The Comorbidity Model of Internet Gaming Disorder: A Narrative Review
Song Tu, Feiting Xiong, Min Huang, Xiaoqing ZengObjective:
Internet Gaming Disorder (IGD) is a behavioral disorder that exhibits high comorbidity rates with multiple psychiatric conditions. Such co-occurring conditions often lead to clinical complexity and suboptimal treatment outcomes. To date, no overarching theoretical framework has been proposed to explain the patterns of comorbidity observed in IGD.
Methods:
This narrative review synthesizes existing literature on IGD comorbidity to construct an integrative theoretical model. The literature search used Pub- Med, Web of Science, and Google Scholar to retrieve peer-reviewed articles published in English. IGD-related terms were combined with keywords for risk factors, comorbidities, and interventions, respectively. Priority went to metaanalyses, systematic reviews, and longitudinal studies.
Results:
The main risk factors for IGD include cognitive, physiological, and personality traits. IGD shows the highest comorbidity rates with mood disturbance (depression and anxiety), Attention Deficit Hyperactivity Disorder (ADHD), and substance use disorder. There are three key mechanisms in comorbidity: (1) vulnerability conferred by personality variables leads to emotional dysregulation and social withdrawal, increasing the rate of comorbidity of IGD, mood disturbance, and ADHD; (2) the malfunction of reward pathways forms the basis of the comorbidity between IGD, mood disturbance, and SUD; (3) inhibition impairments connect ADHD to IGD and SUD. The therapeutic methods may include cognitive-behavioral therapy, cognitive training, and pharmacological interventions, although their effectiveness varies across comorbid profiles.
Discussion:
IGD comorbidity is not a collection of isolated associations but arises from shared transdiagnostic vulnerabilities spanning personality, reward, and inhibitory control systems. The model highlights that treatments may be more effective when matched to the dominant mechanism underlying a given comorbid profile rather than applied uniformly.
Conclusion:
This study defines a conceptual framework of IGD comorbidity, highlighting relationships among the personality, reward, and regulatory systems. The key focus of future studies should be on a more comprehensive approach to assessing comorbidity, including familial and environmental factors, to enhance the accuracy and efficacy of clinical interventions.