Diagnóstico de la Adicción a Internet

At present, "Internet addiction" is not recognized as a mental disorder in the diagnostic manuals of the World Health Organisation (ICD-11) and the United States (DSM-5). Only some of its variants have been considered in these manuals due to their prevalence in recent years. In 2013, the DSM-5 recognized ‘Internet Gaming Disorder’ as a condition for further study, and subsequently, in 2019, the 11th edition of the International Classification of Diseases (ICD-11) included ‘Gaming Disorder’ (online or offline) as a diagnostic category.

There are also recognized addictions that may manifest through the Internet, such as gambling disorder or compulsive sexual behaviour disorder.

Other addictive screen-based behaviours (e.g., those related to social networks, online shopping or internet browsing) are currently under study for potential inclusion as “mental disorders”. Thus, they can be defined only as “problematic behaviours” rather than given a clinical diagnosis of “addiction”.

At this time, the following diagnoses related to addictive behaviours are recognized: 

• Gaming disorder (online and offline) (CIE-11).
• Gambling disorder (CIE-11), which may manifest through the Internet.
• Compulsive sexual behaviour disorder (CIE-11), which may manifest through the Internet.

For excessive or problematic Internet use to be considered “pathological” or “addictive”, the following criteria must be met:

• Significant impairment in daily functioning and adjustment to everyday life due to these behaviours. For example, a significant decrease in school performance, domestic conflicts, social isolation or work absenteeism, as well as the person being unable to control these behaviours despite being aware of these negative consequences. 
• Duration of this behaviour must be at least 12 months, although a shorter period may be sufficient in minors and adolescents. 

In all cases, the diagnosis is clinical, and there are no additional tests to confirm or deny it. These tests are performed only if other comorbidities are suspected and they are considered necessary.

Validated questionnaires are available for the early detection of compulsive or addictive use of internet-connected screens. 

One of the most commonly used is the CIUS (Compulsive Internet Use Scale). This is a scale of 14 items with a possible total of 56 points, in which a score greater than or equal to 28 indicates a risk of addiction. When this score is exceeded, it is advisable to consult a health professional, who can provide initial guidance; assess the presence of other common disorders or risk factors; and, if necessary, refer the patient to mental health or addiction services.