The pitfalls of regular videogame use were once again highlighted late last year with the World Health Organisation (WHO) releasing details of the beta-draft of the 11th iteration of the International Classification of Diseases, the ICD-11, which included proposed diagnostic criteria for “gaming disorder”.

This is slightly different to the current inclusion in the Diagnostic and Statistical Manual of Mental Disorders – the DSM-5, which included “internet gaming disorder” as a condition for future study back in 2013. With 93% of Australian households now containing one or more gaming devices, and 67% of the total population regularly playing games (Digital Australia Report 2018), it is time that condition was further studie

General Practitioner Dr Jennifer Hazel is founder and Executive Director of CheckPoint, a non-profit organisation connecting mental health care with videogame technology that provides education, consultation and resources to games industry and clinical professionals.

Including an everyday practice such as videogames into the two major diagnostic guidelines for mental health practice is an important step forward in the health profession gaining better understanding of something that is often left up to parents, teachers and caregivers to deal with.

“It opens up an important conversation. What is it about games that can be addictive? And if there are bad games, are there not-bad games? These sorts of questions will start to validate the work we have been doing at CheckPoint to reduce the stigma against games and introduce more balanced information about the risks and benefits of gaming.”

“On the other hand, I don’t particularly like the idea of lots of healthcare professionals suddenly feeling empowered to diagnose Gaming Disorder.

“Videogames are vast and varied, as are their players. Many people (80% in a study we did) feel games improve their mental health and wellbeing. If you are a healthcare professional and you are reading this, I would really implore you to consider these factors in your practice. Could you be doing more harm than good?”

Dr Hazel has highlighted a few points, and you can read further detail on the CheckPoint website. Consider the following regarding the ICD-11 draft:

• The research is weak: evidence is based on small group research; rarely considering the differences between types of games (Minecraft vs Call of Duty are very different); not to mention technical difficulties are enough to make anyone angry!
• There are no exclusion criteria: gaming death from deep vein thrombosis has been noted, however positives including depression and anxiety therapy, social phobia or autistic spectrum disorder socialisation benefits has been studied – but not included in the draft.
• There is no guidance provided on treatment.
• Games have clear psychological (and cognitive) benefits. CheckPoint has access to studies on the benefits of games in mood, depression, creativity and social benefits. Dementia Australia’s The Virtual Forest is designed for aged care residents and has shown improvements in memory and mood; and ReachOut has resources on the social and educational benefits of gaming.

“That is not to say that games can’t be addictive – there is plenty of anecdotal and good quality research evidence to suggest that they definitely can be misused. And for that reason, I do support the move toward understanding gaming addiction better. I just hope we don’t get swept away again with how terrible video games are.”

“Function includes the things we really should be doing, as a responsible person, to be safe, secure, healthy and happy. This includes going to work or school, showering and eating well, maintaining friendships and relationships, paying the bills, etc. If gaming has prevented someone from achieving these things, there is an obvious problem.”

“However it is super important to note that you can play games for as many hours as you may please and not be addicted – as long as you are still doing all these things.”

Learn what your patients are playing:
The Digital Australia Report 2018 conducted by Bond University is an interesting read on who plays games, what they play and why they play – you can download it here.