Availability of Data and Material
Data sharing not applicable to this article as no datasets were generated or analyzed during the study.
Conflicts of Interest
Seon-Cheol Park, a contributing editor of the Psychiatry Investigation, was not involved in the editorial evaluation or decision to publish this article. All remaining authors have declared no conflicts of interest.
Author Contributions
Conceptualization: Hyung-Jun Yoon. Investigation: all authors. Writing—original draft: Eun Hyun Seo, Hae-Jung Yang, Hyung-Jun Yoon. Writing—review & editing: all authors.
Funding Statement
None
Study | Country | Medication | N | Design | Duration | Inclusion criteria for IGD | Efficacy variable | Comorbid disease | Main findings |
---|---|---|---|---|---|---|---|---|---|
Han et al. [37] | Republic of Korea | Bupropion | 11 | Pre/post | 6 wks | YIAS >50 | YIAS | Subclinical depression (BDI<17) | Decrease of YIAS, craving for game, and gaming time compared with baseline |
Gaming time >30 hrs/wks | Craving for game | After bupropion treatment, neural response of DLPFC to gaming decreased and positively correlated with craving for gaming | |||||||
Distress due to gaming based on DSM-IV criteria for substance abuse | Gaming time | ||||||||
Han and Renshaw [38] | Republic of Korea | Bupropion with education | 25 | Double-blind RCT | 8 wks | YIAS >50 | YIAS | MDD | Greater reductions of YIAS, CGI-S, and time of gaming in the bupropion with education group compared with placebo with education group |
Placebo with education | 25 | Gaming time >30 hrs/wks | CGI-S | ||||||
Distress due to gaming based on DSM-IV criteria for substance abuse | Gaming time | ||||||||
Bae et al. [39] | Republic of Korea | Bupropion | 16 | Pre/post | 12 wks | DSM-5 criteria | YIAS | None | Decrease of YIAS compared with baseline |
Decreased RSFC within the DMN produced by bupropion significantly correlated with clinical improvement | |||||||||
Song et al. [40] | Republic of Korea | Bupropion | 44 | RCT | 6 wks | DSM-5 criteria | YIAS | None | Decrease of YIAS and CGI-S in active groups, but not control group |
Escitalopram | 42 | CGI-S | Greater reductions in YIAS and CGI-S in the bupropion group than in the escitalopram group | ||||||
No medication (control) | 33 | ||||||||
Nam et al. [41] | Republic of Korea | Bupropion with education | 15 | RT | 12 wks | YIAS >50 | YIAS | MDD | Decrease of YIAS in both groups, whereas there were no significant differences between groups |
Escitalopram with education | 15 | Gaming time >30 hrs/wks | |||||||
Maladaptive behavior due to excessive gaming | Bupropion and escitalopram attenuated RSFC within the DMN significantly | ||||||||
Han et al. [47] | Republic of Korea | MPH | 62 | Pre/post | 8 wks | Internet video game player | YIAS | ADHD | Decrease in YIAS and gaming time compared with baseline |
Gaming time | The change of YIAS positively correlated with that of inattention and omission errors | ||||||||
Park et al. [48] | Republic of Korea | MPH | 44 | RT | 12 wks | DSM-5 criteria | YIAS | ADHD | Decrease of YIAS in both group whereas there were no significant differences between groups |
ATM | 42 | The change of YIAS positively correlated with that of impulsivity |
ADHD, attention-deficit/hyperactivity disorder; ATM, atomoxetine; BDI, Beck Depression Inventory; CGI-S, Clinical Global Impression-Severity; DLPFC, dorsolateral prefrontal cortex; DMN, default mode network; DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; IGD, internet gaming disorder; MDD, major depressive disorder; MPH, methylphenidate; RCT, randomized controlled trial; RSFC, resting state functional connectivity; RT, randomized trial; YIAS, Young Internet Addiction Scale
Study | Country | Intervention | N | Design | Duration (sessions) | Inclusion criteria for IGD | Efficacy variable | Main findings |
---|---|---|---|---|---|---|---|---|
Wölfling et al. [72] | Germany and Austria | Manualized | 72 | RCT | 15 wks (Group: 15, Individual: 8) | Computer game addiction according to AICA-S and AICA-C | AICA-S | Remission rate was higher in the STICA group compared with WLC group |
CBT (STICA) | Gaming time | Greater reductions of AICA-S and gaming time in the STICA group compared with WLC group | ||||||
WLC | 71 | |||||||
Li et al. [73] | United States of America | Group-based MORE | 15 | RCT | 8 wks (8) | ≥3 DSM-5 criteria | N of DSM-5 criteria | Higher reductions of number of DSM-5 criteria in the MORE group than support group |
Support group | 15 | |||||||
Li and Wang [74] | China | CBT | 14 | RCT | 6 wks (12) | YDQ >3 | YDQ | Decrease of OGCAS in both groups compared with the baseline, but no significant differences in the rate of reduction of OGCAS between the groups |
Basic counseling | 14 | Gaming time >30 hrs/wks | OGCAS | |||||
OGCAS >35 | ||||||||
Distress due to gaming | ||||||||
Kim et al. [75]* | Republic of Korea | CBT with BPR | 32 | RT | 8 wks (8) | YIAS >50 | YIAS | Greater reductions of YIAS and gaming time in the CBT with BPR group than BPR-only group |
BPR only | 33 | Gaming time >30 hrs/wks | Gaming time | |||||
Distress due to gaming based on DSM-4 criteria for substance abuse | No significant differences in the rate of severity of depressive symptoms between the groups | |||||||
Park et al. [76] | Republic of Korea | CBT | 12 | RT | 4 wks (8) | YIAS >50 | YIAS | Decrease of YIAS in both groups compared with baseline, but no significant differences in the change of YIAS between the groups |
VRT | 12 | Gaming time >30 hrs/wks | ||||||
Maladaptive behavior due to excessive gaming | CBT increased the RSFC from the PCC to the bilateral thalami and right cerebellum | |||||||
González-Bueso et al. [77] | Spain | CBT with psycho-education | 15 | Non-RCT | (CBT: 12, Psychoeducation: 6) | DSM-5 criteria | DQVMIA | Decrease of DQVMIA as a whole group, but no significant differences in the reduction of DQV MIA between groups |
CBT alone | 15 | |||||||
Torrez-Rodríguez et al. [78] | Spain | Specialized CBT | 17 | Non-RCT | 6 months (22) | DSM-5 criteria | IGD-20 Test | Decrease of IGD-20 Test and gaming time in both groups compared with baseline |
Standard CBT | 17 | IGD-20 Test >70 | Gaming time | Greater reductions of IGD-20 Test and gaming time in the specialized CBT than standard CBT | ||||
Zhang et al. [79] | China | CBI | 23 | Non-RCT | 6 wks (6) | CIAS >66 | CIAS | Greater reductions of CIAS and gaming time in the CBI group than the no intervention control group |
No intervention | 17 | Gaming time >14 hrs/wks | Gaming time | CBI increased insular activation and decreased insular connectivity with the lingual gyrus and precuneus | ||||
Yao et al. [80] | China | Combined reality therapy and MM | 18 | Pre/post | 6 wks (6) | DSM-5 criteria | CIAS | Decrease of CIAS compared with baseline |
Gaming time >14 hrs/wks | Depressive/anxiety symptoms also improved | |||||||
Han et al. [81]† | Republic of Korea | CBT | 101 | Pre/post | (14) | DSM-5 criteria | YIAS | Greater reductions of YIAS in the CBT group compared with supportive therapy group |
Supportive therapy | 104 | Greater improvements of anxiety, impulsivity, and social avoidance in the CBT group than supportive therapy | ||||||
Han et al. [82] | China | CBT | 20 | Pre/post | (12) | YDQ >4 | CIAS | Decrease of CIAS and gaming time compared with baseline |
Gaming time | CBT increased RSFC between the medial OFC and putamen | |||||||
Zhang et al. [83] | China | CBI | 20 | Non-RCT | 6 wks (6) | CIAS >66 | CIAS | Greater reductions of CIAS and gaming time in CBI group than no intervention control group |
No intervention | 16 | Gaming time >20 hrs/wks | Gaming time | CBI decreased RSFC of the OFC with HCP and PHG, and RSFC of the PCC with SMA, precentral gyrus and postcentral gyrus | ||||
Liu et al. [84] | China | CBI | 20 | Non-RCT | 6 wks (6) | CIAS >67 | CIAS | Greater reductions of CIAS and gaming time in CBI group than no intervention control group |
No intervention | 16 | Gaming time >14 hrs/wks | Gaming time | CBI increased RSFC within the DMN and decreased RSFC between the DMN and SN |
† medication use was allowed to treat comorbidities including MDD, ADHD and anxiety spectrum disorders.
ADHD, attention-deficit/hyperactivity disorder; AICA-C, Checklist for the Assessment of Internet and Computer game Addiction; AICA-S, Scale for the Assessment of Internet and Computer game Addiction; BPR, bupropion; CBI, craving behavioral intervention; CBT, cognitive behavioral therapy; CIAS, Chen Internet Addiction Scale; DMN, default mode network; DQVMIA, diagnostic questionnaires for video games, mobile phone, or internet addiction; DSM-4, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; HCP, hippocampus; IGD, internet gaming disorder; MDD, major depressive disorder; MM, mindfulness meditation; MORE, mindfulness-oriented recovery enhancement; OFC, orbitofrontal cortex; OGCAS, online game cognitive addiction scale; PCC, posterior cingulate cortex; PHG, parahippocampal gyrus; RCT, randomized controlled trial; RSFC, resting state functional connectivity; RT, randomized trial; SMA, supplementary motor area; SN, salience network; STICA, short-term treatment for internet and computer game addiction; VRT, virtual reality therapy; WLC, wait-list control; YDQ, Young Diagnostic Questionnaire; YIAS, Young Internet Addiction Scale
Study | Country | Intervention | N | Design | Duration (sessions) | Inclusion criteria for IGD | Efficacy variable | Main findings |
---|---|---|---|---|---|---|---|---|
Han et al. [85] | Republic of Korea | FT | 15 | Pre/post | 3 wks (5) | YIAS >50 | YIAS | Decrease of YIAS and gaming time compared with baseline |
Gaming time >30 hrs/wks | Gaming time | After treatment, increased family cohesion was associated with an increased activity of the CN in response to affection stimuli | ||||||
Distress due to gaming based on DSM-IV criteria for substance abuse | ||||||||
Sakuma et al. [86] | Japan | SDC | 10 | Pre/post | 9 days | DSM-5 criteria | Gaming time | At 3 months after the SDC, decrease of hrs/day and hrs/week of gaming but not days/week |
Pallesen et al. [87] | Norway | Eclectic treatment (CBT, FT, ST, MI) | 12 | Pre/post | (13) | GASA-S >2 and/or PVP parent version >3 | GASA | Decrease of parent-reported PVP but not self-reported GASA or PVP |
PVP | ||||||||
Kim et al. [88] | Republic of Korea | Game-based education | 27 | RCT | 8 wks (21) | Gaming time >4 hrs/day | Gaming time | Greater reductions of gaming time in the game-based education group than general education group |
General education | 32 | |||||||
Lee et al. [89] | Republic of Korea | tDCS | 15 | Pre/post | 4 wks (12) | 2 or more of DSM-5 IGD symptoms or | YIAS | Decrease of YIAS and gaming time compared with baseline tDCS improved interhemispheric balance of rCMglc in the DLPFC |
Gaming time >1 hr/day on average | Gaming time | |||||||
King et al. [90] | Australia | Brief voluntary abstinence | 9 | Pre/post | 84 hrs | DSM-5 criteria | IGD checklist | Significant improvement in IGD symptoms and gaming time occurred 75% and 38% of individuals with IGD |
Gaming time | ||||||||
Pornnoppadol et al. [91] | Thailand | RC | 24 | Non-RCT | 7 days | GAST parent version score meeting the cutoff for pro-blematic on-line gaming | GAST | Greater reductions of IGD severity in three active treatment group (RC, PMT, and RC+PMT) compared with controls (BP) at 1, 3, 6 months post-intervention |
PMT | 24 | 8 wks (8) | ||||||
RC+PMT | 26 | 7 days+8 wks (8) | ||||||
BP (control) | 30 | (1) |
BP, basic psychoeducation; CBT, cognitive behavioral therapy; CN, caudate nucleus; DLPFC, dorsolateral prefrontal cortex; DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; FT, family therapy; GASA, game addiction scale for adolescents; GASA-S, short version of the game addiction scale for adolescents; GAST, Game Addiction Screening Test; IGD, Internet gaming disorder; MI, motivational interviewing; PMT, parent management training; PVP, the problem video game playing scale; RC, residential camp; rCMglc, regional cerebral glucose metabolism; RCT, randomized controlled trial; SDC, self-discovery camp; ST, solution-focused therapy; tDCS, transcranial direct current stimulation; YIAS, Young Internet Addiction Scale