Journal Article Annotations
2024, 4th Quarter

Child and Adolescent Psychiatry/Pediatrics

Annotations by Sneha Jadhav, MD
January, 2025

Young and adult patients with gaming disorder: Psychiatric co-morbidities and progression of problematic gamin.

PUBLICATION #1 — Child and Adolescent Psychiatry/Pediatrics

Young and adult patients with gaming disorder: Psychiatric co-morbidities and progression of problematic gamin.

Annika Hofstedt, Anna Söderpalm Gordh.

Abstract: Front Psychiatry. 2024 Dec 10:15:1423785. doi: 10.3389/fpsyt.2024.1423785. eCollection 2024.

Background:
Previous research suggests age-dependent differences in the progression of addiction, and evidence is accumulating, showing that an early initiation of gaming increases the risk for addiction. With the recent introduction of gaming disorder (GD) as a psychiatric diagnosis, there is a need to extend the knowledge of the clinical characteristics of patients seeking treatment for GD of all age groups. Compared to adolescents and young adults, less is known about treatment-seeking adults. This study aimed to investigate whether there are clinically relevant age-dependent differences among patients seeking treatment for GD.

Method:
Participants were recruited among patients seeking treatment and fulfilling diagnosis for GD at an outpatient clinic specialized in the treatment of GD. During the study period, 142 patients went through assessment for GD at the clinic, 37 did not fulfill the diagnosis for GD, and 36 declined participation, leaving a sample of 69 patients (age range = 15-56) for analysis. The sample (men, n = 66; women, n = 3) was divided in two age groups: adolescents and young adults (25 years or younger) and adults (26 years or older). Gaming-related data and information about psychiatric co-morbidity was collected through structured clinical interviews and questionnaires.

Results:
The adolescents and young adults (AYAs) reported a more rapid progression into problematic gaming than the adult group. The younger group developed problematic gaming four years faster than the adults. We also observed comparable clinical profiles in both groups. Both age groups had similar levels of GD as well as symptoms of psychiatric co-morbidities including possible attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD) and problematic gambling. We also noticed that half of our study population consisted of adults.

Conclusion:
With the increasing prevalence of gaming in all age groups, it is unknown how the occurrence of GD will develop in different stages of life. We conclude that the adolescents and young adults had almost double as fast progression to problematic gaming than the adult group, highlighting the need for preventive strategies. The similarity in clinical profiles indicates that treatments with the same type of interventions could be offered to both age groups.

Annotation

The finding:
The article explores problematic gaming among adult patients, emphasizing differences in the age of onset and development of issues between younger and older players. Adult gamers typically start gaming later than younger individuals and often do not exhibit gaming problems during their teenage years. It was found that younger patients began exhibiting problematic gaming behaviors approximately 7 years after they started playing, around age 14. Conversely, older patients took about 11 years to develop similar issues, beginning around age 22. Common comorbidities associated with problematic gaming in both age groups include ASD (Autism Spectrum Disorder) and ADHD (Attention Deficit Hyperactivity Disorder). The study also observed no significant differences in weekly gaming hours, symptoms of problematic gaming, or reasons for gaming; with tendencies to escape being a major factor in both groups. Additionally, there were no notable differences in family history of addiction or current substance use between the younger and older gamers.

Strength and weaknesses:
The study used validated self-report questionnaires. Patients had the opportunity to ask questions about the questionnaires to the study clinicians. Diagnostic assessment was a combination of self-report and a structured clinical interview. Weaknesses of the study include small sample size, use of self-reported questionnaires, cross sectional design, risk of recall bias and a predominance of male patients which may affect generalizability.

Relevance:
It is known that gaming disorder is associated with multiple psychiatric comorbidities as well as physical comorbidities. CL psychiatrists often treat adults with multiple physical and psychiatric comorbidities and gaming disorder is known to have high psychiatric and physical comorbidities. Screening for problematic gaming is indicated even in high functioning adults with university level education and occupational training. Including gaming behaviors in assessment and treatment planning may be imperative in achieving long term stability and improvement in the adult population with multiple health conditions.