Abstract
Purpose: As a new category proposed in the International Classification of Diseases (11th Revision) (ICD-11), the reliability and clinical utility of ICD diagnostic guidelines for gaming disorder (GD) in the Chinese population have not been studied. The purpose of this field study is to clarify the reliability, clinical utility, and cultural applicability of ICD diagnostic guidelines for GD in China and its comparability with Internet GD (IGD) in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5).Methods: Participants included 21 paired clinical raters consisting of seven psychiatrists and 200 gaming players aged from 15 to 18 years with different risk levels of Internet addiction based on the scores of Young's Internet Addiction Test. Each participant received a semi-structured face-to-face interview by paired clinical raters at the same time. Then clinical raters made the diagnosis and filled the clinical utility questionnaire independently according to the diagnostic guidelines for GD in both ICD-11 and DSM-5.Results: The diagnostic consistency coefficient (kappa value) between the paired clinical raters was 0.545 (0.490–0.600, p < 0.001) and 0.622 (0.553–0.691, p < 0.001) for ICD-11 and DSM-5 diagnostic guidelines, respectively, for GD. The diagnostic consistency was 0.847 (0.814–0.880, p < 0.001) between GD in ICD-11 and IGD in DSM-5. Meanwhile, 86.7% of responses that agreed with the ICD-11 diagnostic guidelines for GD provided enough detailed implementation characteristics and showed good overall clinical applicability (86.0%), specificity (94.4%), usefulness (84.1%), and acceptable cultural adaptation (74.8%). GD in ICD-11 was slightly more accepted than IGD in DSM-5 (p < 0.001), while the clinical efficiency of ICD-11 was inferior to that of DSM-5 (p < 0.001).Conclusion: This study indicates that the ICD-11 diagnostic guidelines for GD have acceptable clinical reliability and high consistency with IGD in DSM-5. Their clinical applicability and cultural adaption are comparable with those of DSM-5. Although the guidelines still need to be adjusted for better implementation in China, this is already a great step committed to reducing the serious consequences caused by excessive gaming behaviors through effective identification and normative diagnosis, especially for adolescents.
Highlights
In 2018, the WHO released the draft of the 11th revision of the International Classification of Diseases (ICD-11) [1]
The decision was based on reviewing the available evidence in the scientific literature and on case series [2,3,4], as well as experiences from clinical practice provided by international experts in psychiatry, clinical psychology, internal medicine, family practice, epidemiology, neurobiology, and public health [5]
Paired clinical raters conducted clinical interviews with gaming players to determine whether the players met the diagnostic criteria of GD in ICD-11 or Internet GD (IGD) in DSM-5
Summary
In 2018, the WHO released the draft of the 11th revision of the International Classification of Diseases (ICD-11) [1]. It is worth noting that there is an inclusion of a new diagnostic category “gaming disorder (GD)” in the section “Disorders due to substance use or addictive behavior.”. The decision was based on reviewing the available evidence in the scientific literature and on case series [2,3,4], as well as experiences from clinical practice provided by international experts in psychiatry, clinical psychology, internal medicine, family practice, epidemiology, neurobiology, and public health [5] This highly controversial diagnosis, reminds us to pay more attention to problems caused by games and even the Internet [6]. GD is one of the “disorders due to addictive behaviors.” It has become a recognizable and clinically significant syndrome associated with distress or interference with personal functions that develop by repetitive rewarding behaviors other than the use of dependence-producing substances [1]. National surveys have shown the prevalence rates of GD of 10∼15% among young people in several Asian countries and of 1∼10% in their counterparts in some Western countries [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
