Determining the prevalence of internet gaming disorder in a clinical sample, evaluating the change in disorder severity after interventions on comorbid psychopathology and parental attitudes

Objective: This study aimed to determine the prevalence of internet gaming disorder (IGD) in a clinical sample, evaluate changes in disorder severity after psychopharmacological treatment and interventions on parental attitudes during a 6-month follow-up period, and identify variables predicting the development and persistence of IGD diagnosis at the end of 6 months. Methods: During the 12-month period, the child and adolescent psychiatry outpatient clinic evaluated 73 cases with IGD and 38 cases without IGD. The evaluation process included DSM-5-based interviews and IGD screening scales for both the child and parent. The study employed a range of assessment tools, including the Internet Gaming Disorder Scale-Short Form, Children's Depression Rating Scale (CDI), Childhood Anxiety Screening Scale, Social Skills Scale, Coping Strategies Scale for Adolescents, Family Internet Attitude Scale, Family Assessment Scale, and sociodemographic form, to comprehensively evaluate the cases with confidence. Gaming Disorder-Parent Form, DSM-IV Based Screening and Assessment Scale for Disruptive Behavior Disorders in Children and Adolescents (TURGAY), Psychological Symptom Screening Test, Parent Questionnaire for Internet Gaming Disorder in Children, IGD Parent Attitude Questionnaire and sociodemographic form for parents; and Turgay Scale for teachers. Results: In this study, the prevalence of IOOB was found to be 6.9% in the clinical sample. The prevalence of IGD was 14.4% in boys and 1.1% in girls. The prevalence of IGD based on self-report of children and adolescents was 1.5%. The most common comorbidities observed in the group receiving treatment for IGD were attention deficit hyperactivity disorder, major depressive disorder and specific learning disabilities. After family intervention and psychopharmacological treatment, 78.9% of the IGD treatment group lost their IGD diagnosis, 10.5% stopped playing games completely and 21.1% continued to have IGD. In the group receiving IGD treatment, after family intervention and psychopathology treatment, decrease in IGD severity, improvement in coping and social skills, decrease in neglectful parental internet attitudes perceived by children, and increase in family functioning were significant at the 6th month. ADHD comorbid to IGD, after 6 months of methylphenidate (MPH) treatment, the severity of IGD reported by children and parents, play time, severity of attention deficit symptoms reported by parents, and severity of conduct disorder symptoms reported by teachers decreased significantly. As a result of multivariate linear regression analyses, depressive symptom severity and attention deficit symptom severity predicted the development of IGD; each unit increase in the attention deficit subscale increases the risk of having IGD by 1.21 times and each unit increase in depressive symptom severity increases the risk of having IGD by 1.11 times; each unit increase in the CDI and parental Turgay attention deficit subscale scores increases the risk of having IGD diagnosis at the end of 6 months by 5.132 times, 1.056 and 1.136 times, Additionally, parents reported a decrease in the severity of attention deficit symptoms, and teachers reported a decrease in the severity of conduct disorder symptoms. As a result of multivariate linear regression analyses, depressive symptom severity and attention deficit symptom severity predict the development of IGD, and each unit increase in the attention deficit subscale increases the risk of having IGD by 1.21 times and each unit increase in depressive symptom severity increases the risk by 1.11 times; at the end of 6 months, having a computer of one's own increases the risk of continuing IGD diagnosis by 5.132 times, and each one-unit increase in CDI and parental Turgay attention deficit subscale scores increases the risk by 1.056 and 1.136 times, respectively. Conclusion: In this study, the prevalence of IGD based on self-report was much lower than the prevalence based on clinical interview and parental report. This difference shows that the rates of IGD prevalence studies in the literature, most of which are based on self-report scales, reflect much less than the actual rates and that more prevalence studies based on clinician interviews are needed. Our study shows that the "Parent Intervention Program" we implemented was effective on IGD severity, family functioning and parental attitudes. Effective treatment of comorbid conditions in IGD with high comorbidity rates significantly improves IGD clinical outcomes. Depressive symptom severity and attention deficit symptom severity are the factors that significantly predict the development of IGD and the continuation of IGD diagnosis at 6-month follow-up.