Is video-gaming addiction a medical disease? The World Health Organisation’s (WHO’s) latest International Classification of Diseases (ICD-11), adopted by member countries on May 25, puts gaming addiction in that category. The ICD-11 lists “Gaming Disorder” as a modern disease with clinical symptoms. The new classification is likely to cause a great deal of grief to the world's billion-plus dedicated gamers since it puts ammunition into the hands of those who have been seeking to either outright ban, or otherwise curtail, the playing of video games. It will also have negative repercussions for the consumer electronics industry, which depends on gamers for the sale of high-end consoles, specialised PCs and high-performance tablets, and mobiles.
The global gaming industry is roughly the same size as the global movie industry with $135 billion in 2018 revenues. Almost everybody has played games on his or her mobile to stave off boredom at some time or another. Industry analysts reckon that over a billion people play games on a daily basis, while over two billion people have played a game within the last month. Dedicated gamers form active online communities, and participate in conferences where MBAs in suits mingle with fans in fantastic costumes. Apart from inventing its own storylines, the industry does spinoffs using themes borrowed from popular culture, with games based on popular TV shows, graphic novels and movies. The global gaming industry is lobbying with the WHO to rescind its classification. The apex industry body, the Entertainment Software Association, which has representation from all over the world, has protested that the WHO classification is “not based on sufficiently robust evidence” and it should not be included in the ICD.
The WHO defines gaming disorder “as characterised by impaired control over gaming, increasing priority given to gaming over other activities, and the continuation or escalation of gaming despite the occurrence of negative consequences. For gaming disorder to be diagnosed, the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning and would normally have been evident for at least 12 months”. But the WHO classification is more nuanced than the headlines would indicate. Every gamer is not at risk. Indeed, there are academic studies that indicate that gaming can be a healthy and stimulating activity with educational value and the WHO says that the vast majority of gamers are not suffering from the disorder.
The WHO classification is based on 200-odd studies and surveys. But critics from the gaming industry (and several academics who have examined the details) say that the studies are basically surveys, with small samples. Moreover, unlike with other physical addictions, no clear-cut substance that causes dysfunction (such as alcohol or nicotine) has been identified. However, the classification will feed into oft-expressed fears that violent games can foster aggressive behaviour and that addiction may occur, harming social lives and impacting academic performance. Regulators and politicians in the WHO’s member-nations will probably respond in different ways to the classification. This could result in outright bans in some places, as has occurred with PUBG. It could result in sin taxes being imposed, in analogy with the taxes imposed on the tobacco, alcohol and cannabis industries. There might well be censorship and labelling imposed on games as well.
One way or another, the gaming industry is likely to receive a lot of unwelcome attention from regulators. It is utterly impossible to shut down gaming in an era when smartphones are ubiquitous, and the Internet is a repository of millions of free downloads. But it is possible that as a result of this declaration, gamers may be driven underground. One way around the situation might be for the industry to adopt an ethical code of conduct, and self-regulate to cut down on violence, or expunge politically incorrect storylines (such as games where points are awarded for committing rape). Game developers could also contribute some of their profits to medical treatment for addicts. Howsoever it responds, the industry will now face unprecedented social and regulatory pressure.