The NIMHANS review reveals Internet Gaming Disorder's impact on mental health, sleep, and academic performance among medical students.
In the fast-paced world of medical education, where assignment deadlines and personal issues exert immense mental and physical pressure on students, an unlikely ally has emerged — video games.
Medical students, like their peers worldwide, are increasingly turning to video games as a means of relaxation and entertainment.
“Recent statistics reveal that approximately 3.09 billion people worldwide are active video gamers. Among these gamers, a significant portion consists of students, with studies indicating that over 75 percent of students spend an average of 20 hours per week engrossed in video games. And within the medical student community, the allure of video games becomes even more apparent,” said Dr Manoj Kumar Sharma, professor at the Department of Clinical Psychology in NIMHANS.
Dr Sharma recently did a comprehensive review of eight papers from a total of 102 studies conducted in various countries, including India, Malaysia, and Saudi Arabia, on how Internet Gaming Disorder (IGD) has emerged as a prevalent mental health issue among medical students, affecting their well-being and academic performance.
Dr Sharma also heads the Service for Health Use of Technology Clinic, which deals with digital addictions.
According to the lead author, Dr Sharma, the aim of the review was to compile data on the variables and consequences associated with IGD in medical students.
“Over the last five years, study interest in this area has been gradually increasing in tandem with the surge in popularity of internet gaming. We found that IGD has been linked to gamer characteristics, psychopathology, and consequences among players,” Dr Sharma told South First.
More than 20 hours of gaming per week is considered as a risk factor for IGD. The type of game, whether it was a multiplayer or single-player game, the gamer’s membership with a gaming community, the amount of time spent online, and so on, were all revealed to be important gaming-related characteristics.
According to the review, gaming characteristics play a significant role in the development of IGD among medical students. Spending more than 20 hours per week gaming was identified as a risk factor for IGD, emphasising the importance of monitoring gaming time and implementing preventive strategies.
The review found that multiplayer games were associated with a higher risk of IGD, indicating the need for awareness regarding the potential negative impact of these gaming environments. Psychological characteristics were also found to be correlated with IGD among medical students.
“There are several other factors already leading into depression among medical students, some even leading to suicidal tendencies. Our review also found that depressive symptoms were identified as a significant predictor of higher IGD scores, highlighting the interplay between mental health and gaming behaviour,” Dr Sharma explained.
Interestingly, interpersonal sensitivity and the global symptoms index were also linked to IGD. Interpersonal sensitivity refers to a person’s heightened awareness and sensitivity to the thoughts, feelings, and behaviours of others in social interactions.
It involves being more attuned to the subtle cues and dynamics in relationships, such as picking up on nonverbal cues, understanding others’ emotions, and being responsive to social situations.
In the review, the researchers found that interpersonal sensitivity is one of the psychological characteristics that has been found to be associated with Internet Gaming Disorder, indicating that individuals with IGD may exhibit lower levels of interpersonal sensitivity compared to those without the disorder.
However, the relationship between anxiety and IGD remains ambiguous, with some studies finding a significant association while others didn’t.
Also, as in various other professions and even children, the impact of the Covid-19 pandemic on gaming behaviour was also explored, revealing that increased stress during lockdown periods led to a rise in gaming activity among participants.
The review also looked into the consequences of IGD on sleep and academic performance of medical students.
While some studies did not find a direct link between IGD and these aspects, others reported a negative relationship between IGD scores and academic achievement.
“Males were particularly vulnerable to the detrimental effects of IGD on academic performance. Medical students exhibiting signs of stress, depression, or poor academic performance were more likely to engage in problematic gaming behaviour,” said Dr Sharma.
“When academic performances drop, the sense of purposelessness can come in, leading to depression and other mental health issues.”
The reviewers said that the implications of these findings are significant for identifying individuals at risk and implementing preventive measures. Gaming time emerges as a crucial risk indicator, underscoring the importance of screening and monitoring excessive gaming habits.
Moreover, the association between IGD and psychological issues, such as depression and anxiety, suggests the need for comprehensive assessment and tailored interventions for medical students.
Speaking to South First, Dr Sandeep NS, Clinical Psychologist from Bengaluru, said that monitoring gaming time and promoting awareness of potential risks are crucial for the well-being of the population.
“The medical profession is considered to be a highly stressful one. Not just medical students, I have clients who are doctors themselves. While several lack awareness, many of them are unable to handle the stress and think resorting to video games is the only way of gratification,” he told South First.
Meanwhile, Dr Sharma explained that “the findings suggest that addressing underlying psychological difficulties and providing tailored therapy may be instrumental in preventing and managing Internet Gaming Disorder among medical students”.
“A comprehensive assessment and targeted interventions can make a significant difference.”
Agreeing with this, Dr Sandeep Dagar, Senior Resident, Internal Medicine, at the Indira Gandhi Hospital in Dwarka told South First, “IGD is a serious issue amongst all youngsters especially after the Covid pandemic. Medical colleges can prevent this by conducting various awareness programmes, like conducting workshops, seminars to inform about risks associated with IGD, and signs and symptoms.”
Doctors stressed that medical colleges need to encourage physical activities and recreational activities by increasing team games.
“Organising sport events, tournaments, outdoor activities promoting healthy and lifestyle changes can help them overcome this addiction,” added Dr Sharma.
Speaking to South First, Dr BL Sujatha Rathod, Director of Medical Education, Karnataka, said that gaming is an alternative to stress but it can turn into addiction if not controlled. To reduce this we need to have mentors for all medical students- faculty can monitor five to 10 students, also mentors need to watch attendance, anxiety or depressive symptoms, and counsel accordingly.
Stress relieving activities like yoga and deep breathing need to be done. Also, once a month talks by motivational or positive speakers can be arranged, she opined.
Meanwhile, Dr Dagar said that training time management and self-discipline training can help medicos to balance their academics and personal lives.
“Mental health experts play a major role in this. They can provide counselling session where they can speak about the addiction and early sign identification where students can seek help. I would ask students to socialise more with friends and family members,” he said.
“Prevention needs holistic approach from medical college, including faculty and students themselves. By fostering a supportive environment the medical colleges can provide stress-free college life and boost their confidence to achieve academic goals.”
Psychologists also stressed on the need for further research to understand the complexities of this relationship and explore potential gender differences to ensure effective support and intervention.
The reviewers also mentioned that to address the gaps in existing knowledge, future research should employ diverse methodologies and larger sample sizes.
Longitudinal studies would be particularly valuable in establishing causal relationships and uncovering the underlying mechanisms of IGD.
Additionally, qualitative research could provide a deeper understanding of the experiences and perspectives of medical students regarding their gaming habits and their struggles with IGD, added Dr Sharma.