Seo Eun Hyun, Yang Hae-Jung, Kim Seung-Gon, Park Seon-Cheol, Lee Sang-Kyu, Yoon Hyung-Jun
Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea.
Department of Psychiatry, Chosun University Hospital, Gwangju, Republic of Korea.
Psychiatry Investig. 2021 Dec;18(12):1149-1163. doi: 10.30773/pi.2021.0207. Epub 2021 Dec 8.
Internet gaming disorder (IGD) has attracted considerable attention as a serious mental and public health issue worldwide. Currently, there are no established treatment guidelines for IGD. Herein, we review the latest findings on the efficacy and related neural effects of pharmacological and psychosocial treatments for individuals with IGD.
A database search of relevant studies published between 2007 and 2020 was conducted using PubMed and Google Scholar. Twenty-seven studies were reviewed for current evidence related to the efficacy and neural effects of pharmacological and psychosocial IGD treatments.
Pharmacological studies suggest that bupropion may play a significant role in IGD. Additionally, nuclear imaging studies on IGD have demonstrated functional impairment of the dopamine system, providing a neurobiological basis for the efficacy of dopamineenhancing drugs. Among the various psychosocial interventions, current evidence suggests that cognitive behavioral therapy may be an effective intervention for IGD. Cognitive behavioral therapy and bupropion were found to influence resting-state functional connectivity within the cortico-subcortical circuit and default mode network, suggesting a possible neural mechanism. Innovative approaches, including virtual reality treatment, residential camps, voluntary abstinence, and transcranial direct current stimulation, have shown promising results. However, methodological limitations, such as the absence of proper controls, small sample sizes, short duration, inconsistency of inclusion criteria across studies, and self-report measures of outcome, hamper conclusions regarding the efficacy of treatments.
Ongoing basic research and clinical trials overcoming these limitations could add to the existing knowledge on IGD and contribute to the development of evidence-based treatments.
作为一个严重的精神和公共卫生问题，网络游戏障碍（IGD）在全球范围内引起了广泛关注。目前，尚无针对IGD的既定治疗指南。在此，我们综述了针对IGD患者的药物治疗和心理社会治疗的疗效及相关神经效应的最新研究结果。
使用PubMed和谷歌学术对2007年至2020年间发表的相关研究进行数据库检索。对27项研究进行了综述，以获取与IGD药物治疗和心理社会治疗的疗效及神经效应相关的现有证据。
药理学研究表明，安非他酮可能在IGD中发挥重要作用。此外，关于IGD的核成像研究已证明多巴胺系统存在功能障碍，为多巴胺增强药物的疗效提供了神经生物学基础。在各种心理社会干预措施中，现有证据表明认知行为疗法可能是治疗IGD的有效干预措施。研究发现，认知行为疗法和安非他酮会影响皮质-皮质下回路和默认模式网络内的静息态功能连接，提示可能存在神经机制。包括虚拟现实治疗、寄宿营地、自愿戒断和经颅直流电刺激在内的创新方法已显示出有前景的结果。然而，方法学上的局限性，如缺乏适当的对照、样本量小、持续时间短、各研究纳入标准不一致以及结局的自我报告测量方法等，妨碍了对治疗疗效得出结论。
正在进行的克服这些局限性的基础研究和临床试验可能会增加关于IGD的现有知识，并有助于循证治疗的发展。
