1. Dr.V.Jaikumar,AP, IMH
Visiting Consultant
@Manashasthra

2. A Case Summary
 Mr.X is IX standard student and was doing well in
academics till 8 the standard.
 From 9 the standard his academic performance
deteriorated.
 He started increasingly to become glued to the
computer monitor playing online games.
 He spends the entire day from dawn to dusk playing
video games.
 He stopped going to school.
 If the internet connection is cut he gets aggressive
and breaks the TV.
 He demands his parents to give their credit card for
upgrades in the games.

3. AVAILABILITY
 With the popularity of high-tech devices (computer,
tablet, and smartphone) and internet use in recent
years, playing online or offline games has become a
popular activity, especially among young people
 The ubiquitous presence of these devices compounds
the issue by increasing the access to anywhere and
anytime.

4. Introduction to Gaming Addiction
 Gaming addiction is getting onto adolescents. Many
adolescents are getting into this problem.
 It has been reported that 8% of American teenagers are
pathological gamers
 The type of video game called Massively Multiplayer
Online Role-Playing Games (MMORPGs) is more addictive
than others.
 The motivation for gaming, when it is escapism,it leads to
more dangerous addiction.
 The Gaming addiction short scale ( GAS) can be used for
measuring the severity of addiction.

7. Psychiatric comorbidity
 Also some of them might have baseline childhood
psychiatric disorder like an autistic spectrum disorder
when the magnitude of the challenge increases.
 Whether the autism and social isolation led to the
gaming addiction or is it the gaming addiction which
resulted in a social isolation is a chick and egg puzzle
to be solved.
 Also underlying anxiety and depressive symptoms
might be there which has to be treated.

8. PREVALENCE
 A few studies have examined the prevalence of video gaming addiction
, but the reported data varied greatly across countries.
 Choo et al. reported a prevalence of 8.7% among Singaporean youth
 Salguero and Morán found a similar rate of 9.9% among Spanish
adolescents .
 A study using a national sample of American youth aged 8 to 18 years
indicated a prevalence of 8.0% [5].
Rehbein and colleagues [4] found among German adolescents a
prevalence of 1.7%, but another study [15] reported a lower prevalence
of 0.2%.
 Haagsma et al. reported a prevalence of 3.3% among adolescents and
young adults in the Netherlands [16].
 India-24.8% Internet addiction among adolescents in Bombay.(IJP “13)

10. DSM-V
 . However, the term “internet addiction” is not
endorsed in the recently published fifth edition of
the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5).
 Instead, the term “internet gaming disorder” has been
included in the third section of theDSM-5 as a
condition warranting more clinical research and
experience before it might be considered a formal
disorder [14].
 Thus, scientific studies on internet or video gaming
addiction are indeed needed

12. Inclusion in DSM-V
 Though the DSM has for the first time incorporated
the diagnosis of gaming addiction disorder in DSM-V,
the diagnosis is yet to enter our diagnostic cognitions.
 The diagnosis has features similar to pathological
gambling and impulse control disorders.

13. Challenges
 The psychiatric community needs to equip itself
adequately to deal with modern psychic parasite.
 It is very challenging to treat these patients as there is
no way to completely cut the internet connection.
 There is a need to evolve exclusive deaddiction centres
for adolescents as the parents usually from higher
socio economic status who do not want to put their
children to be put in an alcohol and drug
rehabilitation centre along with others who might
teach these children many “bad habits”.

14. International Scenario
 Countries like Korea where this problem is rampant has
more than 100 exclusive gaming deaddiction centers.
 In china, the government monitors video games by asking
everyone to provide resident identity numbers during log
in. After 3 hours of play the players lose their points by half.
After 5 hours of play their points are completely erased.
 .Comparatively, the problem in our country is at a budding
stage. Having said that, we have to prepared to face an
increasing magnitude of this issue in the days to come. The
Indian government also may need to intervene with
external restrictions in the future.

15. Treatment
 The lack of specific treatment is also frustrating from
the therapist point of view,

16. Game addicts Anonymous
 The 12 AA steps which has been adapted for various
forms of addictive disorders can be used productively
in the management of gaming addiction as well.

17. CONCERNS
 Even sudden deaths have been reported among people
addicted to games while actually playing the video
game.
 Parents have neglected their children to die while
ironically growing virtual children..This shows the
severity of the problem
 The other concern is that the games increase violence
in the kids. Even one gaming child actually shot a
parent with a real gun and killed him.

18. Brandon Crisp
 The disappearance and death of Brandon Crisp, a 15
year old who left his Barrie, Ontario home after his
Xbox 360 was taken from him, fueled nation-wide
concern towards video game addiction and obsession.
 Parents across Canada grew fearful that their own
children were as dangerously enraptured as Brandon
with computer and console games

19. Why?
 People usually play video games for entertainment,
excitement, challenge seeking, emotional coping, and
escaping from reality to virtuality to fulfill their
unsatisfied needs or motivations

20. ADVERSE EFFECTS
 Insomnia
 limited leisure activities
 attention problems
 poor academic performance
 anxiety, depressive symptoms
 deterioration of interpersonal relationships,
 family conflicts,
 youth violence or crimes,
 lower self-esteem
 lower satisfaction with daily life [6]

22. ADVERSE EFFECTS
 Video game addiction may lead to particularly serious
health problems in adolescents as they are
experiencing significant physical and psychosocial
changes and lack self-regulation .
 Worldwide, addiction to video games is becoming a
serious concern among youth players [10].

23.  Given the vulnerability of adolescents who are facing
developmental challenges, a good understanding of
video gaming activities among this group would be
helpful for tailoring effective education or prevention
programs to promote their health

24. FUTURE TRENDS
 There is a need to accept this diagnosis and plunge
into research about it.
 Studies have to be conducted about the efficacy of
specific drugs in the condition.
 Also the topic has to be given preference in the
psychiatric conferences and workshops. Debates and
discussions need to be conducted in this topic