to the extent that it takes precedence over other life interests and activities of everyday life.
continuation or escalation of playing in spite of negative consequences. The pattern of behavior shall be sufficiently severe to cause serious impairment in a person’s personal, family, social, educational, professional or another relevant area of functioning.

Game behavior patterns can be continuous or episodic and recurrent. Game behavior and other features are usually visible for a period of at least 12 months in order to assign a diagnosis, although the required duration can be shortened if all diagnostic requirements are met and symptoms are severe.

What about the Americans?

DSM 5 criteria for the diagnosis of online gambling disorders (addictions) include:

Repeated use of online games, often with other players, leads to significant functional problems. Five of the following criteria must be met within one year:

Attracting or obsessing with online games.

Withdrawal symptoms when a person does not play online games.
Increasing tolerance – he has to spend more time playing games.
A person tried to stop or limit playing online games but failed
This person has lost interest in other life activities, such as hobbies.
The person continued to abuse online games, even knowing how badly they were for them.

The person lied to others about the time they spent playing online games.
A person uses online games to alleviate anxiety or guilt, which is a way of escaping.

A person has lost or is at risk of losing, a relationship or an opportunity to have a relationship with another person through online gaming.
Finally, according to some sources, Poland is ranked second in Europe and 23rd in the world in terms of the number of players, of which there are about 16 million. Of these, 15 may meet the criteria for overbilling problems.

Doubts remain!

Will the introduction of a new diagnosis on the list of mental disorders result in the obligation to undertake therapy? Will this enable carers and physicians to do the same as they did for the rest of us?


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