Video game addiction among Tunisian adolescents in Sousse: A cross-sectional study in high schools

BACKGROUND: Addiction to video games is a theme regularly mentioned and associated with the risks that concern adolescents. This study aimed to determine the prevalence of video game addiction (VGA) among adolescents and identify its associated factors. METHODS: We conducted a cross-sectional study within public high schools, in Sousse, Tunisia in 2019. The target population was high school students. A structured self-administered questionnaire was used to collect data about sociodemographic characteristics, lifestyle behaviors, and mental health disorders, and we used the 21-item Game Addiction Scale to objectify video game addiction. Statistical analysis was carried out using the program SPSS v.20. RESULTS: A total of 1342 participants were recruited for the study,36.8% of whom were boys. The average age was 17.5 ±1.44 years. The analysis of mental health disorders showed that 67% were anxious, 66.8% were alexithymic, 65.4% were depressed and 39% had low self-esteem. The analysis of lifestyle behaviors showed that a lack of physical activity was reported by 57.6% of participants. Problematic use of the Internet (>2 hours per day) was reported among 72.4% of the students. The prevalence of video game addiction was 13%. Boys were more prone to be addicted than girls (66.2% versus 33.8%, p < 0.001). ≥17 years old students had a higher rate of VGA than those aged<17 years old (57.3% vs 42.7%, p = 0.031). VGA was higher among students who follow the non-scientific study section (69.4%, p = 0.007). Students who had moderate depression had the highest percentages of VGA (35.7%, p = 0.005). Students who had problematic use of the internet were more addicted to video games (80.3%) than those not having problematic use (19.7%), p = 0.009. CONCLUSIONS: This study allowed us to identify the students who are vulnerable to VGA. Also, a huge responsibility is accorded to school staff and parents to tackle this health problem by sensitizing their children and setting up some protective family rules. KEY MESSAGES: • Several factors were significantly associated with video game addiction, especially problematic internet use. • Further research is needed to understand the underlying mechanisms of video game addiction and to explore effective preventive or interventional strategies.