OBJECTIVES: To comprehensively summarize the existing literature on the association between video gaming habits and psychological distress.

METHODS: This systematic review was conducted in compliance with PRISMA. A search was performed in September 2023 with the following keywords: “video game, or computer game, or internet game,“ and “adolescent,“ and “psychological distress or anxiety or depression” on PubMed, ScienceDirect, and PsychARTICLES databases. Studies published from January 01, 2000, to May 01, 2023, were included.

RESULTS: 15 studies were included for review. Out of 15 studies, 10 assessed the association between gaming habits and depression while the remaining 5 studies focused on anxiety. Primary survey instruments used in assessing psychological distress were Center for Epidemiologic Studies Depression Scale and Generalized Anxiety Disorder Scale. The time spent playing video games (³ 2 hours per day) was associated with an increased risk of depression. Playing high-violence video games for ³ 2 hours per day was significantly associated with higher number of depressive symptoms among boys (Cohen’s d= 0.19) than low-violence games. Excessive gaming predicted increases in depressive symptoms, and in turn, depressive symptoms predicted a decrease in gaming over time. Adolescents with patterns of gaming behavior characterized by impaired control over gaming were at higher risk of all forms of anxiety (mild, moderate, and severe) than those without gaming disorder (OR: 1.689-3.849, p <.001).

CONCLUSIONS: Excessive game time in adolescents is associated with an increased risk of psychological distress. Psychological distress affects the overall quality of life and impairs academic or occupational functioning. This study raises awareness of the public health concern associated with gaming habits among adolescents. Additional studies are needed to clarify elements such as the game content, example, low or high-violence games, or the interaction of online gamers with other multiplayers, which may play role in the development of psychological distress.