Advances in problematic usage of the internet research – A narrative review by experts from the European network for problematic usage of the internet

Naomi A. Fineberg, José M. Menchón, Natalie Hall, Bernardo Dell'Osso, Matthias Brand, Marc N. Potenza, Samuel R. Chamberlain, Giovanna Cirnigliaro, Christine Lochner, Joël Billieux, Zsolt Demetrovics, Hans Jürgen Rumpf, Astrid Müller, Jesús Castro-Calvo, Eric Hollander, Julius Burkauskas, Edna Grünblatt, Susanne Walitza, Ornella Corazza, Daniel L. KingDan J. Stein, Jon E. Grant, Stefano Pallanti, Henrietta Bowden-Jones, Michael Van Ameringen, Konstantinos Ioannidis, Lior Carmi, Anna E. Goudriaan, Giovanni Martinotti, Célia M.D. Sales, Julia Jones, Biljiana Gjoneska, Orsolya Király, Beatrice Benatti, Matteo Vismara, Luca Pellegrini, Dario Conti, Ilaria Cataldo, Gianluigi M. Riva, Murat Yücel, Maèva Flayelle, Thomas Hall, Morgan Griffiths, Joseph Zohar

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Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.

Original languageEnglish
Article number152346
Number of pages24
JournalComprehensive Psychiatry
Early online date16 Aug 2022
Publication statusPublished - Oct 2022


  • Behavioral addiction
  • Compulsive
  • Covid-19 pandemic
  • Gaming disorder
  • Impulsive
  • Patient and public involvement (PPI)
  • Problematic usage of the Internet


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