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

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.
Competing Interests: AH has an employment at Lund University, sponsored by the state-owned Swedish gambling operator Svenska Spel. AH also has research funding from the research council of the Swedish state monopoly for alcohol, Systembolaget AB. EC has funding from the research council of Svenska Spel. None of these bodies had any role in, or influence on, the present study. The authors alone are responsible for the content and writing of the paper. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 André, Kapetanovic, Einarsson, Trebbin Harvard, Franzén, Möttus, Håkansson and Claesdotter Knutsson.)