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Friday, March 28, 2008

Should Internet Addiction be in DSM?

In the American Journal of Psychiatry for March, an editorial offers the opinion that Internet addiction is a 'compulsive-impulsive' disorder, and should be added to the official DSM guidebook of disorders. The editorial characterizes net addiction as including 'excessive gaming, online sexual pre-occupations and e-mail/text messaging'. From the article: 'Like other addicts, users experience cravings, urges, withdrawal and tolerance, requiring more and better equipment and software, or more and more hours online, according to Dr. Jerald Block, a psychiatrist at the Oregon Health and Science University in Portland. Dr. Block says people can lose all track of time or neglect "basic drives," like eating or sleeping. Relapse rates are high, he writes, and some people may need psychoactive medications or hospitalization."

Going back to 1994, when I started to study Internet addiction, many did question its validity. Today, documented cases in Italy, Germany, China, Taiwan, and Korea as well as the US, support that Internet addiction is a serious condition.

Last summer, doctors from the Internet Addiction Recovery Center in Beijing had visited with me to personally discuss my work on Internet addiction. They had repeatedly asked me why in America we didn't have more treatment centers for Internet addiction. In China, the government had funded their clinic and were considering opening several more. They were surprised that Internet addiction was being debated as a disorder. To a large extent, in the US, accurate estimates of the prevalence of the disorder are lacking. Unlike in Asia, where Internet caf├ęs are frequently used, in the US, computers are mainly accessed from home. Further, attempts to measure the phenomenon are clouded by shame, denial, and minimization.

Internet addicts often suffer from other psychological problems such as depression or anxiety, masking signs of Internet problems, especially if therapists do not routinely screen for it.

As the psychiatry field gains a deeper understanding, Internet addiction may very well appear in the next DSM. The movement towards its inclusion grows as more professionals are urging a closer examination of the problem. As an opinion question, do you think Internet addiction be included in the next DSM?