Estimated prevalence of gaming disorder based on ICD-11 and DSM-5 frameworks in a large and representative sample of young Swiss men

Background: The International Classification of Diseases, 11th revision (ICD-11), and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), provide distinct frameworks to assess gaming disorder (GD). We aimed to compare GD prevalence estimates using both frameworks in a representative sample of Swiss males. A secondary objective was to examine the associations between GD, and depressive and anxiety symptoms, across both frameworks. Methods: This was a cross-sectional single-center study at a Swiss military recruitment center. Participants completed a survey assessing DSM-5 and ICD-11 GD criteria. GD was defined as meeting at least five DSM-5 or all three ICD-11 criteria. Depressive and anxiety symptoms were assessed with the two-item Patient Health Questionnaire and the two-item General Anxiety Disorder scale. Weekly gaming time was self-reported. Multivariable logistic regressions explored associations between GD and psychological correlates. Results: Among the 2,620 participants aged 19.6 ± 1.8 years old, the estimated GD prevalence was 3.83% (95% confidence interval [CI]: 3.13; 4.69) with DSM-5 criteria and 2.48% (95% CI: 1.92; 3.18) with ICD-11 criteria (p < 0.001). In the subsample of past-year gamers (n = 2,164), screening positive for major depressive disorder was associated with GD under both classifications. Screening positive for generalized anxiety disorder was associated with GD only under DSM-5 criteria. Conclusion: These findings support the assumption that the ICD-11 classification provides a more conservative estimated prevalence than the DSM-5. This study also highlights the differences between DSM-5 and ICD-11 frameworks in their associations with mental health correlates.