What exactly the WHO defines – and since when it applies
The WHO describes Gaming Disorder (GD) in ICD-11 as persistent or recurrent gaming behavior with three core features: impaired control, increasing priority given to gaming over other activities, and continuation despite negative consequences. The disorder must usually persist for at least 12 months and lead to significant impairment.
Formally, the ICD-11 was adopted by the World Health Assembly in 2019 and entered into force globally on January 1, 2022. From this point on, it serves as the official standard – although implementation is gradual, as countries may temporarily continue to use ICD-10. For context: the ICD-11 definition differs in scope and thresholds from the DSM-5’s “Internet Gaming Disorder” research concept; the WHO emphasizes functional impairment and the three core criteria.
Are there WHO case numbers? – What exists (and what does not)
The WHO does not publish globally consolidated, annual GD case numbers. Instead, it provides definitions, FAQs, and background information, stressing that only a small proportion of gamers meet clinical criteria – prevalence varies depending on study design, measurement tools, and population.
A recent WHO Europe report illustrates this complexity: it noted that 12% of adolescents are “at risk” for problematic gaming (not identical to the clinical GD diagnosis). Boys are more affected (16%) than girls (7%). This shows the breadth of gaming behavior – but not the narrow, clinical GD diagnosis.
What do reliable prevalence studies say?
The best reference values come from meta-analyses – with the caveat that instruments and thresholds vary widely:
Global GD prevalence is estimated at ~3%, adjusted to ~2% in stricter study designs.
Another meta-analysis estimated 3.3% (95% CI 2.6–4.0); in representative samples 2.4%, adjusted (Trim-and-Fill) 1.4%. Men around 8.5%, women around 3.5% – based on the respective screening criteria.
These discrepancies have clear reasons: studies use over 50 different scales, with varying cutoffs and recall periods (1-month vs. 12-month), and often assess IGD (DSM-5 construct) rather than GD (ICD-11). This heterogeneity explains why estimates range from <1% to >10% – and why the WHO refrains from publishing global “exact numbers.”
Summary of figures: Globally, a reasonable estimate for GD is ~1–3%, with higher rates among boys/men – but always dependent on methodological rigor, instrument, and population.
What has the WHO classification actually achieved?
1) Unified diagnostic framework Inclusion in ICD-11 provides clinics, insurers, and health systems with a standardized code and clear criteria. Since 2022, international health statistics have been aligned with the ICD-11 standard – facilitating comparability, billing, and planning. Implementation, however, is gradual.
2) Improved access to care An official disease classification lowers barriers to diagnosis, referral, reimbursement, and treatment offers – particularly in systems that rely on ICD coding. Clinical care pathways can now be standardized.
3) Stimulus for research and measurement tools The ICD-11 has triggered a wave of validation and measurement research, including screening instruments developed directly along WHO criteria. This improves comparability with older, heterogeneous scales – even if the landscape remains diverse.
4) Prevention and public debate The WHO’s classification sharpened public awareness: health authorities, schools, parents, and providers now discuss media literacy, screen-time management, and early warning signs more actively. WHO Europe’s data on problematic behavior (12% at risk; boys 16%, girls 7%) provide preventive entry points – without overstretching the GD diagnosis.
5) But: Implementation is still work in progress The WHO emphasizes that countries need time to migrate to ICD-11; there are no sanctions for delays. In practice, this means incomplete data coverage, parallel use of ICD-10, and slow data flow – which hampers the availability of global GD statistics.
Controversies and open issues
From the outset, there was criticism: some researchers warned against stigmatizing passionate gamers and the risk of over-diagnosis due to inconsistent tools. The general consensus, however, has grown that a narrow, function-oriented diagnosis (WHO) is necessary to identify and help a small but vulnerable group.
Another issue is measurement heterogeneity. Meta-analyses show that the choice of instrument and study design can drastically affect prevalence estimates – making comparisons over time and across regions tricky. The ICD-11 framework is expected to bring more standardization.
Comparing figures: Clinical GD vs. “problematic” gaming
Clinical GD (ICD-11): best global estimate ~1–3% (depending on study quality/definition), with higher rates in males.
Problematic gaming (risk/screenings): significantly higher proportions, e.g. WHO Europe 12% among adolescents (males 16%, females 7%) – not a clinical GD rate, but relevant for prevention.
Interpretation: The WHO diagnosis addresses a small, clinically significant minority, while risk behavior is much more widespread. Both dimensions matter: the first for targeted treatment, the second for prevention in schools, parenting, and youth protection.
Bottom line: What has the WHO achieved since the introduction?
Today, there is a clear diagnostic standard, better comparability, impetus for research, and increased awareness in prevention and care. Still lacking are global routine data and complete national implementation – which is why there are no reliable WHO “case numbers” in the sense of an annual global GD register. With growing ICD-11 adoption, however, data quality and comparability are expected to improve significantly in the coming years.