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Validity, functional impairment and complications related to Internet gaming disorder in the DSM-5 and gaming disorder in the ICD-11
Abstract
Background: Many concerns have been raised regarding the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for Internet gaming disorder and International Classification of Diseases, 11th Revision (ICD-11) criteria for gaming disorder. Aims: In this study, we demonstrated the diagnostic validity of each criterion for Internet gaming disorder in the DSM-5 in terms of their intensity and frequency thresholds and evaluated functional impairments, unhealthy behaviors and complications among adults with Internet gaming disorder and gaming disorder. Methods: We recruited 69 subjects with Internet gaming disorder, 69 regular gamers and 69 controls without regular gaming based on diagnostic interviewing conducted by a psychiatrist according to the DSM-5 Internet gaming disorder criteria. Results: Except for the ‘deceiving’ and ‘escapism’ criteria, all criteria for Internet gaming disorder had a diagnostic accuracy ranging from 84.7% to 93.5% in differentiating between adults with Internet gaming disorder and regular gamers. A total of 44 participants with Internet gaming disorder (63.8%) fulfilled the gaming disorder criteria. In addition, 89% and 100% of the Internet gaming disorder and gaming disorder groups, respectively, had academic, occupational or social functional impairment. Both the Internet gaming disorder and gaming disorder groups had higher rates of delayed sleep phase syndrome and insomnia. The gaming disorder group also had a higher obesity proportion. Conclusion: The ‘deceiving’ and ‘escapism’ criteria had relatively lower diagnostic accuracy. Both the Internet gaming disorder and gaming disorder groups demonstrated functional impairments and unhealthy behaviors. They also exhibited complications, such as obesity and sleep disorders. These results support the utility of the DSM-5 Internet gaming disorder and ICD-11 gaming disorder criteria in identifying individuals who need treatment for both gaming addiction symptoms and complications resulting from the addiction.
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“Ko et al 207 compared individuals formally diagnosed with gam ing disorder with non-problematic gamers. They found that those with gaming disorder reported significant functional impairment across multiple domains, including academic and work performance, social functioning, and physical health (including problems related to sleep, pain, body weight, vision, and physical exercise).”
In the citing paper
“Studies that include the administration of diagnostic interview schedules to identify co-occurring conditions have reported that individuals diagnosed with gaming disorder experienced negative consequences in multiple life areas 199,205-210 .”
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Ko, C., & Yen, J. (2023) · Springer eBooks · doi:10.1007/978-3-030-42825-9_164-1 · Cited by 3
Self-citationNetwork analysis of additional clinical features of (Internet) gaming disorder
Martončik, M., Adamkovic, M., & Ropovik, I. (2024) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.2021 · Cited by 3
Yen, J., Higuchi, S., Ko, C., & Su, S. (2022) · Current Addiction Reports · doi:10.1007/s40429-022-00444-5 · Cited by 3
Self-citationUnderstanding the gaming disorder–depression co-occurrence: A narrative literature review
Sun, A., & Diez, S. L. (2025) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2025.100961 · Cited by 2
Ino, H., Ohtani, T., & Takahashi, A. (2025) · Discover Psychology · doi:10.1007/s44202-025-00456-y · Cited by 2
Lee, S. J., Kim, S. Y., Ferguson, C. J., & Jeong, E. J. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1614807 · Cited by 2
Vilca, L. W., Turpo, J. A., Dávila-Valencia, C., Lupaca-Huarac, E., Travezaño-Cabrera, A., & Caycho‐Rodríguez, T. (2023) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-023-01123-w · Cited by 3
Metadata
- Authors
- Ko, C.-H., Lin, H.-C., Lin, P.-C., & Yen, J.-Y.
- Affiliations
- Kaohsiung Medical University (TW)
- Corresponding author
- Yen, Ju-Yu
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2019-10-21
- Volume
- 54
- Issue
- 7
- Pages
- 707-718
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W2981847305
- Cited by
- 136
- References
- 40
- Citations by year
- 2026: 17 · 2025: 21 · 2024: 12 · 2023: 23 · 2022: 25 · 2021: 27 · 2020: 10 · 2019: 1
- FWCI
- 31.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- ministry of science and technology, taiwan (MOST105-2314-B-037-027-MY2, MOST107-2314-B-037-101-MY2)
- kaohsiung medical university (KMUH105-5R54)
- the Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education in Taiwan (NHIRD-1060407)
- Kaohsiung Municipal Hsiao-Kang Hospital (KMUH105-5R54)
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Keywords
- internet gaming disorder, gaming disorder, DSM-5 diagnostic criteria, ICD-11 diagnostic criteria, diagnostic validity, functional disability, sleep disorders, delayed sleep phase syndrome, insomnia, obesity, gaming addiction
- MeSH terms
- Internet Addiction Disorder, Adult, Female, Humans, Male, Reproducibility of Results, Behavior, Addictive, Video Games, Internet, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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