(Internet) Gaming Disorder inDSM-5 andICD-11: A Case of the Glass Half Empty or Half Full: (Internet) Le trouble du jeu dans leDSM-5 et la CIM-11: Un cas de verre à moitié vide et à moitié plein

Abstract

Background: Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) included in 2013 Internet gaming disorder (IGD) as a condition for further study, and in 2018, the World Health Organization included gaming disorder (GD) as a mental disorder in the International Classification of Disease ( ICD-11). We aim to compare disorders of gaming in both diagnostic systems using a sample of young adults in Mexico. Methods: Self-administered survey to estimate the prevalence of DSM-5 IGD and ICD-11 GD in 5 Mexican universities; 7,022 first-year students who participated in the University Project for Healthy Students, part of the World Health Organization World Mental Health International College Student Initiative. Cross-tabulation, logistic regression, and item response theory were used to inform on 12- month prevalence of DSM-5 IGD and ICD-11 GD, without and with impairment. Results: The 12-month prevalence of DSM-5 IGD was 5.2% (95% CI, 4.7 to 5.8), almost twice as high as the prevalence using the ICD-11 GD criteria (2.7%; 95% CI, 2.4 to 3.1), and while adding an impairment requirement diminishes both estimates, prevalence remains larger in DSM-5. We found that DSM-5 cases detected and undetected by ICD-11 criteria were similar in demographics, comorbid mental disorders, service use, and impairment variables with the exception that cases detected by ICD-11 had a larger number of symptoms and were more likely to have probable drug dependence than undetected DSM-5 cases. Conclusion: DSM-5 cases detected by ICD-11 are mostly similar to cases undetected by ICD-11. By using ICD-11 instead of DSM-5, we may be leaving (similarly) affected people underserved. It is unlikely that purely epidemiological studies can solve this discrepancy and clinical validity studies maybe needed.

The Causes, Diagnose and Intervention of Game Addiction

“…When it comes to the diagnosis of game addiction, the most mainstream diagnostic standard in the world is DSM-5. In comparison, the diagnostic standard of ICD-11 is very strict, leading to some potential game addicts not being correctly diagnosed [29,30,33].…”

“…This movement has led to a convergence of research in defining play using the nine symptoms proposed by the DSM-5 [32]. In the nearly 20 years since IGD was included in the DSM-5, this criterion has gradually become the most accepted in this area, and there is a growing number of studies in this area that aim to provide DSM-5 prevalence estimates for IGD and to evaluate different tools for assessing the disorder [33].…”

“…The 11th Revision of the International Classification of Diseases (ICD-11) defines 'gaming disorder' as a pattern of gaming behavior ('digital gaming' or 'video gaming'), and the symptoms are described in three ways only: impaired control overplay, increased prioritization of play, and continued or escalating dependence on the play despite negative consequences [30,33].…”

“…When researchers compared the two groups of addicts' cases detected by DSM-5, one group of them not found by ICD-11 and both DSM-5 and ICD-11 identified another group, the result did not found any significant differences. There appeared to be little reason to intervene in one group over the other [33]. Therefore, using only ICD-11 as a diagnostic criterion may lead people with a similar behavioral disorder that could not be intervened in time, so that DSM-5 may be a more appropriate diagnostic criterion for gaming disorder.…”

The gaming problem: A latent class analysis of DSM-5 criteria for Internet Gaming Disorder in a non-clinical sample

“…A comparison of both systems in Mexico found that prevalence estimates of the DSM were almost twice as high as the ICD (Borges et al, 2021). Similarly, Jo et al (2019) found that while all ICD-11 cases were found by the DSM-5, not all DSM-5 cases were found by the ICD-11.…”