Limited evidence exists about what interventions are most effective for those impacted by PIU. Several small-scale and open-label studies have supported the use of naltrexone, quetiapine, selective serotonin reuptake inhibitors and methylphenidate for these problems7.
In addition to the multiple factors that complicate researching psychiatric conditions and treatment in adolescence, there are challenges in how to best conceptualize these difficulties (e.g. separate psychiatric disorder, overlying psychiatric manifestation, co-morbid psychiatric disorder), thus making it complicated to study and understand. However, it is clear that finding effective interventions is essential for the successful treatment of many adolescents, such as Thomas.
To further complicate the picture, video games have been effectively used by practitioners to study and treat medically and mentally ill individuals. In addition to their use to provide and supplement psychotherapeutic care (e.g. online, self-paced CBT approaches), video games have been used expansively in the medico-professional field for physical therapy, rehabilitation and psycho-education of chronic ailments requiring consistent treatment adherence3,5.
Video games, like other aspects of the Internet and media, tend to elicit strong opinions as to their benefit or harm, particularly for children and adolescents. Probably, for most individuals, moderate use, in conjunction with other developmental appropriate behaviors, is reasonable, and in some cases, beneficial. Developing better information on how to identify those at risk as well as effective preventative and treatment strategies is essential, as is helping parents learn to effectively teach their children about safe and appropriate Internet use.
Jay S. Kothari, MD, is a Child PRITE fellow in child and adolescent psychiatry at the University of Arizona School of Medicine. Arden D. Dingle, MD, is a psychiatry professor at Emory University School of Medicine. They will be presenting on this topic on Feb. 20 at the American College of Psychiatrists Annual Meeting in Huntington Beach, Calif.
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