Virtually addicted: why general practice must now confront screen dependency
This paper acknowledges the widespread significance of the medical impact of screen time/gaming on the general population and urges health professionals to actively consider and question the effect of screen time on the health problem presenting to them by the patient.
For the whole paper see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240116/
"Discretionary screen time (ST) is now the main waking activity of children: a lifestyle factor as relevant to health as nutrition and physical activity. High ST is increasingly considered an independent risk factor, often exhibiting a dose–response relationship with cardiometabolic disease, unfavourable child development outcomes, and adult morbidity and mortality, ultimately placing greater pressure on primary care services.1 The US Department of Health has issued ‘recommended limits for screen time’ as one of its national ‘health improvement priorities’ and a key ‘disease prevention objective’.2 Public Health England recently reported their concern over:
‘Increased screen time … evidence suggests a “dose-response” relationship, where each additional hour of viewing increases the likelihood of experiencing socio-emotional problems’.3
As concern grows over the amount of ST, the term ‘addiction’ is increasingly used by physicians to describe the rising number of children engaging in a variety of screen activities in a dependent, problematic manner. The diagnostic vernacular is still evolving: internet addiction disorder (IAD), at-risk/problematic internet use (ARPIU), pathological video game use, video game addiction, pathological technology use, online game addiction, and more. Although the current medical focus is on ‘video gaming’, other forms of screen use, from excessive messaging and social networking to ‘porn addiction’, can also become highly problematic. While there is a lack of consensus as to whether such screen use constitutes a formal psychiatric disorder, the NHS doesn’t consider it a passing phase, stating ‘as computer use has increased, so too has computer addiction’.4
Involving primary care in this emerging problem should not be construed as medicalising a popular pastime, the thin end of the wedge leading GPs to meddle in patient lifestyles. ST is a health issue and the GP’s surgery is the entrance hall through which patients seek authoritative guidance, referral, and where education can take place. Raising parental awareness of both excessive ST and problematic, dependent screen use is vital. As the guardians of family health, GPs’ views on child health hold currency. Unfortunately, families are courted and bedazzled, child development research is funded, and governments are lobbied by a well-heeled, highly influential technology industry. It is, therefore, incumbent on GPs to confront the iridescent elephant(s) in the room.
Irrespective of the formal status of screen ‘addictions’, those in primary care must step back and simply consider the extent to which excessive, seemingly dependent, non-work-related ST affects the health and wellbeing of patients, and ST’s impact on functioning including work, study, relationships and finances. In this rapidly developing field, a better understanding of the subject will enable physicians to make clinical and policy decisions. "