Controversial video gaming condition, current timeline examined
The still developing 11th version of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) is expected to improve functionally from that of ICD-10. That is not to suggest that there won’t be complications, however. One of the more talked about diagnoses among the 55,000 codes reportedly involved in the system1 recently has been “gaming disorder,” a condition characterized by an excessive playing of video games.2 Currently included within the substance use and addictive behavior disorders section of the ICD-11, specific symptoms of the diagnosis include increasing priority given to playing games to the extent that gaming takes precedence over other life interests and daily activities, and continuation or escalation of game playing despite negative consequences.2 Gaining criticism gaming companies, according to a recent report by Psychology Today, the gaming disorder and other codes will be up for further evaluation at the 72nd World Health Assembly this coming May, when member states3 of the World Health Organization (WHO), the directing and coordinating authority for health within the United Nations System that is tasked with maintaining each version of the ICD, enter the decision-making process for the coding system, which was released in a version for purposes of preparing implementation in June 2018.
Considered to be the foundation for the identification of health trends and statistics globally, and the international standard for reporting diseases and health conditions, according to the WHO, the ICD is the diagnostic classification standard for all clinical and research purposes. First adopted by the International Statistical Institute in 1893, the ICD defines diseases, disorders, injuries, and other related health conditions, which are listed in a hierarchical fashion, to allow for easy storage, retrieval, and analysis of health information for evidenced-based decision-making, sharing, and comparing, according to the WHO.
Another controversial code includes compulsive sexual behavior disorder, which is characterized by “a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior,” according to the WHO. According to a report published this past summer, critics of this diagnosis worry that this new diagnosis inappropriately pathologizes people who have a strong sex drive or act out sexually, but supporters of adding compulsive sexual disorder to ICD-11 probably see its inclusion as long overdue.4
Attention To Antimicrobial Resistance & Other Updates
The ICD is also used by health insurers whose reimbursements depend on ICD coding; national health program managers; data collection specialists; and others who track progress in global health and determine the allocation of health resources, according to the WHO, whose officials have also said that the new system is meant to reflect progress in medicine and advances in scientific understanding. As an example, WHO officials claim that codes related to antimicrobial resistance are more closely in line with the Global Antimicrobial Resistance Surveillance System (GLASS), a system being developed to support the global action plan on antimicrobial resistance. WHO officials have also touted ICD-11 as also “able to better capture data regarding safety in healthcare, which means that unnecessary events that may harm health – such as unsafe workflows in hospitals – can be identified and reduced.”5
The newly proposed ICD-11 also reportedly includes a new chapter on sexual health that brings together conditions that were previously categorized in ways such as “gender incongruence,” was listed as a mental health condition. Other highlights of ICD-11, as explained by the WHO, include:
- fewer diagnostic terms for post-traumatic stress disorder to allow for easier diagnosis;
- allergies are grouped under diseases of the immune system to better understand the circumstances of a person’s reaction;
- stroke is now classified as a disease of the brain rather than the circulatory system;
- quality of care information is anticipated to be more easily reported; and
- updates to the section on HIV are said to better reflect what “modern” patients who live with the infection are experiencing.
Following endorsement, Member States will begin reporting health data using ICD-11 as of Jan. 1, 2022. The currently released version up for endorsement can be viewed online.6 Those who wish to contribute to the classification by writing proposals or comments can do so by registering and accessing a form online.7
- Stewart A. ICD-11 contains nearly 4x as many codes as ICD-10: here’s what WHO has to say. Becker’s ASC Review. 2018. Accessed online: www.beckersasc.com/asc-coding-billing-and-collections/icd-11-contains-nearly-4x-as-many-codes-as-icd-10-here-s-what-who-has-to-say.html
- Raskin JD. Debate over gaming disorder is not all fun and games. Psychology Today. 2019. Accessed online: www.psychologytoday.com/gb/blog/making-meaning/201901/debate-over-gaming-disorder-is-not-all-fun-and-games
- Alphabetical list of WHO member states. WHO. 2019. Accessed online: www.who.int/choice/demography/by_country/en
- Raskin JD. What’s New in the international classification of diseases? Psychology Today. 2018. Accessed online: www.psychologytoday.com/us/blog/making-meaning/201807/what-s-new-in-the-international-classification-diseases
- WHO releases new international classification of diseases (ICD 11). WHO. 2018. Accessed online: www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11)
- ICD-11 for mortality and morbidity statistics (ICD-11 MMS) 2018 version. WHO. 2018. Accessed online: https://icd.who.int/browse11/l-m/en
- ICD-11 Maintenance Platform. WHO. 2019. Accessed online: https://icd.who.int/dev11/l-m/en