1Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
2Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
J Behav Addict. 2023 Nov 7;12(4):855-861. doi: 10.1556/2006.2023.00059. Print 2023 Dec 22.
The eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily activities, and impaired functioning due to gaming. While this definition has implications for the prevention and treatment of GD, there is significant heterogeneity in the symptoms and etiology of GD among individuals, which results in different treatment needs. Cognitive control, emotional regulation, and reward sensitivity are three critical dimensions in the etiology model for GD. Aspects such as gender, comorbidity, motivation for gaming, stage or severity of GD, and risk factors all contribute to the heterogeneity of etiology among individuals with the disorder.
On the basis of clinical symptoms and comorbidity characteristics among approximately 400 patients with gaming disorder, the present paper proposes a clinical typology of patients with GD based on the authors' clinical experience in treating individuals with GD.
The findings indicated three common types of patients with GD: (i) impulsive male patients with attention deficit hyperactivity disorder (ADHD), (ii) dysphoria patients with dysfunctional coping skills, and (iii) isolated patients with social anxiety. The paper also discusses the presentation and treatment priority for these patients.
Personalized treatments for patients with GD should be developed to fit their individual needs. Future studies should examine the heterogeneity of GD and confirm these types, as well as obtain evidence-based information that can help in the development of personalized treatment. Treatment resources should be developed, and professionals should be trained to provide integrated individualized treatment.
国际疾病分类第 11 次修订版（ICD-11）定义了游戏障碍（GD）的三个关键诊断标准。这些标准包括对游戏失去控制、将游戏置于日常活动之上以及因游戏而导致的功能受损。虽然这一定义对 GD 的预防和治疗具有重要意义，但个体之间 GD 的症状和病因存在显著异质性，这导致了不同的治疗需求。认知控制、情绪调节和奖励敏感性是 GD 病因模型中的三个关键维度。性别、共病、游戏动机、GD 的阶段或严重程度以及风险因素等方面都导致了该障碍个体病因的异质性。
基于大约 400 名游戏障碍患者的临床症状和共病特征，本论文根据作者治疗 GD 患者的临床经验，提出了 GD 患者的临床分型。
研究结果表明，GD 患者有三种常见类型：（i）患有注意缺陷多动障碍（ADHD）的冲动男性患者，（ii）功能失调应对技能的心境障碍患者，以及（iii）患有社交焦虑的孤立患者。本文还讨论了这些患者的表现和治疗重点。
应针对 GD 患者的个体需求制定个性化治疗方案。未来的研究应检查 GD 的异质性并确认这些类型，并获取有助于制定个性化治疗的循证信息。应开发治疗资源并培训专业人员，以提供综合个性化治疗。
