Abstract
BackgroundPokémon Go is a very popular location-based augmented reality game with widespread influences over the world. An emerging body of research demonstrates that playing Pokémon Go can lead to improvements in physical activity and psychosocial well-being; however, whether Pokémon Go reduces self-harm incidence at the population-level is still questionable.ObjectiveThis study aimed to quantify how the launch of Pokémon Go in Hong Kong affected the incidence of self-harm using a quasi-experimental design.MethodsAn interrupted time-series design with Poisson segmented regression adjusted for time and seasonality trends was used on data from 2012 to 2018 to detect any changes in the number of accident and emergency attendances due to self-harm, after Pokémon Go was launched. The findings were validated using a baseline control period and using other intentional injuries and minor noninjuries as control outcomes. We also assessed intervention effects by age group.ResultsFrom January 1, 2012 to July 31, 2018, there were 13,463 accident and emergency attendances due to self-harm in Hong Kong. During the period after launching Pokémon Go, self-harm attendances dropped by 34% (adjusted incidence rate ratio: 0.66, 95% CI 0.61-0.73). When analyzed by age group, a reduction in self-harm incidence was only apparent in adults (18 to 24 years of age: adjusted incidence rate ratio: 0.78, P=.02; 25 to 39 years of age: adjusted incidence rate ratio: 0.75, P<.001; 40 years of age and older: adjusted incidence rate ratio: 0.57, P<.001).ConclusionsSelf-harm incidence in the population, particularly in adults, showed a significant decline in the period after Pokémon Go was launched. Augmented reality games such as Pokémon Go show great promise as a tool to enhance psychosocial well-being and improve mental health.
Highlights
Self-harm refers to an act of causing physical injury to oneself without suicidal intent
Of 13,463 accident and emergency attendances attributed to self-harm recorded for the period from January 1, 2012 to July 31, 2018, 7521 (55.9%) were female, 5942 (44.1%) were male, and most episodes (6898, 51.2%) occurred in patients aged 40 years or older
The decline was larger in older ages, possibly because, as it has been suggested in various reports [30,39,40], adolescents are less likely to engage in Pokémon Go, and this age group may be less affected by the game
Summary
Self-harm refers to an act of causing physical injury to oneself without suicidal intent (for example, self-cutting, scratching oneself, hitting oneself, or intentional drug overdose). Research has shown that self-harm may signal distress or may be used as a way to escape from a troubling situation [6,13]. Psychosocial characteristics such as elevated stress, depression, anxiety, and feelings of lack of belonging, social isolation, or low self-esteem are common in people who self-harm [14,15]. An emerging body of research demonstrates that playing Pokémon Go can lead to improvements in physical activity and psychosocial well-being; whether Pokémon Go reduces self-harm incidence at the population-level is still questionable
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