The Development of and Rationale for Gaming Disorder in ICD-11 and a Review of Available Assessment Tools

Purpose of reviewIn the 11th revision of the International Classification of Diseases (ICD-11) published in 2022, Gaming Disorder (GD) was introduced as a "Disorder due to Addictive Behaviours" by the World Health Organization (WHO). Herein, we describe the rationale behind its inclusion, compare the ICD-11 guidelines for GD to the diagnostic criteria for the provisional diagnosis of Internet Gaming Disorder (IGD) in the appendix of the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), summarize current empirical evidence on GD, and provide a brief summary of available assessment tools.Recent findingsBeginning in 2014, a WHO technical working group reviewed the literature to evaluate the public health implications of excessive use of the internet in a series of annual meetings. Evidence was found that video- (online-) gaming may lead to addictive behaviour patterns, as is recognised with gambling, but for other internet-based activities there was insufficient empirical support. GD is characterized by three diagnostic features (impaired control, increasing priority in life, continued use despite negative consequences) that can be regarded as core elements of addictive behaviours, together with evidence of functional impairment. The DSM-5 definition of IGD partly overlaps with GD; however, it also includes a number of peripheral criteria which may lead to overpathologization. Emerging studies support the validity of GD in ICD-11. ICD-11 GD assessment tools are beginning to be developed and are reviewed here.SummaryIt has yet to be established if a monothetic or a polythetic approach leads to an optimal diagnostic accuracy that avoids overpathologization and overdiagnosis, while ensuring no one in need of treatment is left adrift. An important area of research will be the development of sound diagnostic and screening tools and these are beginning to emerge.