Gaming Quantity Versus Problematic Gaming in Adolescents And Young Adults: A Systematic Review of Mental Health and Functional Outcomes

Abstract

Public debate about gaming-related harm tends to treat time spent playing as the exposure of interest, yet diagnostic frameworks define gaming disorder through impaired control, increasing priority given to gaming, and interference with everyday functioning. This systematic review compared how gaming quantity and problematic or disordered gaming relate to mental health and functional outcomes in adolescents and young adults. We searched PubMed/MEDLINE on 30 August 2026 using three Boolean queries and retrieved the 50 most relevant records returned by each. Screening covered 95 unique records, of which 27 empirical studies met the eligibility criteria. Because extraction was carried out at the level of published abstracts and no formal risk-of-bias appraisal was undertaken, the evidence was synthesized narratively. Of the included studies, 20 were cross-sectional, six were longitudinal or cohort studies, and one was a case-control study. Across outcome domains, validated problematic-gaming and gaming-disorder measures were associated with depression, anxiety, sleep disruption, aggression, suicidality, and poorer academic or social functioning more consistently than gaming duration alone. In the clearest paired analysis, associations were much larger for internet gaming disorder than for excessive leisure screen time. Direction of effect was another matter: some longitudinal studies linked gaming-disorder symptoms with later adverse outcomes, whereas others found that baseline psychopathology predicted later gaming disorder, or reported effects running in both directions. The distinction between quantity and a pattern of impaired control and functional interference therefore appears clinically meaningful. Conclusions nevertheless remain provisional, given retrieval from a single database with relevance-capped records, screening by one reviewer with automated assistance, and the predominance of cross-sectional designs among the included studies.