12/22/2013 12:45 am ET Updated Feb 20, 2014

How the Official Psychiatric Guidebook Deals With the Internet

The Internet is now an integral, even inescapable part of many people's daily lives, used to send messages, read news, conduct business, and much more. But some individuals become consumed with certain aspects of the Internet, particularly online games, to the exclusion of jobs, studies, or family commitments. The impact of this behavior on mental health has been an area of burgeoning research and clinical interest in recent years.

Studies available to date and the high prevalence rates of these behaviors reported in specific Asian countries warranted the inclusion of Internet gaming disorder in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM-5's Section III highlights important conditions that require additional investigation before they can be considered disorders.

Most people who play online games do not become consumed with the activity. But there are individuals whose habit can endanger their well-being. The diagnostic criteria for Internet gaming disorder describe individuals who play compulsively, to the point where online gaming becomes the dominant focus of their life and all other interests or needs are ignored. They may spend eight or more hours a day gaming and go for long periods without food or sleep because they are unable to stop playing.

Extensive studies from China, South Korea and Japan suggest that compulsive online gamers may have certain pathways in the brain triggered during play in the same direct and intense way that a drug addict's brain is affected by a particular substance. The scientific literature describes traits exhibited by these gamers that are remarkably similar to traits seen in substance use disorders. In addition to withdrawal, they include impairment in day-to-day functioning and unsuccessful attempts to cut back or quit playing.

Further research, like the studies described above, will be required before firm conclusions can be drawn and precise, reliable diagnostic criteria determined. Internet gaming disorder also has public health ramifications that need to be explored to a greater degree.

It is important that clinicians take the condition seriously, as considerable mental distress and even physical harm can occur in the lives of those with these behaviors. The inclusion of Internet gaming disorder in section III encourages further research so that the condition can be better understood, more precisely defined and potentially used in the future to help patients get the care they need.