Conceptualization, diagnosis, and differential diagnosis of gaming disorder
Authors:
Jaroslava Suchá 1; Barbora Hoňková 1; Kateřina Kloučková 2
Authors‘ workplace:
Katedra psychologie, FF UP, Olomouc
1; Klinika adiktologie 1. LF UK a VFN v Praze
2
Published in:
Čes. a slov. Psychiat., 122, 2026, No. 3, pp. 95-104.
Category:
Review
doi:
https://doi.org/10.48095/cccsp202603
Overview
Popularity of digital gaming is increasing and the phenomenon of problem gaming is growing. In response to the increased prevalence of problem gaming, the World Health Organization has classified digital gaming disorder (GD) under the code 6C51 in the 11th revision of the International Classification of Diseases (ICD-11) in 2019. It is becoming increasingly important to accurately diagnose these criteria while distinguishing them from hazardous gaming (code QE22). Therefore, in addition to defining the diagnostic criteria, the text also focuses on a more detailed description of the clinical manifestations of digital gaming disorder, which are not currently listed in the Czech web version of the ICD-11, but are important for an accurate and reliable diagnosis. The article also includes a comparison with the conceptualization of internet gaming disorder (IGD) according to the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The proposed diagnosis of IGD in the DSM-5 requires that five (or more) out of the nine possible criteria be present over a one-year period. A diagnosis of GD under ICD-11requires the experience of all three of the defined diagnostic criteria, usually for a period of 12 months, but with the possibility of reducing this period. Both diagnostic criteria agree that a diag-nosis is warranted only if the pattern of gaming behavior is associated with functional impairment in important life domains. Some experts pointed out that diagnostic criteria based on the DSM-5 may pathologize common gaming behavior. They noted that some symptoms (e. g., gaming as an escape, tolerance, deception) are not specific enough and may lead to false positive diagnoses. The MKN-11 approach is considered more conservative as it requires clear functional impairment caused by gaming for diagnosis, thus refining previous approaches to identifying addictive gaming. Epidemiological surveys suggest that digital gaming disorder affects a small but not insignificant proportion of gamers. Comparison of diagnostic frameworks shows that the DSM-5 criteria lead to higher prevalence estimates than the stricter ICD-11 criteria; thus, the same individual may be classified as ill under the broader DSM-5 criteria, but not under the narrower ICD-11 criteria. These differences have implications for clinical practice – the broader definitions of the disorder may lead to overdiagnosis of borderline cases, while the narrower concept may leave some affected individuals without a diagnosis. To accurately diagnose this disorder, valid diagnostic criteria must be consistently applied and all conditions, including functional impairment and sufficient duration of symptoms, must be verified. At the same time, it is necessary to distinguish disordered gaming from mere high levels of engagement in order to avoid excessive pathologization of normal behavior. A careful clinical approach that takes into account the individual context and comorbidities is important to minimize the risk of misdiagnosis and to ensure that intervention is focused on the truly affected individuals. In summary, beyond clarifying specific diagnostic criteria, this text aims to provide a comprehensive overview of differential diagnosis considerations and a critical evaluation of both the ICD-11 and DSM-5 diagnostic approaches to gaming-related disorders. Accuracy of diagnostic boundaries is essential for both research and clinical practice, as it helps to prevent the over-pathologization of normal gaming behavior while ensuring that those individuals who truly need help are accurately identified.
Keywords:
differential diagnosis – Diagnostic and statistical manual of mental disorders 5 (DSM-5) – gaming – International classification of diseases (ICD-11) – gaming disorder – internet gaming disorder – hazardous gaming
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Addictology Paediatric psychiatry PsychiatryArticle was published in
Czech and Slovak Psychiatry
2026 Issue 3
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