As debate has raged for years over whether excessive gaming should be classified as a disease, a new academic paper proposes establishing clear scientific criteria to determine if it is indeed a medical condition before taking a side in the 'for or against' debate.
Jang-joo Lee, Director of the Lee Rak Digital Culture Institute, published a paper titled "How Should the Medicalization of Gaming Disorder Be Decided: A Decision Tree Approach Based on Falsifiability" in Vol. 45, No. 4 of the Korean Journal of Psychology: General, published by the Korean Psychological Association.
The paper points out that judgment on this issue remains divided globally. The American Psychiatric Association (APA) still designates Internet Gaming Disorder as a condition requiring further study rather than recognizing it as an official disorder. In contrast, the World Health Organization (WHO) has listed "Gaming Disorder" as a formal disease in its International Classification of Diseases (ICD). Thus, two authoritative institutions have reached conflicting conclusions regarding the same phenomenon. South Korea has not yet decided whether to adopt the classification.
Director Lee noted that the debate thus far has largely been framed around a binary "adopt or not" stance. Without pre-established criteria defining which research outcomes justify maintaining a disease classification and which recurring findings would require altering or withdrawing it, different conclusions can be drawn from the exact same data. The paper states in its introduction that it takes a critical stance toward medicalizing gaming disorder at its current stage.
The paper outlines six key questions to examine whether gaming disorder can be viewed as an independent disease: First, is there a distinct "gaming-specific problem" that cannot be explained by other conditions such as depression, anxiety, or ADHD? Second, do different diagnostic tools consistently yield the same diagnosis for the same individual? Third, does gaming cause life disruption, or do individuals immerse themselves in gaming due to pre-existing stress or family issues? Fourth, is the issue a continuous or recurring problem over time, rather than a temporary state of immersion? Fifth, does giving it a separate medical name actually provide greater practical benefit than existing counseling and treatment? Sixth, do the benefits of creating a medical diagnosis outweigh potential side effects such as stigmatization?
The paper constructs a decision flowchart to evaluate these questions sequentially. If the first question is not satisfied, gaming is treated as a risk factor for other issues rather than an independent disease. If it fails at later stages, the conclusion shifts accordingly—such as using the classification only provisionally, altering treatment approaches, or narrowing its scope. Cases where judgment is difficult due to insufficient research are designated as "decision pending" rather than a "fail."
The paper also incorporates the principle of taking a conservative approach when judgments are ambiguous. Classifying something that is not a disease as one can stigmatize ordinary gaming behavior as pathological, and once established, a classification is difficult to reverse. Conversely, even if a formal classification is postponed, individuals facing difficulties can still be helped through existing counseling and therapy that address issues like depression or family conflicts. However, the paper also introduces experimental findings showing that framing gaming issues as an addiction did not significantly increase public prejudice, noting that the stigma effect requires separate empirical verification. It cites the historical precedent of homosexuality being classified as a mental illness and later removed to illustrate the harm caused by improper medicalization, though it draws a line by clarifying that gaming disorder should not be viewed as an identical issue.
Ultimately, based on reviewing existing studies against the six questions, the paper concludes that neither sufficient evidence to classify gaming disorder as an independent disease nor tangible benefits from doing so have been adequately established yet. However, it emphasizes that this is not a final conclusion; if research satisfying the criteria accumulates in the future, the same decision flowchart could support medical classification. It also makes clear that support for individuals genuinely struggling due to gaming should be provided regardless of whether it is officially classified as a disease.
Director Lee believes these criteria can serve as a benchmark when discussing future revisions to South Korea's national disease classification. He also emphasized that as new behaviors like AI overdependence and excessive short-form video consumption continue to be proposed as potential clinical disorders, a more rigorous, evidence-based approach becomes increasingly essential during periods of high social anxiety.
