During the last few decades, a growing field of literature is focusing on hikikomori, a phenomenon described as a form of pathological social withdrawal or social isolation that lasts for more than 6 months leading to significant functional impairment and/or distress. Despite initially considered a culture-bound syndrome, hikikomori syndrome later gained a wider recognition in different countries, ranging from an attempt to take refuge in an idealistic world, when society success\' standards are not reached, to a maladaptive coping strategy complicating several psychiatric illnesses such as anxiety disorders, major depression, internet addiction, internet gaming disorder (IGD) and autism spectrum disorder (ASD). In this framework, difficulties in social interaction, in problem solving strategies and socio-emotional reciprocity, may lead to social withdrawal and hikikomori-like behaviors. In this work, we described two cases of patients where the presence of underlying autism spectrum may have represented a sign of vulnerability towards the development of a possible full-blown case of hikikomori with IGD.

BACKGROUND: Over the last ten years, the video game industry has grown exponentially, involving about 2.5 billion young adults in the world. The estimated global prevalence of gaming addiction has been reported to be 3.5% ranging from 0.21% to 57.5% in the general population. Moreover, during the recent COVID-19 pandemic period, school closures and stay-at-home measures have also further increased the opportunities for prolonged and intensified playing of video games. Little is known about the relationship between IGD and psychosis, and the literature is still scarce. Some characteristics of patients with psychosis, particularly those with a first-episode psychosis (FEP), may suggest that these individuals would be particularly liable to develop IGD.
METHODS: We report two cases of young patients with to Internet gaming disorder, experiencing early onset psychosis treated with antipsychotic therapy.
CONCLUSIONS: Although it is difficult to show the specific mechanisms underlying the psychopathological alterations in IGD, it is clear that excessive exposure to video games could be a risk factor for precipitating psychosis especially in a vulnerable age group such as adolescence. Clinicians should be aware of the possibility of a higher risk of psychotic onset associated specifically with gaming disorders in very young people.

The disorder of internet gaming is increasingly being blamed on major psychological problems affecting youth. Action video games are enjoyable for masochists. Video game chores that practise bondage and other acts that cause pain and anoxia may be masochistic in nature in order to promote player satisfaction. Asphyxia will result in pleasure in asphyxiophilia, a dangerous and occasionally lethal form of sexual masochism. Constriction of the neck with ligature materials is a frequent method of causing hypoxia. The subject of this case study was a compulsive player of online video games. During the masochistic act, along with a recording of it, he unintentionally died. Given that he was naked, had a ligature around his neck, had his wrists and legs bound, and had two fabric-holding clamps on his scrotum, asphyxiophilia was determined to be the cause of his death. At the scene of death, neither pornographic materials nor proof of frequent use of this kind of behaviour were discovered. Along with recording, the subject\'s cell phone\'s flash was on to help with the dim lighting and he may have been videotaping these masochistic acts as part of a videogame task. The results of the autopsy, circumstantial evidence, police inquiry and witness accounts all support accidental death.

The internet has become an indispensable tool in people´s daily lives during the COVID-19 pandemic. Internet and video game use are experiencing rapid growth in the youth and adult populations as a major source of entertainment. However, excessive gaming may cause addiction and negatively impact mental health, entailing low psychosocial well-being, poor social skills, and decreased academic achievement. We report the case of a 16-year-old student with a \"typical\" pattern of internet gaming disorder (IGD) developed during the pandemic, which improved after weeks of treatment with pharmacotherapy and psychosocial interventions. This case highlights that it is essential for the mental health professionals to know the psychopathology of IGD and multimodal approaches to treat it.

Background: Online or internet gaming disorder (IGD) is currently not recognized as a mental disorder in the actual Diagnostic and Statistical Manual of Mental Disorders (DSM-5), although it is an emerging disease. Non-substance-related addictions often have similarities with substance addictions. It is therefore important to have a good understanding of the client but also to have a good endurance. Due to the rise of e-sports, there is an anticipated and therefore possible trend to have many more patients with a non-substance addiction. There are many parallels, for instance tolerance, withdrawal and social problems, resulting from an increasing investment of time spent on the internet. Case presentation: To reduce possible inhibition in treating a patient with IGD, we present a case of a 19-year-old adolescent man who exhibited IGD and showed social problems associated with his addiction. Conclusions: This paper shows the importance and the effects of treating a non-substance addiction with cognitive behavioral therapy (CBT). After having successfully coped with an addiction, several shifts in addiction were often reported. In this case, no shifts were reported. The absence of such shifts makes our case a distinct and unique case. This is not a multimorbidity case, and that is the reason why we think this is an excellent example to show what we achieved, how we achieved it, and what we could establish. Of course, additional research and manuals are urgently needed.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included in 2013 Internet gaming disorder (IGD) as a condition for further study, and in 2018, the World Health Organization included gaming disorder (GD) as a mental disorder in the International Classification of Disease (ICD-11). We aim to compare disorders of gaming in both diagnostic systems using a sample of young adults in Mexico.
Self-administered survey to estimate the prevalence of DSM-5 IGD and ICD-11 GD in 5 Mexican universities; 7,022 first-year students who participated in the University Project for Healthy Students, part of the World Health Organization World Mental Health International College Student Initiative. Cross-tabulation, logistic regression, and item response theory were used to inform on 12- month prevalence of DSM-5 IGD and ICD-11 GD, without and with impairment.
The 12-month prevalence of DSM-5 IGD was 5.2% (95% CI, 4.7 to 5.8), almost twice as high as the prevalence using the ICD-11 GD criteria (2.7%; 95% CI, 2.4 to 3.1), and while adding an impairment requirement diminishes both estimates, prevalence remains larger in DSM-5. We found that DSM-5 cases detected and undetected by ICD-11 criteria were similar in demographics, comorbid mental disorders, service use, and impairment variables with the exception that cases detected by ICD-11 had a larger number of symptoms and were more likely to have probable drug dependence than undetected DSM-5 cases.
DSM-5 cases detected by ICD-11 are mostly similar to cases undetected by ICD-11. By using ICD-11 instead of DSM-5, we may be leaving (similarly) affected people underserved. It is unlikely that purely epidemiological studies can solve this discrepancy and clinical validity studies maybe needed.

Internet gaming disorder (IGD) has been a controversial entity with various opinions about its clinical relevance as an independent mental disorder. This debate has also included discussions about the relationships between problematic gaming, various psychiatric disorders, and personality traits and dimensions. This paper outlines a developmental-theory based model of Internet gaming misuse inspired by the treatment of two adolescent inpatients. The two clinical vignettes illustrate distinct developmental pathways: an \"internalized pathway\" via the development of social anxiety, emotional and behavioral avoidance; and an \"externalized pathway\" with a low level of emotional regulation strategies and impulsivity. In both clinical cases, attachment issues played a key role to understand the specific associations of risk and maintaining factors for IGD, and gaming behaviors may be seen as specific forms of maladaptive self-regulatory strategies for these two youths. These clinical observations support the assumption that gaming use problematic in adolescents should be viewed with a developmental approach, including key aspects of emotional development that represent significant targets for therapeutic interventions.

暂无摘要。

Internet gaming disorder (IGD) is not currently a recognized diagnosis in the Diagnostic and Statistical Manual for Mental Disorders-5 (DSM-5). However, IGD has been noted to warrant further research for possible future inclusion in the DSM. In many ways, IGD strongly resembles substance and gambling addictions. Such characteristics include tolerance, withdrawal, and social and occupational neglect resulting from increased time invested in video game use and acquisition. The use of similar or closely related media is also seen, which mirrors the natural course of substance and gambling addictions. We present a case of a 22-year-old man who exhibited IGD and problems associated with pornography use. This case report exemplifies the sequelae of IGD. Our paper also reviews the possible mechanisms of behavioral addiction, as well as the status of IGD as a potential subcategory of behavioral addiction. Additional research is needed to determine if IGD co-occurs with problematic use of pornography.