As smartphones have gained popularity, technology has announced the advent of digital era. It is hard to imagine a day without the use of digital technology which has grown its root within all domains of our existence varying from education, entertainment, different industries and research. In fact, if we only talk about entertainment, digital technology offers several ways for a person to spend entire day without a hint of boredom, namely with internet surfing, binge watching, social media or internet gaming.
When we talk about gaming, video games have also shifted from bulky arcades and television consoles to Internet mobile gaming. These games are a very popular method of entertainment among smartphone users of all age groups. The games have evolved into different genres providing the users with plethora of options to choose from as per their liking. For example, someone who needs a game to challenge his mind can play quizzes and puzzles, while those with a taste for aggression may choose shooting games.
In fact, the act of occasional gaming could even take the form of behavioural addiction among some users. Though, several online addictions have already been identified, internet gaming addiction has allured the interest of many researchers and clinicians as it can affect the user both mentally and physically.
Several similarities can be drawn between gaming addiction and other forms of substance abuse and addictions. The mechanism involved with other behavioural addictions involving ‘The Reward Circuit’ seems to work same way with Gaming addiction as well [1,2].
The Diagnostic and Statistical Manual, fifth edition (DSM-5) has already included Internet gaming disorder and specified criteria for the same consisting of 9 items where 5 needs to be fulfilled for a successful diagnosis.
Recently, WHO has also included Internet gaming disorder in International Classification of diseases – 11 defining it as a pattern of gaming behaviour with debilitated control over gaming, prioritising gaming above other activities till an extent that it takes precedence over most daily activities and interests, and persistence of gaming even though having negative consequences [3].
Also, APA has identified IGD as a potentially new psychiatric condition which needs further research in understanding its prevalence, validating the diagnostic criteria, and establishing significance of this ailment.
India has emerged as a major and fast-growing market for digital consumers. It’s only natural that Internet gaming has not only found its footing among Indians, but it has become one of the favourite leisure time activities among users of all age groups and gender. According to a worldwide survey conducted in 3rd quarter of 2022, India ranks 6th with 91.9% gaming penetration among digital consumers [4]. This trend has made Indian population, particularly teens and young adults markedly susceptible to harms associated with internet gaming [5].
The prevalence of IGD varies globally, and estimated to be between 0.5% to 27.5% [6]. This variation maybe a result of difference of study population, assessment tools and diagnostic criteria of IGD. It is found that prevalence rates are higher among Eastern Asian countries, among males in the age group of 12 years to 20 years [7]. The prevalence of Gaming Disorder was estimated to be 3.05% after including results from 53 studies worldwide conducted between 2009 to 2019 when considering studies with strict criteria only [8]. The prevalence of IGD in India is only slightly higher with 3.50% among school children. It is as high as 8.8% among Indian males while 0.8% among Indian females [9].
Even though, playing video games in a limited environment may be harmless, or even advantageous with cognitive, physical and social benefits, excessive gaming ultimately proves to be hazardous for both physical and mental health. In fact, various case reports have shown serious health issues associated with intensive internet gaming like metabolic disorders, obesity, seizures, heart malfunction, hypertension, abrupt rise in systolic blood pressure, prolonged stress and poor posture leading to injuries [10,11,6]. Apart from physical health, internet gaming disorder has also been shown to affect mental and social health as well including sleep disturbances, increase anxiety and aggression, poor academic performance, interpersonal relations neglection, and unable to meet work-related commitments [12]. Studies have also shown that people who spend too much time playing internet games may have decreased hippocampal integrity which predisposes a person to neurological disorders such as Alzheimer’s disease [13].
