A Clinical Study of Internet Gaming Disorder in Adolescents with Psychiatric Disorders

Objectives: The severity of different internet gaming disorder (IGD) symptoms criteria has not been explored much. The study describes the phenomenology of IGD in adolescents with comorbid psychiatric disorders attending child and adolescent psychiatry outpatient department (OPD). Materials and Methods: A total of 46 adolescents aged 13-16 years, who have attended child and adolescent psychiatry OPD, of a tertiary care teaching hospital for psychiatric disorders, with a history of gaming and who fulfilled criteria as per the fifth edition of Diagnostic and Statistical Manual (DSM-5) for IGD have been included. All the adolescents have then assessed using semi-structured pro forma, internet gaming disorder scale (IGDS), and K-SADS-PL. Results: In the study sample, the most common IGDS criterion was "conflict" and the least common criterion was "tolerance." The IGDS mean score of "conflict" was the highest while of "displacement" was the least. "Escape" and "deception" were significantly higher for females. "Displacement" was significantly higher for urban domicile and online mode of gaming. "Persistence" was significantly higher for those who were gaming on personal devices and playing Massively Multiplayer Online Role-Playing Games (MMORPGs). Psychiatric disorders associated with IGD were ODD (46.66%), dissociative disorder (24.44%), attention-deficit hyperactivity disorder (ADHD, 17.77%), and depressive disorder (11.11%). Phenomenology of IGD was comparable across all psychiatric comorbidities, except subjects with dissociative disorders, who had significantly higher scores for "escape" than for ADHD and depression. Furthermore, subjects with ODD had significantly higher scores for "displacement" than the subjects with dissociative disorder in terms of IGDS scores. Conclusion: Significant differences in the severity of DSM-5-IGD symptoms criteria are found in terms of gender, domicile, gaming genre (MMORPGs), accessibility of smartphones, online/offline modes of gaming, and the associated psychiatric comorbidity.