Statement on WHO ICD-11 List and the Inclusion of Gaming



June 19, 2018



In view of the publication by the WHO of the so-called ICD-11 list, organisations representing video game publishers and developers across the world would like to express their concern:

“Video games across all kinds of genres, devices and platforms are enjoyed safely and sensibly by more than 2 billion people worldwide, with the educational, therapeutic, and recreational value of games being well-founded and widely recognised. We are therefore concerned to see ‘gaming disorder’ still contained in the latest version of the WHO’s ICD-11 despite significant opposition from the medical and scientific community. The evidence for its inclusion remains highly contested and inconclusive. We hope that the WHO will reconsider the mounting evidence put before them before proposing inclusion of ‘gaming disorder’ in the final version of ICD-11 to be endorsed next year.Weunderstand that our industry and supporters around the world willcontinue raising their voices in opposition to this move and urge the WHO toavoid taking steps that would have unjustified implications for national health systems across the world.”

Background information on the WHO ICD-11 list:

  1. What is the ICD-11 list?

The World Health Organisation (WHO) is currently reviewing its list on classification of diseases (ICD) that is widely used as a manual by practitioners and importantly is implemented by many countries in their national health policies.

The current draft proposes to add “gaming” under the section that deals with ‘Disorders due to addictive behaviours’ (category 06) which also deals with alcohol, drugs, gambling.  The ICD-11 beta draft can be consulted here:

  1. Will the ICD-11 list be approved or is it just ‘published’?

The updated ICD list is expected to be launched in June 2018 and will be open for consultation before the WHO General Assembly formally approves the list in May 2019.

  1. Why is there so much debate around the inclusion of gaming in this list?

There is strong disagreement among experts on the inclusion of video gaming in the ICD-11 list, and the issue has been heavily debated since 2016 when 36 internationally renowned and respected mental health experts, leading social scientists and academics from research centers and universities – including Oxford University, Johns Hopkins University, Stockholm University and The University of Sydney –opposed the inclusion in an Open Debate paper.

Two years later, in March 2018, the same academics reiterated their opposition as there had been little acknowledgement from the WHO of their views in a second open paper published in the Journal of Behavioral Addictions. The paper alerts on the weak evidence base, stressing that the“burden of evidence andthe clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses”. ‘A Weak Scientific Basis for Gaming Disorder: Let us err on the side of caution’:

Views of practitioners: In May 2013, the American Psychiatric Association (APA) proposed criteria for video game addiction in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM), but concluded that there was insufficient evidence to include it as an official mental disorder.  Proposed criteria for “Internet Gaming Disorder” were included in a section called “Conditions for Further Study”.  For the time being there is no timetable for a review of the DSM. Subsequently there have been numerous academic papers and research both for and against the formalisation of problematic gaming behaviours.

In March 2018, the Society for Media Psychology & Technology, division 46 of the American Psychological Association called on the WHO not to include video game addiction in the ICD-11 list.  Link:

  1. Video games are enjoyed for recreational, educational and therapeutic uses

Videogames are enjoyed by people all over the world for recreational, educational and therapeutic purposes.  The therapeutic value of games ais increasingly important in today’s society and brings innovation to treatments, such as in the field of dementia but there are numerous other areas:

The value of the educational benefits of video games for educational purposes no longer needs to be proved. Games improve strategic thinking and increasingly teachers bring games into the classroom for an enhanced learning experience, ranging from Minecraft’s Education Edition allowing teachers to create workshops and initiate pupils to work on mathematics, languages and science. Other games such as Assassins Creed Origin‘s Discovery Tour, dedicated to teachers brings the history of Ancient Greece into the classroom allowing virtual visits to monuments and historical places.

There are 2.5 billion gamers across the globe who play video games for all the above-mentioned purposes. To classify gaming as a disorder under the mental health and addiction category of the ICD-11 list will create moral panic and may lead to abuse of diagnosis as the inclusion is not based on a high level of evidence, as would be required to formalise any other disorder.



The Brazilian Union of Video and Gamesrepresents leading companies in Brazil’s audiovisual and interactive entertainment industries. The Entertainment Software Associationrepresents the major publishers in the United States and also owns and operatesE3, the premier global trade show for video games and related products. Entertainment Software Association of Canadarepresents the major publishers of interactive software throughout Canada. European Games Developer Federationrepresents some 1500 studios based in Austria, Belgium, Denmark, Finland, France, Germany, Norway, Spain, Sweden and the United Kingdom, which together employ about 25,000 people. Interactive Entertainment South Africais mandated to lobbying, develop policy and help grow the local game, serious games, simulation, board-game, augmented reality and VR industries.The Interactive Games & Entertainment Associationrepresents the major publishers of interactive software throughout Australia and New Zealand. The Interactive Software Federation of Europerepresents major publishers of interactive software and trade associations in 18 countries throughout Europe. The Korea Association of Game Industryis composed of 66 member companies including the major publishers in Korea that account for more than 90% sales of game industry, and has cooperative ties through an official partnership of the Korean government to promote and develop the Korean game industry.


Media contact:

Raelene Knowles, IGEA

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