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Brainstorm Health: Gaming Disorder, Valeant Stock, Migrant Family Separation and Health

June 18, 2018, 9:30 PM UTC

I hope you’ve had a wonderful weekend, readers. This is Sy.

It’s not every day that a group as significant as the World Health Organization (WHO) adds a whole new disorder to its official classification of diseases, appropriately dubbed the “International Classification of Diseases” (which is now on its 11th edition, or ICD-11).

Well, today is one of those days. The WHO is officially classifying “gaming disorder” as an “addictive behavior” included under the umbrella of “mental, behavioral, or neurodevelopmental disorders” in the ICD-11 unveiled Monday.

The ICD is, as the name implies, a global disease classification system. It’s meant for adoption by countries around the world for citing which conditions are afflicting their populations; ICD codes are used for everything from medical billing to gauging public health.

So what’s up with “gaming disorder”? The WHO lists a number of varieties (those related to online gaming, offline gaming, and unspecified gaming) in the ICD. It’s characterized “by a pattern of persistent or recurrent gaming behavior… and is manifested by: 1) impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 2) increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and 3) continuation or escalation of gaming despite the occurrence of negative consequences.”

Those are definitions that mirror the criteria for other substance use and gambling addiction disorders. And, in modern times, when video game and technology frenzy are undoubtedly on the rise, it may make intuitive sense to put some more emphasis on this kind of compulsive behavior. And it’s not like “gaming disorder” could be diagnosed just because your teenager spent a week playing video games for hours and hours on end; she or he would have to display the behavior for at least 12 months and to the detriment of social, family, or work life.

But not all mental health professionals are sure it’s entirely necessary (or, more to the point, more accurate) than pointing out underlying conditions that lead to what may seem like video game addiction. For instance, as psychologist Anthony Bean, executive director of the Telos Project mental health clinic, tells CNN, people who obsessively game may be using it “more as a coping mechanism for either anxiety or depression.” Those are conditions well-established under previous ICDs.

The issue reflects one of the broader controversies around new ICD versions—they’ve been getting more and more specific, at times to what some may consider comical degrees (the previous iteration, ICD-10, contained a whopping 68,000 billing codes, or more than five times the number in ICD-9, and including provisions for your second doctor visit after getting sucked into a jet engine—seriously).

Does that level of specificity really improve public health, or create more administrative headaches? There’s plenty of debate on that front. But, regardless, ICD-11 won’t be hitting doctor’s and insurers’ offices any time soon—it could take more than a decade to finally implement, if ICD-10’s history serves as an example.

Read on for the day’s news.

Sy Mukherjee


Will EHRs catch up to modern gender identity norms? Modern Healthcare highlights a fascinating issue in the sterile, jargon-filled world of electronic health records (EHRs)—how can these systems of billing collection and patient histories reflect modern gender norms given the highly binary nature of insurance information collection? As the publication reports, a growing number of health systems and health record vendors are pushing for fluidity in recording patients' chosen genders. Such a move could make tangible differences in both non-binary gender conforming patients' experiences with the health care system and the way that care is delivered to them. (Modern Healthcare)


Valeant hit with FDA rejection of psoriasis lotion, shares sink. Valeant stock plunged more than 12% in Monday trading after the Food and Drug Administration (FDA) rejected its experimental psoriasis treatment lotion Duobrii. While Valeant said that it didn't expect the agency's complete response letter (CRL) to ultimately scuttle the drug's fortunes, investors appeared concerned over a setback that could rankle the firm's attempts to build out a new, successful pipeline following its recent scandals (and massive debt burden). (Fortune)


Doctors' group warns of the health risks of separating children from families. The American Academy of Pediatrics (AAP) is wading into one of the most heated political issues of the day: The separation of migrant children from their families at the border—and the profoundly disturbing health effects such separation could have on the young. "These children have been traumatized on their trip up to the border, and the first thing that happens is we take away the one constant in their life that helps them buffer all these horrible experiences," AAP president Colleen Kraft said during a CNN appearance, adding, "that’s child abuse." Specifically, Kraft noted that this kind of early-age trauma could impede brain development and the ability to effectively develop both physical motor skills and emotional bonds. (The Hill)


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Produced by Sy Mukherjee

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