Debates about pathological gaming continues in the wake of the World Health Organization's (WHO) decision to establish a gaming disorder diagnosis. Questions persist whether gaming disorder is best conceived as a stand-alone psychiatric disorder, or whether it heralds or accompanies other, more established conditions, such as depression or ADHD. We tested these hypotheses in a sample of 3,034 youth from Singapore. Evidence suggests that pathological gaming is a somewhat unstable construct, often remitting spontaneously. Youth with preexisting ADHD or depression were more likely to develop later pathological gaming problems, while the inverse was not true, with neither early pathological gaming nor gaming time predictive of later mental health problems. Results suggest that, whenever there is any need to conduct robust evidence-based studies, more evidence should be collected before new disorders are recognized by means of "expert consensus".