Relapse prevention therapy for internet gaming disorder in Swedish child and adolescent psychiatric clinics: a randomized controlled trial

OBJECTIVES: To evaluate the effectiveness of relapse prevention (RP) as a treatment for internet gaming disorder (IGD). DESIGN: Randomized controlled trial. SETTING: Three child and adolescent psychiatry (CAP) units in Region Skåne, Sweden. PARTICIPANTS: Children aged 13–18 years, coming for their first visit to CAP during 2022, were screened for gaming behavior. Those who met the proposed DSM-5 criteria for IGD were offered participation in the trial, if they had the capacity to provide written informed consent and if they spoke Swedish. A total of 111 CAP patients agreed to participate. Out of those, 11 patients were excluded due to incorrect inclusion such as young age (n = 1), or due to the absence of responses to follow-up measures (n = 9). After exclusion, 102 participants remained (intervention = 47, control = 55). INTERVENTIONS: The intervention, RP, is based on cognitive behavioral treatment (CBT) and was provided individually, comprising of five to seven 45-min sessions over a period of 5 to 7 weeks versus treatment as usual. OUTCOME MEASURES: Participants were assessed with Game Addiction Scale for Adolescents pre-treatment (GASA) (baseline), post-treatment (treatment group only), and 3 months after baseline (follow-up). RESULTS: The repeated measures ANOVA showed a significant interaction effect between treatment and time. Both the control group and treatment group lowered their mean GASA score from baseline to follow-up significantly, but the improvement was greater in the treatment group (mean difference in control group −5.1, p < 0.001, 95% CI = − 3.390 to −6.755, mean difference in treatment group −9.9, p < 0.001, 95% CI = −11.746 to −8.105). CONCLUSION: RP was found to be superior to treatment as usual in terms of reduction of IGD symptoms. Future research should address which aspects within a given treatment are effective, who benefits from treatment, in what aspects, and why. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT05506384 https://clinicaltrials.gov/ct2/show/NCT05506384.