Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Curr Opin Pediatr. 2019 Aug;31(4):435-441. doi: 10.1097/MOP.0000000000000771.
To review the literature and provide a guide to assessing patients with problematic interactive media use (PIMU).
0.3-1.0% of the world population meets criteria for internet gaming disorder (IGD). 26.8-83.3% of adolescents meeting criteria for internet addiction have comorbid attention-deficit/hyperactivity disorder. IGD is associated with increased anxiety and social anxiety/phobias. Group counseling, cognitive behavioral therapy, and sports intervention are associated with significant reductions in internet addiction.
With the Diagnostic and Statistical Manual of Mental Disorders-5 inclusion of IGD under 'Conditions for Further Study' and the addition of gaming disorder to International Classification of Diseases (ICD)-11, the idea that PIMU is a mental health disorder gained traction. Although certain populations may be at increased risk, all children and adolescents should be screened for PIMU given now-normal heavy media usage rates. Effective treatment of PIMU starts with identification and management of comorbid mental and behavioral health problems. Depending on their degree of functional impairment, patients may benefit from various forms of psychotherapy with coordinated outpatient management or may warrant higher level of care in one of several established residential treatment programs. Few studies have evaluated pharmacologic approaches to treating PIMU, but some medications targeting comorbid mental and behavioral health conditions improve PIMU-related behaviors.
回顾文献并提供评估有问题互动媒体使用(PIMU)患者的指南。
全球有 0.3-1.0%的人口符合互联网游戏障碍(IGD)的标准。有 26.8-83.3%符合互联网成瘾标准的青少年同时患有注意力缺陷/多动障碍。IGD 与焦虑和社交焦虑/恐惧症增加有关。团体咨询、认知行为疗法和运动干预与网瘾显著减少有关。
随着《精神障碍诊断与统计手册-5》将 IGD 纳入“进一步研究条件”,以及《国际疾病分类(ICD)-11》将游戏障碍纳入其中,PIMU 是一种心理健康障碍的观点得到了更多关注。尽管某些人群可能面临更高的风险,但鉴于现在媒体的高使用率,所有儿童和青少年都应该接受 PIMU 的筛查。PIMU 的有效治疗始于识别和管理合并的精神和行为健康问题。根据其功能障碍的程度,患者可能受益于各种形式的心理治疗,同时需要协调门诊管理,或者可能需要在几个已建立的住院治疗项目中获得更高水平的护理。很少有研究评估治疗 PIMU 的药物方法,但一些针对合并精神和行为健康状况的药物可以改善与 PIMU 相关的行为。