Relapse prevention therapy for internet gaming disorder in Swedish child and adolescent psychiatric clinics: a randomized controlled trial

Frida André; Sabina Kapetanovic; Isak Einarsson; Sunna Trebbin Harvard; Leonard Franzén; Annika Möttus; Anders Håkansson; Emma Claesdotter-Knutsson

doi:10.3389/fpsyt.2023.1256413

Relapse prevention therapy for internet gaming disorder in Swedish child and adolescent psychiatric clinics: a randomized controlled trial

Front Psychiatry. 2023 Oct 20:14:1256413. doi: 10.3389/fpsyt.2023.1256413. eCollection 2023.

Authors

Frida André¹, Sabina Kapetanovic², Isak Einarsson^{1

3}, Sunna Trebbin Harvard⁴, Leonard Franzén⁵, Annika Möttus³, Anders Håkansson^{1

6}, Emma Claesdotter-Knutsson^{1

3}

Affiliations

¹ Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden.
² Department of Social and Behavioral Sciences, University West, Trollhättan, Sweden.
³ Region Skane, Child and Adolescent Psychiatry, Regional Outpatient Care, Lund University Hospital, Lund, Sweden.
⁴ Civic Centre Children and Youth, The Social Services Administration, Copenhagen, Denmark.
⁵ Social Services, Malmö, Sweden.
⁶ Region Skåne, Malmö Addiction Centre, Gambling Disorder Unit, Malmö, Sweden.

Abstract

Objectives: To evaluate the effectiveness of relapse prevention (RP) as a treatment for internet gaming disorder (IGD).

Design: Randomized controlled trial.

Setting: Three child and adolescent psychiatry (CAP) units in Region Skåne, Sweden.

Participants: Children aged 13-18 years, coming for their first visit to CAP during 2022, were screened for gaming behavior. Those who met the proposed DSM-5 criteria for IGD were offered participation in the trial, if they had the capacity to provide written informed consent and if they spoke Swedish. A total of 111 CAP patients agreed to participate. Out of those, 11 patients were excluded due to incorrect inclusion such as young age (n = 1), or due to the absence of responses to follow-up measures (n = 9). After exclusion, 102 participants remained (intervention = 47, control = 55).

Interventions: The intervention, RP, is based on cognitive behavioral treatment (CBT) and was provided individually, comprising of five to seven 45-min sessions over a period of 5 to 7 weeks versus treatment as usual.

Outcome measures: Participants were assessed with Game Addiction Scale for Adolescents pre-treatment (GASA) (baseline), post-treatment (treatment group only), and 3 months after baseline (follow-up).

Results: The repeated measures ANOVA showed a significant interaction effect between treatment and time. Both the control group and treatment group lowered their mean GASA score from baseline to follow-up significantly, but the improvement was greater in the treatment group (mean difference in control group -5.1, p < 0.001, 95% CI = - 3.390 to -6.755, mean difference in treatment group -9.9, p < 0.001, 95% CI = -11.746 to -8.105).

Conclusion: RP was found to be superior to treatment as usual in terms of reduction of IGD symptoms. Future research should address which aspects within a given treatment are effective, who benefits from treatment, in what aspects, and why.

Trial registration number: ClinicalTrials.gov, NCT05506384 https://clinicaltrials.gov/ct2/show/NCT05506384.

Keywords: CBT; GASA; gaming; internet gaming disorder; relapse prevention.

Associated data

ClinicalTrials.gov/NCT05506384

Grants and funding

This work was supported by Swedish governmental funding of clinical research (ALF), Svenska Spel Research Council, Fanny Ekdahls Foundation, FoU Regional funds of Region Skane, SUS funds and stipends, Craaford foundation, Sigurd and Elsa Goljes memorial fund.