An analysis of all published articles on internet gaming disorder (IGD) notes that the condition has a complex psychosocial background, and many personal, neurobiological, familial, and environmental factors may put certain individuals at increased risk.

The Developmental Medicine & Child Neurology review notes that the tentative definition of IGD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a good starting point for diagnosing the condition, with the most stringent criteria including a build-up of tolerance (more time needs to be spent playing computer games), loss of control, giving up other interests, and excessive use despite clear-cut psychosocial and health-related problems. There are, however, weaknesses of the DSM-5 definition.

The evidence of a diagnostic entity of IGD and the pathways to the disorder are not entirely clear, and long-term follow-up studies are lacking.

"For the majority of individuals, computer gaming is an enjoyable and stimulating activity. Persons with risk factors may, however, become attracted to use computer gaming as a strategy to overcome individual problems," said lead author Dr. Frank W. Paulus, of Saarland University Hospital, in Germany. "Excessive gaming may lead to avoiding negative moods and neglecting 'normal' relationships, school- or work- related duties, and even basic physical needs."