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World Health Organisation add ‘gaming disorder’ to the International Classification of Diseases

By the book

The World Health Organisation (WHO) have voted to recognise ‘gaming disorder’ as a health condition. After drafting it into the updated International Classification of Diseases (ICD) last year, members of the assembly unanimously agreed the draft yesterday, despite dissent from academics, industry groups, and governmental bodies. The classification will come into effect in 2022.

The entry, which falls under "disorders due to addictive behaviours," reads:

Gaming disorder is characterised by a pattern of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’), which may be online (i.e., over the internet) or offline, manifested by:

1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context);

2. increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and

3. continuation or escalation of gaming despite the occurrence of negative consequences. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

The pattern of gaming behaviour may be continuous or episodic and recurrent. The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.

It is worth reading some accounts from people who would likely fit under this classification, like those discussed in Cecelia D’Anastasio’s exploration of what gaming addiction really is at Kotaku. D’Anastasio points out that a classification might help inform doctors and therapists about how they can help those who do feel as though gaming is taking over their lives to the detriment of all else.

But most who shared their story identify a different problem that they were using gaming to cope with, like depression. That’s also a question raised by academics in the Journal of Behavioural Addictions, who previously spoke out against the seemingly hasty inclusion of gaming disorder in the ICD without further research, as Alice O covered in detail. "We acknowledge there could be benefits to formalising gaming disorder," say the academics, "but we think they do not yet outweigh the wider societal and public health risks involved [in] diagnostic classification."

The games industry, unsurprisingly, were concerned then and continue to be concerned now. A statement published yesterday from a group including the UK’s Ukie and the US's Entertainment Software Association, is calling on the WHO to “rethink their decision.” Games are good, they promise, including being “significant in advancing in research science across many fields ranging from mental health, dementia, cancer, and pioneer advances in accessibility.” Which is true, if deeply selective. “The industry developed world-class consumer protection tools including parental controls and responsible game-education initiatives to ensure the players are able to engage in the safest environments,” feels…more questionable.

Still, like the aforementioned academics, they also emphasise that more research is needed given how influential the WHO can be for “norm-setting.” Even governmental bodies, like the South Korean culture ministry, have informed the WHO they are against the classification.

The ICD is theoretically a list of all diseases and disorders, including mental health conditions. The other addictions listed are mostly classified as substance-caused, but gambling disorder also falls under the "addictive behaviours" subhead. Its language is functionally identical to the description of gaming disorder. This latest revision also includes changes to sections including antimicrobial resistance, traditional medicine, and allergies.

The WHO also note that the ICD "is the foundation for identifying health trends and statistics worldwide," and they themselves do plenty of long-term tracking. It's possible this will prove useful for future research on the topic.

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