游戏障碍的诊断演变与共病情况:来自中国五家医院精神科2018年至2023年的见解
Evolving diagnosis and comorbidities of gaming disorder: Insights from psychiatry departments in five Chinese hospitals from 2018 to 2023.
作者信息
Wang Xuhao, Lin Shuhong, Liu Xuebing, Huang Shucai, Qi Jing, Shao Tianli, Liao Zhenjiang, Chen Xinxin, Li Yifan, Tang Ying, Shen Hongxian, Huang Qiuping
机构信息
1National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, China.
2Department of Psychology, School of Humanities and Management, Hunan University of Chinese Medicine, China.
出版信息
J Behav Addict. 2025 Jun 23;14(2):873-888. doi: 10.1556/2006.2025.00051. Print 2025 Jul 2.
BACKGROUND AND AIM
The 11th Revision of the International Classification of Diseases (ICD-11) recognizes gaming disorder (GD) as a behavioral addiction, but its implications for the clinical diagnostic practice of GD remain underexplored. This study examines the clinical diagnosis of GD since its inclusion in ICD-11 to understand trends in diagnosis rates in psychiatric departments and patient characteristics, particularly comorbidities.
METHOD
This multicenter, retrospective observational study was conducted in five large tertiary hospitals and mental health centers across four Chinese provinces. Diagnoses of GD in each hospital were based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or ICD-11 criteria. Data were extracted from hospital records, including demographics, diagnoses, and medical history.
RESULT
Of the 7,877,415 total visitors, 3,517 unique patients (0.045%) met GD diagnostic criteria. GD diagnoses showed a significant linear increase (χ2 = 83.143, p < 0.001) from 2018 to 2023. 37.59% of GD patients had comorbidities, mostly mood disorders, followed by impulse control disorders, schizophrenia or other primary psychotic disorders, and attention deficit hyperactivity disorder. Patients were younger (F = 48.69, p < 0.001), mainly aged 12-18.
DISCUSSION AND CONCLUSIONS
This study reveals an upward trend in GD diagnosis from 2018 to 2023, showing a trend toward younger diagnosis age, especially in males. Notably, there's a high rate of comorbidities, with mood disorders being the most common. While ICD-11 may have improved GD identification, further research is needed to clarify whether the increased rates are due to higher prevalence or better recognition.
背景与目的
《国际疾病分类》第11次修订版(ICD - 11)将游戏障碍(GD)认定为一种行为成瘾,但它对GD临床诊断实践的影响仍未得到充分探索。本研究考察了自GD被纳入ICD - 11以来的临床诊断情况,以了解精神科的诊断率趋势及患者特征,尤其是共病情况。
方法
本多中心回顾性观察研究在四个中国省份的五家大型三级医院和精神卫生中心开展。各医院对GD的诊断基于《精神疾病诊断与统计手册》第五版(DSM - 5)或ICD - 11标准。数据从医院记录中提取,包括人口统计学信息、诊断结果和病史。
结果
在总共7877415名就诊者中,3517名独特患者(0.045%)符合GD诊断标准。2018年至2023年期间,GD诊断呈显著线性增长(χ2 = 83.143,p < 0.001)。37.59%的GD患者有共病情况,主要是情绪障碍,其次是冲动控制障碍、精神分裂症或其他原发性精神障碍,以及注意力缺陷多动障碍。患者年龄较小(F = 48.69,p < 0.001),主要年龄在12 - 18岁。
讨论与结论
本研究揭示了2018年至2023年期间GD诊断呈上升趋势,诊断年龄有年轻化趋势,尤其是男性。值得注意地是,共病率较高,情绪障碍最为常见。虽然ICD - 11可能改善了GD的识别,但仍需进一步研究以明确诊断率上升是由于患病率增加还是识别度提高。