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Addictive behaviour

    Overview

    Many people around the world are engaged in (video) gaming and gambling behaviours ,which are recognized as addictive behaviours, but usually do not result in any significant health consequences. However, a small proportion of people engaged in such behaviours may develop disorders due to addictive behaviours associated with functional impairment or distress.

    Video gaming is highly prevalent in modern culture, particularly among young people, and a healthy hobby for most users. However, in recent years there has been increasing global recognition among public health professionals and academics that particular patterns of video gaming may lead to marked impairment in personal, family, social, educational, occupational or other important areas of functioning and psychological distress for a significant minority of players. People who partake in gaming 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 that could be attributed to their pattern of gaming behaviour.

    Gambling in many countries and jurisdictions is considered a form of entertainment, characterized by betting/wagering mechanics and monetization features. Like gaming, repetitive gambling behaviour can potentially lead to gambling disorder associated with distress or impairment.

    In recent years, there has been an increasing convergence between gaming and gambling on various platforms, significantly aided by the Internet. This convergence may give rise to migration from games to gambling and co- occurrence of the two disorders. 

     

    Public health dimension

    Use of the Internet, computers, smartphones and other electronic devices has dramatically increased over recent decades, and this increase is associated not only with clear and tremendous benefits to the users and societies, but also with documented cases of excessive use which often has negative health consequences. Health concerns associated with gaming behaviour are not limited to gaming disorder, but also include other aspects of health such as insufficient physical activity, unhealthy diet, problems with eyesight or hearing, musculoskeletal problems, sleep deprivation, and associated health conditions such as depression and venous thromboembolism. 

    Prevalence estimates of gaming disorder vary considerably between countries and jurisdictions, largely due to the lack of a standardized assessment instrument, and prevalence of "problem gaming" which is a proxy measure for prevalence of “gaming disorder” varies in populations from 1.3 to 9.9%. 

    Past-year prevalence of “problem gambling” which is a proxy measure for prevalence of gambling disorder among adults varies between 0.1% and 5.8%.

    Harms caused by the gambling are significant. For example, studies at a national level from Oceanian countries indicate that potential harms due to gambling are comparable to the harms due to depression and alcohol use disorders. Harms negatively impact the gamers/gamblers themselves as well as their families and community.

    Further international research activities - particularly in the case of gaming disorder - are imperative in order to yield a comprehensive picture of past and current problems, generate prevalence estimates, inform prevention and treatment planning and to facilitate comparisons. Psychometrically sound instruments based on reliable diagnostic criteria must be developed for this purpose. 

     

    Disorders

    Disorders due to addictive behaviours are recognizable and clinically significant syndromes associated with distress or interference with personal functions that develop as a result of repetitive, rewarding behaviours other than the use of dependence-producing substances.

    Gambling disorder has long been included in formal classification systems and epidemiological surveys, but Gaming disorder was introduced as a new condition in the 11th revision of the International Classification of Diseases (ICD-11) endorsed by the 72nd World Health Assembly (WHA72) in 2019.

    Based on similarities in symptomatology, epidemiology and neurobiology, gaming disorder and gambling disorder are categorized as disorders due to addictive behaviors in ICD-11.  

     

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