The World Health Organization (WHO)’s decision of recognizing gaming disorders in its 11th edition of the International Classification of Diseases (ICD-11) has received mixed reaction from experts and the public in China. While some suggest that China should follow the same path, others expressed their discontent, calling the classification “groundless and absurd.”

The ICD-11, which the global game industry was awaiting since the WHO detailed its intention to include gaming disorders last summer, defines a gaming disorder as a pattern of gaming behavior characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

According to WHO, the decision on inclusion of gaming disorder in ICD-11 is based on reviews of available evidence and reflects a consensus of experts from different disciplines and geographical regions that were involved in the process of technical consultations undertaken by WHO in the process of ICD-11 development.

The decision quickly sparked controversy in China. The hashtag “GamingDisorderIsNowAMentalDisease” on Sina Weibo garnered over 150 million page views in three days.

“Needless to say, the new classification has created panic among the public, showing biased opinions against computer games. Many scientists have already expressed their opposition against the decision,” VGgame, China’s top gaming website, noted on its social media platforms.

Showing a different opinion, Tian Chenghua, Chief Physician at the Institute of Mental Health of Peking University Sixth Hospital, told China National Radio that the new classification can provide solid scientific support for hospitals to accept patients with gaming addiction issues.

“Without such a classification, compulsory admission of patients [with gaming addiction issues] would lead to legal disputes. By approving the classification, hospitals would face less challenges when accepting those patients,” added Tian.

Grey Area

Gaming addiction has been a heated topic in China. According to a report released by Chinese Society for Juvenile Delinquency Prevention Research in 2014, over 66.3 percent of teenagers in China had played games online, while based on its report in 2018, over 85 percent of juvenile criminals are “addicted to” internet.

Teenager’s over-exposure to online games has led to negative consequences. In 2017, a 13-year-old boy from Hangzhou, Zhejiang Province committed suicide because his parents would not allow him to play computer games, while a year later, a 15-year-old boy from Cili, Hunan Province killed his 23-year-old neighbor because he liked the “feeling of killing people” and wanted to try it in real life.

Fearing their children may suffer such additions, many Chinese parents have resorted to extreme and unscientific therapies for their kids. Yang Yongxin, a controversial Chinese psychiatrist who advocated and practiced electroconvulsive therapy as a cure for alleged internet addiction in teenagers, has been criticized by many medical professionals of “misleading the public and causing trauma for kids.” Before his practice was banned by China’s Ministry of Health (MOH) in 2009 [MOH was dissolved and its functions integrated into the new agency called National Health Commission in 2013], thousands of children had undergone the electroshock treatment.

“The research on gaming addiction in China is still scarce, and so far, we don’t have a standard to diagnose or cure such problems. Normally, we would accept patients with game addictions only if they have exhibited other mental issues, such as dysthymic disorder,” said Tian, who believed that a WHO approved classification would provide scientific basis for hospitals to cure those with gaming additions.

But others hold different opinions. According to a poll conducted by Caijing.com, a news portal in China, out of 25,000 participants, around 50 percent believe that calling a game addiction a “disorder” is an exaggeration, with many saying that the classification will bolster negative perceptions towards the online game industry, damaging the nation’s cultural industry.

“It’s worrisome that the WHO is pushing to label game addiction as a formal mental disorder while many medical professionals believe there is a lack of objective evidence to define and diagnose gaming addiction,” noted VGgame in its announcement.

“Though WHO has already issued the classification, it is China’s decision whether or not to accept it. From my opinion, it would take a long time before Chinese authorities officially recognize game addictions as a disorder,” said Tian.