Table 1.
Studies included in the final review.
| First author, year | Country | Treatments | N | Treatment duration (sessions) | Age M(SD) or range | Study Design | Assessment of IGD Inclusion Criteria; Type of Measure | Primary Outcome Variable(s) | Significant Results (follow-up timeframe) |
|---|---|---|---|---|---|---|---|---|---|
| Medication | |||||||||
| Bae, 201821 | South Korea | Bupropion | 15 | 12wks | 25.3±5.2 | Pre-post*~ | DSM-5 criteria; measure based on SCID-I; diagnostic interview | IGD symptoms (YIAS) | Decrease in YIAS (post-treatment) |
| Han, 201020 | South Korea | Bupropion | 11 | 6wks | 21.5±5.6 | Pre-post* | YIAS>50 + gaming >30 hr/wk + distress or impairment ; self-report | Weekly gaming (hrs); IGD symptoms (YIAS) | Decrease in gaming time and YIAS (post-treatment) |
| Han, 200914 | South Korea | Methylphenidate |
62 |
8wks |
9.3±2.2 |
Pre-post** | Video game playing was the only criteria; self-report | Weekly gaming (hrs); IGD symptoms (YIAS) | Decrease in gaming time and YIAS (post-treatment) |
| Nam, 201715 | South Korea | Bupropion Escitalopram |
15 15 |
12wks 12wks |
22.9±1.9 23.9±1.6 |
RT, no control group** | YIAS>50 + gaming > 4hrs/day or 30hrs/wk + distress or impairment; self-report | IGD symptoms (YIAS) | Decreased YIAS in both groups; no significant differences between groups (post-treatment) |
| Park, 2016a16 | South Korea | Atomoxetine Methylphenidate |
42 44 |
12wks 12wks |
17.1±1.0 16.9±1.6 |
RT, no control group** | DSM-5 criteria; specific measure not specified | IGD symptoms (YIAS) | Decreased YIAS in both groups but a test statistic for pre-post changes was not presented; no significant differences between groups (post-treatment) |
| Han, 2012b22 | South Korea | Bupropion+education Placebo+education |
25 25 |
8wks 8wks |
21.2±8.0 19.1±6.2 |
RCT*** | YIAS>50 + gaming >30 hrs/wk + distress or impairment; self-report | Weekly gaming (hrs); IGD symptoms (YIAS) | Greater reductions in gaming time and YIAS in the bupropion compared to placebo group (post-treatment) Reductions and group differences maintained at follow-up (4 wks post-treatment) |
| Song, 201623 | South Korea | Bupropion Escitalopram No Treatment Control |
44 42 33 |
6wks 6wks 6wks |
20.0±3.6 19.8±4.2 19.6±4.0 |
RCT† | DSM-5 criteria, no specific measure identified; diagnosed by a psychiatrist | IGD symptoms (YIAS) | Decreased YIAS for active groups, but not control. Greater decrease for bupropion than escitalopram (post-treatment) |
| CBT-based Psychotherapy | |||||||||
| Yao, 201725 | China | Group Reality & Mindfulness Therapy | 25 | 6wks (6) | 22.2±1.6 | Pre-post* | At least 5 DSM-5 criteria + ≥14 hr/wk of gaming + gaming was primary Internet activity; diagnostic interview | IGD symptoms (CIAS) | Decrease in CIAS (post-treatment) |
| González-Bueso, 201818 | Spain | Individual CBT Individual CBT + Parent Psychoed |
15 15 |
(12) (12 ind + 6 parent) |
15.5(2.3) 16.1(2.2) |
Non-RCT* | DQVMIA and SCID-I adapted to assess IGD; self-report and diagnostic interview | IGD symptoms (DQVMIA) | Decreased DQVMIA in both groups; no significant differences between groups (post-treatment) |
| Torres-Rodríguez, 201819 | Spain | Specialized CBT Standard CBT |
17 17 |
6mnth (22) 6mnth (22) |
15.1(1.9) 14.7(1.6) |
Non-RCT | 5 or more DSM-5 symptoms and IGD-20 score≥71; self-report and diagnostic interview | Weekly gaming (hrs); IGD symptoms (IGD-20) | Fewer hours of gaming and IGD symptoms in treatment vs control group (post-treatment). Differences were sustained but no between group comparison was presented (3 month follow-up) |
| Zhang, 2016b17†† | China | Craving behavioral intervention group No intervention control |
23 17 |
6wks(6) N/A |
21.9±1.8 22.0±1.9 |
Non-RCT | CIAS ≥67 + gaming >14hr/wk for ≥1yr; plays 1 of 4 most popular game^; self-report | Weekly gaming (hrs); IGD symptoms (CIAS) | Lower CIAS and less gaming in intervention group than controls (post-treatment) |
| Li et al., 201326 | China | CBT group therapy Basic counseling |
14 14 |
6wks(12) 6wks(12) |
12-19 yrs |
RCT | Gaming >30hr/wk + OGCAS >35 + IAS >3 + distress or maladaptive behavior; self-report and diagnosed by a psychiatrist | IGD symptoms (YIAS) | YIAS decreased in both groups but no group differences (post-treatment) |
| Li, 201724††† | USA | Mindfulness-oriented group therapy Support group |
15 15 |
8 wks(8) 8 wks(8) |
22.2(3.8) 27.8(5.5) |
RCT | At least subthreshold IGD (≥3 DSM-5 symptoms [yes/no questions]); self-report | Checklist based on DSM-5 IGD criteria (yes/no questions) | Greater reduction in IGD symptoms in treatment vs support group (3 month post-treatment) |
| Kim, 201227 | South Korea | CBT+ Bupropion Bupropion only |
32 33 |
8wks(8) 8wks |
16.2±1.4 15.9±1.6 |
RCT*** | YIAS>50 + gaming >30hr/wk + maladaptive treatment or distress; self-report |
Weekly gaming time; IGD symptoms (YIAS) | Greater reductions in gaming time and YIAS for CBT+med than med only group (post-treatment) Group differences maintained at follow-up (4 wks post-treatment) |
| Park, 2016b28 | South Korea | CBT group therapy Virtual Reality group therapy |
12 12 |
4wks(8) 4wks(8) |
24.2±3.2 23.6±2.7 |
RCT* | Gaming >30hr/wk + disruption of life + distress or maladaptive treatment + YIAS>50; self-report | IGD symptoms (YIAS) | Both groups had reductions in YIAS but no between group differences (post-treatment) |
| Other Interventions | |||||||||
| Han, 2012a29 | South Korea | Family therapy | 15 | 3 wks(5) | 14.2±1.5 | Pre-post* | Gaming >4hrs/day and >30hrs/wk + YIAS>50 + impaired treatment or distress; self-report |
Weekly gaming (hrs); IGD symptoms (YIAS) | Decrease in gaming time and YIAS score (post-treatment) |
| King, 201730 | Australia | Brief voluntary abstinence | 24 | 84 hours | 24.6(5.1) | Pre-post | Current MMO player; only n=9 met criteria for IGD; self-report | IGD symptoms (IGD checklist); Weekly gaming (hrs) | Decrease between baseline and 28 day follow-up in IGD checklist for the entire sample (the 9 participants who met IGD criteria had greater declines in symptoms than non-IGD participants). No decrease in gaming time for the entire group (28 day follow-up) but meeting IGD criteria predicted greater decreases in gaming time. |
| Lee, 201831 | South Korea | Transcranial direct current stimulation | 15 | 4 wks(12) | 21.3±1.4 | Pre-post* | Two or more IGD symptoms or plays games an average of 1 hr/day or more; self-report | IGD symptoms (YIAS); Weekly gaming (hrs) | Decrease in YIAS and weekly gaming (post-treatment) |
| Palleson, 201532 | Norway | Eclectic psychotherapy (CBT, family, motivational interviewing, solution-focused) | 12 | (13) | 15.7(1.3) | Pre-post | GASA ≥3 on all items and/or PVP score of 4 or 5 on all items; self-(GASA) and parent- (PVP) report | IGD symptoms (self-reported GASA and PVP, parent-reported PVP) | Decrease in parent-reported PVP but not self-reported GASA or PVP (post-treatment) |
| Sakuma, 201733 | Japan | Self-Discovery Camp | 10 | 9 days | 16.2±2.2 | Pre-post | Satisfied Griffith’s 6 components of addiction^^ + met DSM-V IGD criteria; diagnostic interview | Daily gaming (hours) and weekly gaming (hours and days) | Decrease in hours/day and hours/week of gaming but not days/week (3 months post-treatment) |
| Pornnoppoadol, 201834 | Thailand | Residential Camp (RC) Parent management (PM) RC + PM Psychoed |
24 24 26 30 |
7 days (8) 7 days + 8 PM sessions 1 hour |
14.6(1.4) 14.5(1.1) 14.0(1.4) 14.3(1.2) |
Non-RCT |
GAST-Parent version meeting the cut-off score; parent report | IGD symptoms (GAST-parent report) | Decrease in GAST in all four groups. All three active treatment groups superior to control at post-treatment and 6-month post-treatment. |
| Kim, 201335 | South Korea | MMORPG speaking and writing course General education |
27 32 |
8wks(21) 8wks(21) |
17.4±0.6 17.5±0.6 |
RCT | Playing DF ≥4hr/day; self-report | Average daily gaming in the past month (minutes) | Both groups showed reductions in gaming but no difference between groups (post-treatment) |
Note. CBT = Cognitive Behavioral Therapy; CIAS = Chen Internet Addiction Scale; DF = Dungeon & Fighter; DQVMIA = Diagnostic Questionnaire for Video Games, Mobile Phone or Internet Addiction; GASA = Gaming Addiction Scale for Adolescents; GAST = Gaming Addiction Screening Test; IAS = Internet Addiction Scale; MMORPG = Massive Multiplayer Online Role-Playing Games; OGCAS = Online Game Cognitive Addiction Scale; PM = Parent Management; PVP = Problem Video Game Playing Scale; RCT = randomized control trial; RT = randomized trial; SCID-I = Structured Clinical Interview for DSM-IV; YIAS = Young Internet Addiction Scale.
*
a sample of healthy controls was recruited by not included in primary analyses of interest;
**
all participants had a diagnosis of attention deficit hyperactivity disorder;
***
all participants had a diagnosis of major depressive disorder;
~
a sample of patients with Internet-based gambling disorder was recruited but not reviewed here;
†
participants were randomly assigned to the two medication groups but the control group were participants who declined medication treatment (not randomly assigned).
††
similar results were presented in three other publications by the same authors42, 43, 44; the paper that presented on the largest sample size was chosen for inclusion.
†††
similar results were presented in a more recent publication not included here45.
^
participants reported playing one of the following games as their primary online activity: 1) Cross Fire; 2) Defense of the Ancient version 1; 3) Defense of the Ancient version 2; or 4) World of Warcraft.
^^
Griffith’s six components of addiction are salience, mood modification, tolerance, withdrawal, conflict, and relapse46.