Background: Computer game addiction is excessive or compulsive
use of computer and video games that may interfere with
daily life. It is not clear whether video game playing meets diagnostic
criteria for Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition (DSM-IV). Objectives: First objective is
to review the literature on computer and video game addiction
over the topics of diagnosis, phenomenology, epidemiology, and
treatment. Second objective is to describe a brain imaging study
measuring dopamine release during computer game playing. Methods:
Article search of 15 published articles between 2000 and 2009
in Medline and PubMed on computer and video game addiction.
Nine abstinent “ecstasy” users and 8 control subjects were scanned
at baseline and after performing on a motorbike riding computer
gamewhile imaging dopamine release in vivowith [123I]IBZMand
single photon emission computed tomography (SPECT). Results:
Psycho-physiological mechanisms underlying computer game addiction
are mainly stress coping mechanisms, emotional reactions,
sensitization, and reward. Computer game playing may lead to
long-term changes in the reward circuitry that resemble the effects
of substance dependence. The brain imaging study showed that
healthy control subjects had reduced dopamine D2 receptor occupancy
of 10.5% in the caudate after playing a motorbike riding
computer game compared with baseline levels of binding consistent
with increased release and binding to its receptors. Ex-chronic
“ecstasy” users showed no change in levels of dopamine D2 receptor
occupancy after playing this game. Conclusion: This evidence
supports the notion that psycho-stimulant users have decreased
sensitivity to natural reward. Significance: Computer game addicts
or gamblers may show reduced dopamine response to stimuli
associated with their addiction presumably due to sensitization.