Internet Gaming Addiction in Children and Adolescents: A Narrative Review in the Context of Screen Time

Internet gaming addiction in children and adolescents is an emerging clinical and public health concern within the broader context of increasing recreational screen exposure. Despite growing recognition of gaming disorder, uncertainty remains regarding its distinction from high recreational gaming, its relationship with screen time, and the most appropriate prevention and management strategies for pediatric populations. This narrative review aimed to synthesise evidence published between 2013 and 2026 on diagnostic concepts, epidemiological patterns, screen-time context, mental and physical health associations, and intervention approaches for problematic gaming in children and adolescents. Relevant literature was reviewed and organised into diagnostic, clinical, public health, and therapeutic domains. The conclusions were derived from qualitative narrative synthesis rather than pooled quantitative analysis. Current evidence indicates that gaming disorder should not be defined by screen-time duration alone, but by impaired control, persistence despite harm, prioritisation of gaming over essential activities, and functional impairment across academic, social, developmental, and family domains. Prevalence estimates vary because of differences in diagnostic criteria, assessment tools, cultural gaming practices, and study populations. Excessive gaming commonly overlaps with emotional symptoms, sleep disturbance, sedentary behaviour, reduced physical activity, academic difficulties, social withdrawal, and family conflict. Available evidence suggests potential benefit from multidimensional management involving validated assessment, cognitive behavioural strategies, relapse prevention, parental involvement, school-based digital literacy, structured offline activities, and coordinated pediatric mental health care. Screen-time reduction is important, but restriction alone is insufficient. Given the absence of formal evidence grading and risk-of-bias assessment, conclusions regarding intervention effectiveness should be interpreted cautiously. Pediatric gaming disorder requires impairment-based assessment and developmentally appropriate, family-supported intervention rather than simple screen-time control.