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Recognizing the crucial importance of understanding the impact of video games on health in today's gaming-dominated world, our study aimed to investigate the relationship between gaming time and Internet Gaming Disorder (IGD). Despite the widespread assumption that a connection exists between both, previous studies have revealed highly variable associations, highlighting significant weaknesses in establishing a robust link. To unravel this complex relationship, we recruited two independent samples of League of Legends players. We combined the collection of self-reported and actual gameplay data, together with assessments of mental health, personality traits, and cognitive abilities. Surprisingly, none of the gaming variables demonstrated a robust and stable association with IGD, regardless of whether players spent less than or more than 30 hours per week gaming—a threshold suggested by the American Psychiatric Association as a potential indicator of disordered gaming. Notably, mental health factors, such as anxiety, depression and ADHD, emerged as the most influential predictors of IGD. These findings, replicated across two independent samples, challenge the prevailing belief that limiting screen time alone effectively combats IGD. Instead, mental health factors play a crucial role in mitigating risks associated with gaming. Policies focusing solely on restricting screen time are insufficient in reducing the prevalence or symptoms of IGD. Rather, a comprehensive approach that considers mental health and key personality traits must be adopted to safeguard the well-being of individuals engaged in gaming. •Challenge the belief that more time playing video games implies increased Internet Gaming Disorder symptoms.•Highlight the importance of considering factors beyond screen time, such as mental health issues, as stronger predictors of IGD.•Identify the need to explore protective factors and alternative considerations in addressing individuals suffering from IGD.•Collection of actual gameplay data and development of novel measures of motivated behavior.•Inclusion of two samples collected before and after COVID to enhance the robustness and stability of the conclusions.

The use of social network sites (SNSs) has grown dramatically. Numerous studies have shown that SNS users may suffer from excessive use, associated with addictive-like symptoms. With a focus on the popular SNS Facebook (FB), our aims in the current study were twofold: First, to explore the heterogeneity of FB usage and determine which kind of FB activity predicts problematic usage; second, to test whether specific impulsivity facets predict problematic use of FB. To this end, a sample of FB users (N = 676) completed an online survey assessing usage preferences (e.g., types of activities performed), symptoms of problematic FB use and impulsivity traits. Results indicated that specific usage preferences (updating one's status, gaming via FB, and using notifications) and impulsive traits (positive and negative urgency, lack of perseverance) are associated to problematic FB use. This study underscores that labels such as FB \"addiction\" are misleading and that focusing on the actual activities performed on SNSs is crucial when considering dysfunctional usage. Furthermore, this study clarified the role of impulsivity in problematic FB use by building on a theoretically driven model of impulsivity that assumes its multidimensional nature. The current findings have identifiable theoretical and public health implications.

Introduction The practice of chemsex refers to the use of drugs during sexual activities. Many articles describe chemsex practices and address the risks of sexually transmitted infections; however, few address the topic of addictive patterns of chemsex in terms of diagnostic criteria, predisposing factors, and recommended treatments. Drugs commonly used in chemsex practices include the new synthetic cathinones 3-methylmethcathinone and 4-methylmethcathinone. Knowledge about the addictive properties of 3-methylmethcathinone and 4-methylmethcathinone, as well as the therapeutic possibilities for addiction to these drugs, is still very scarce in the literature. The current case report addresses this gap from a clinical perspective. Case presentation This case report describes the situation of a 37-year-old white European man suffering from chemsex addiction with 3-methylmethcathinone intake. We suggest a model for conceptualizing chemsex addiction as a compulsive sexual behavior disorder coupled with addiction to one or more substances, while taking place in a particular sociocultural context. We provide a description of the collected clinical symptoms and of the personalized psychotherapy and pharmacotherapy treatment interventions that yielded the patient’s recovery. Conclusions We highlight the relevance of our conceptualization model for abstinence from synthetic cathinones for sexualized purposes, through the lens of the patient’s positive response to the fit-for-purpose treatment strategy: personalized psychotherapy and bupropion pharmacotherapy. Finally, we emphasize the importance of carrying out studies that can scientifically validate the predisposing factors, the diagnostic criteria, and the treatments for chemsex addiction. These elements are essential to think about when it comes to adequate public heath interventions for at-risk individuals and groups.

Online gambling and gaming are associated with Problematic Usage of the Internet (PUI) in subgroups of individuals. This study aimed to assess how different personality dimensions are associated with PUI scores of Massively Multiplayer Online Role Playing Games (MMORPG) players and online poker players, and to characterize common and specific personality traits of both groups in their association with PUI. Participants ( N  = 1144) were recruited online and assessed with the Internet Addiction Test (IAT), the Big Five Inventory and the Short UPPS-P Impulsive Behavior Scale. Data were analyzed with multiple robust linear regression models. The first model tested the associations between personality and impulsivity traits with IAT scores, while controlling for age, gender, and type of online activity. The second model included interaction terms to assess whether these associations differed between MMORPG and poker players. In model 1, neuroticism, negative urgency, positive urgency and sensation seeking were significantly and positively associated with higher IAT scores after controlling for the other personality traits, age, gender, and type of online activity. Extraversion was negatively associated with IAT scores. In Model 2, no significant difference in how these personality traits relate to IAT scores was observed between the two groups. Results highlight that traits such as neuroticism, negative urgency, positive urgency, and sensation seeking constitute potential risk factors for PUI, while extraversion might constitute a protective factor against PUI. The identified associations could be useful in understanding players’ attitudes and supporting them in gaining insight into their difficulties.

Massively Multiplayer Online Role-Playing Games (MMORPGs) are a very popular and enjoyable leisure activity, and there is a lack of international validated instruments to assess excessive gaming. With the growing number of gamers worldwide, adverse effects (isolation, hospitalizations, excessive use, etc.) are observed in a minority of gamers, which is a concern for society and for the scientific community. In the present study, we focused on screening gamers at potential risk of MMORPG addiction. In this exploratory study, we focused on characteristics, online habits and problematic overuse in adult MMORPG gamers. In addition to socio-demographical data and gamer behavioral patterns, 3 different instruments for screening addiction were used in French MMORPG gamers recruited online over 10 consecutive months: the substance dependence criteria for the Diagnostic and Statistical Manual of Mental Disorder, fourth revised edition (DSM-IV-TR) that has been adapted for MMORPG (DAS), the qualitative Goldberg Internet Addiction Disorder scale (GIAD) and the quantitative Orman Internet Stress Scale (ISS). For all scales, a score above a specific threshold defined positivity. The 448 participating adult gamers were mainly young adult university graduates living alone in urban areas. Participants showed high rates of both Internet addiction (44.2% for GIAD, 32.6% for ISS) and DAS positivity (27.5%). Compared to the DAS negative group, DAS positive gamers reported significantly higher rates of tolerance phenomenon (increased amount of time in online gaming to obtain the desired effect) and declared significantly more social, financial (OR: 4.85), marital (OR: 4.61), family (OR: 4.69) and/or professional difficulties (OR: 4.42) since they started online gaming. Furthermore, these gamers self-reported significantly higher rates (3 times more) of irritability, daytime sleepiness, sleep deprivation due to play, low mood and emotional changes since online gaming onset. The DAS appeared to be a good first-line instrument to screen MMORPG addiction in online gamers. This study found high MMORPG addiction rates, and self-reported adverse symptoms in important aspects of life, including mood and sleep. This confirms the need to set up relevant prevention programs against online game overuse.

The 7-item Game Addiction Scale (GAS) has been validated under standard confirmatory factor analysis and exhibits good psychometric properties. Whether this scale satisfies the necessary conditions for consideration by item response theory (IRT) modeling remains unknown. However, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recently proposed criteria, in its section 3, to define internet gaming disorder (IGD) to promote research on this possible condition. The objective of our study was to (1) analyze GAS in the context of IRT (graded-response) modeling; (2) investigate differential item functioning (DIF), a feature of IRT modeling, in 2 subsamples; and (3) contribute to the ongoing (IGD) debate related to the validity of the DSM-5 criteria using GAS items as a proxy. We assessed 2 large representative samples of Swiss men (3320 French-speaking and 2670 German-speaking) with GAS. All items comprised high discrimination parameters. GAS items such as relapse, conflict, withdrawal, and problems (loss of interests) were endorsed more frequently in more severe IGD stages, whereas items related to tolerance, salience (preoccupation), and mood modification (escape) were endorsed more widely among participants (including in less severe IGD stages). Several DIF effects were found but were classified as negligible. The results of the analyses partly support the relevance of using IRT to further establish the psychometric properties of the GAS items. This study contributes to testing the validity of the IGD criteria, although cautious generalization of our findings is required with GAS being only a proxy of the IGD criteria.

The World Health Organization (WHO) has added gaming disorder to ICD-11 as a clinical condition associated with distress or interference with personal functioning. This inclusion leads to clinical and public health benefits, such as harmonising terminology, offering clinical landmarks and improving monitoring capabilities and data comparability. Training health professionals to identify and manage gaming disorder is a key challenge for countries. In the present paper we compiled opinions from different countries around the globe on their state of preparedness and needs to tackle this issue. The global views on the topic feed arguments for developing an evidence-based and cross-cultural training tool for gaming disorder management by health professionals.

Pronounced variations in suicide mortality persist across Europe. Understanding long-term temporal patterns through age, period and cohort (APC) effects, alongside suicide means, is essential for tailored prevention. This study aims to determine how suicide mortality rates in Europe have changed across APC dimensions at national and subregional levels. Our analysis was restricted to European countries with complete age- and sex-specific suicide mortality data from 1990 to 2019 within the World Health Organization mortality database. The analysis comprised two components. The first component disentangled long-term suicide mortality trends (1990-2019) into APC dimensions using an age-period-cohort model via the National Cancer Institute's APC Web Tool. The second component involved an assessment of suicide means, restricted to 2010-2019 and to countries with detailed International Classification of Diseases, 10th Revision (ICD-10) cause-of-death data. In 2019, Europe recorded 47,793 male and 13,111 female suicide deaths. Overall suicide mortality rates declined in most subregions from 1990 to 2019, with the largest reductions among Eastern European men, from 77.81 (95% CI: 77.17-78.45) per 100,000 in the mid-1990s to 22.93 (95% CI: 22.58-23.28) per 100,000 by 2019, although this region retained the highest male suicide burden. Age-specific risk patterns differed markedly: among men, risk peaked in early adulthood and then declined in Eastern Europe, while in Western and Southern Europe, it was lower and more stable but rose after age 60; for women, risk was generally lower, with peaks in early adulthood in Eastern Europe and in midlife elsewhere. Period reflected continued improvement, especially in Eastern Europe where the period risk in 2015-2019 was approximately 60% lower than 2000-2004. Cohort effects similarly showed progressive declines. However, upward trends emerged among younger generations. In Northern Europe, the cohort relative risk for females increased from 0.73 (95% CI: 0.68-0.78) in the 1980 cohort to 0.90 (95% CI: 0.70-1.04) in the 2000 cohort. While the completeness of suicide means analysis varied by subregion, the primary data indicated that hanging was the predominant means for both sexes during 2010-2019. Despite an overall decline, suicide mortality in Europe exhibits persistent regional and demographic differences. This study reveals emerging risks among younger cohorts, specifically Northern European women and Southern European men, signalling shifting patterns that are not apparent from overall temporal trends alone. This evolving risk profile calls for sustained surveillance and research to investigate the drivers of these population-specific vulnerabilities.

While the use of telemedicine (TLM) increased worldwide during the early phases of the COVID-19 pandemic, little is known about the use and acceptance of TLM post the COVID-19 pandemic. This study aims to evaluate patients' and physicians' self-reported use, preferences, and acceptability of different types of TLM after the initial phases of the COVID-19 pandemic. We conducted a cross-sectional survey among patients and physicians in Geneva, Switzerland, between September 2021 and January 2022. Patients in waiting rooms of both private and public medical centers and emergency services were invited to answer a web-based questionnaire. Physicians working in private and public settings were invited by email to answer a similar questionnaire. The questionnaires assessed participants' sociodemographics and digital literacy; self-reported use of TLM; as well as preferences and acceptability of TLM for different clinical situations. A total of 567 patients (309/567, 55% women) and 448 physicians (230/448, 51% women and 225/448, 50% in private practice) responded to the questionnaire. Patients (263/567, 46.5%) and physicians (247/448, 55.2%) generally preferred the phone over other TLM formats and considered it to be acceptable for most medical situations. Email (417/567, 73.6% and 308/448, 68.8%) was acceptable for communicating exam results, and medical certificates (327/567, 67.7% and 297/448, 66.2%) and video (302/567, 53.2% and 288/448, 64.3%) was considered acceptable for psychological support by patients and physicians, respectively. Older age was associated with lower acceptability of video for both patients and physicians (odds ratio [OR] 0.03, 95% CI 0.00-0.33 and OR 0.23, 95% CI 0.08-0.66) while previous use of video was positively associated with video acceptability (OR 3.16, 95% CI 1.84-5.43 and OR 3.34, 95% CI 2.91-5.54). Psychiatrists and hospital physicians were more likely to consider video to be acceptable (OR 10.79, 95% CI 3.96-29.30 and OR 3.97, 95% CI 2.23-7.60). Despite the development of video, the acceptability of video remains lower than that of the phone for most health issues or patient requests. There is a need to better define for which patients and in which medical situations video can become safe and efficient.