Current Clinical Practices for Gaming Disorder and Related Issues in Primary Care Settings in Northern Japan: A Regional Survey in Sapporo.

backgroundGaming is a popular leisure activity among children and adolescents in Japan. Recently, gaming disorder (GD) has become a common issue in child and adolescent psychiatry. However, due to a severe shortage of child and adolescent psychiatrists (CAPs) in Japan, we hypothesized that young patients with GD and gaming-related problems may seek help at pediatric or general psychiatric clinics, which serve as primary care providers for children's mental health issues. In this study, we conducted a regional survey in Sapporo, Japan, to understand the current status of medical interventions for GD provided by pediatricians and psychiatrists.

methodsThis was a cross-sectional survey conducted in a specific region of Japan. The subjects of this study were almost all pediatricians, psychiatrists, and CAPs practicing in Sapporo, Japan. A questionnaire was mailed to a total of 196 medical institutions. The survey included questions about clinical practices related to GD, such as experience in treating GD, common presenting symptoms in patients with GD, and psychiatric comorbidities associated with GD. Results were statistically compared between two groups: pediatricians and psychiatrists.

resultsWe received 60 responses, yielding a response rate of 30.6%. All collected response forms were considered valid, and only one response to the question about the percentage of patients with gaming-related problems was considered invalid because it was an outlier (answer of 80%). The rate of respondents who had encountered gaming-related problems was 53.8% (n=14) among pediatricians (n=26), 52.2% (n=12) among psychiatrists (n=23), and, as a reference, 81.8% (n=9) among CAPs (n=11). When asked about the proportion of patients with gaming-related problems among all the patients they had seen, pediatricians reported 0.6%, psychiatrists reported 2.9%, and CAPs reported 8.7%. Autism spectrum disorder (ASD) was the most commonly reported comorbid diagnosis associated with GD, followed closely by attention deficit hyperactivity disorder (ADHD). Depression and anxiety were the third most commonly reported comorbid conditions. DISCUSSION: While many CAPs (81.8%) are already addressing gaming-related issues, only about half of pediatricians (53.8%) and psychiatrists (52.2%) are involved in such treatment. With the increasing number of children and adolescents engaging in online gaming, playtime has gradually increased, potentially leading to an increase in GD cases. The difference was that pediatricians were often consulted about somatic symptoms, while psychiatrists were typically required to manage behavioral issues, such as excessive spending on gaming, and psychiatric symptoms, such as anxiety. As the number of children and adolescents seeking medical care for gaming-related problems is expected to increase, it is anticipated that clinical guidelines will be developed to enable both pediatricians and psychiatrists to effectively manage these cases.