Treatments of internet gaming disorder: a systematic review of the evidence

ABSTRACT

Introduction: The American Psychiatric Association included Internet gaming disorder (IGD) in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders, and the World Health Organization included gaming disorder in the 11th revision of the International Classification of Diseases. These recent updates suggest significant concern related to the harms of excessive gaming.

Areas covered: This systematic review provides an updated summary of the scientific literature on treatments for IGD. Inclusion criteria were that studies: 1) evaluate the effectiveness of an intervention for IGD or excessive gaming; 2) use an experimental design (i.e. multi-armed [randomized or nonrandomized] or pretest-posttest); 3) include at least 10 participants per group; and 4) include an outcome measure of IGD symptoms or gaming duration. The review identified 22 studies evaluating treatments for IGD: 8 evaluating medication, 7 evaluating cognitive behavioral psychotherapy, and 7 evaluating other interventions and psychosocial treatments.

Expert opinion: Even with the recent uptick in publication of such clinical trials, methodological flaws prevent strong conclusions about the efficacy of any treatment for IGD. Additional well-designed clinical trials using common metrics for assessing IGD symptoms are needed to advance the field.

KEYWORDS:

• Internet gaming disorder
• treatment
• systematic review
• video game addiction
• excessive gaming

Article highlights

• Video games use is common, and only a small minority of individuals who play video games develop significant problems related to overuse.

• The American Psychiatric Association included Internet gaming disorder (IGD) in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the World Health Organization included gaming disorder in the 11th revision of the International Classification of Diseases (ICD-11).

• Researchers, clinicians, and the public have shown an uptick in interest in treatment approaches for Internet gaming disorder, and this review summarizes clinical trials of IGD treatments.

• A total of 22 studies of treatment approaches for IGD were included in this review with 7 evaluating medications, 8 evaluating cognitive-behavioral therapy, and 7 evaluating other non-medication approaches.

• Research on medications for IGD is inconclusive. Bupropion shows some promise but remains in initial stages of evaluation.

• Some studies on cognitive-behavioral therapy for IGD find it to be superior to control conditions but others do not. Additional research is needed on these approaches.

• In general, weaknesses in the designs of the reviewed studies, including lack of appropriate control groups, nonrandom assignment to treatment conditions, and small sample sizes, prevent strong conclusions about the efficacy of treatments for IGD.

• Well-designed and adequately powered clinical trials are needed to move the field forward. Researchers should consider adapted treatments known to be effective for other addictive behaviors, including substance use.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Preparation of this manuscript was supported, in part, by grants [K23DA034879 and R21DA042900] from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.