A Case of Internet Gaming Disorder: When #Play Apart Together Takes a Dark Turn

BACKGROUND: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) places internet Gaming disorder (IGD) in its research appendix as a potential new behavioral addiction diagnosis that requires further investigation. As part of the media campaign #HealthyAtHome, recommendation to relieve stress and anxiety during COVID-19, the World Health Organization (WHO) advocated for the playing of video games. The encouragement and expansion of playing video games may have led to the unintentional consequence of increasing the prevalence of IGD as IGD has been postulated to be a maladaptive response to stress. CASE: A 34 year old male presented to his primary care physician with decline in work function, increased depression, and anxiety. Before the COVID-19 pandemic he estimated that he spent 2 h a day playing games and socialized with friends weekly; however at the time of presentation, his social interactions were through online gaming only and he was playing games 14 h per day. The patient began paroxetine and bupropion, with good result, though declined concomitant psychotherapy. DISCUSSION: Internet Gaming Disorder is a potential new behavioral addiction that is likely to increase in prevalence over the continuing course of the COVID-19 pandemic. While initial studies show promising effects of medication and psychosocial interventions, further study on standardized diagnostic criteria and effectiveness of treatment modalities is needed.