The COVID-19 pandemic has a significant impact on various aspects of human life worldwide, including psychological health, as reported in almost all countries (1, 2). The Arab nations are among the populations affected by poor mental health (3, 4). As of June 2020, the Centers for Disease Control and Prevention (CDC) reported that approximately one-third of individuals in the US suffer from depression or anxiety (5). Among young people, the incidence of mental health issues has increased dramatically over the last decade, with nearly 60% of those between the ages of 18 and 24 considered at risk for anxiety or depression, and 25% expressing suicidal ideation in the past month, compared to 11% of all individuals in 2019 (6, 7). These rates represent a substantial increase in depression, coinciding with the implementation of stay-at-home orders, campus closures, and social distancing measures, which have significantly disrupted daily life and interactions (8, 9).

To mitigate the impact of the pandemic on mental health, the World Health Organization (WHO) has recommended video games as part of its “Healthy at Home” program (10). However, excessive gaming may pose a risk to vulnerable individuals, including minors and those with gaming disorders (11). The pandemic has made it difficult to detect harmful effects such as harm to mental health or sleep patterns, as work and school have shifted to home-based practices (12).

Moreover, prolonged stress during the pandemic may lead to significant emotional distress, including anxiety and depression (13, 14). Although online games can help individuals deal with unpleasant emotions, greater involvement may make them more susceptible to Internet Gaming Disorder (IGD) (12, 15, 16). According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria, IGD is characterized by excessive and prolonged internet gaming, which leads to behavioral and cognitive symptoms such as progressive loss of control, tolerance, and withdrawal symptoms, similar to substance use disorders (17). IGD is associated with poorer mental health, sleep quality, interpersonal problems, and academic achievement, and is linked to lower quality of life (18).

This aim of this study is to assess the impact of the COVID-19 pandemic on the prevalence of IGD and SPS among online gamers in the Arab world as well as dentifying risk factors for IGD negative consequences associated with these disorders.

The present study investigated the relationship between sociodemographic factors and both Internet Gaming Disorder (IGD) and Social Phobia Scale (SPS) scores among gamers. The findings suggest that sociodemographic factors play an important role in predicting levels of IGD and SPS, indicating the complex and multifaceted nature of these conditions.

In terms of IGD, the study found that daily playing hours and following streamers were significant predictors of high levels of internet addiction. These findings suggest that certain behaviors, such as excessive gaming or following online influencers, may lead to increased risk of developing IGD. It is important to note that excessive gaming has been associated with a range of negative outcomes, including poor academic performance, social isolation, and decreased physical activity. As such, clinicians should be aware of the potential risks associated with excessive gaming and work with patients to establish healthy gaming habits.

The study also found that sociodemographic factors, such as nationality and the impact of COVID-19 on gaming attitudes, were significant predictors of IGD. Specifically, individuals from Egypt and those who reported a significant increase in gaming time due to the pandemic had the highest IGD scores. The COVID-19 pandemic has led to significant changes in daily routines and social interactions, and as such, it is not surprising that there has been an increase in gaming activity. However, clinicians should be aware of the potential negative impact of increased gaming on mental health and wellbeing.

In terms of SPS, the study found that gender, nationality, and daily playing hours were significant predictors of high levels of social phobia. These findings suggest that there may be a complex interplay between gaming behavior, social anxiety, and sociodemographic factors. Social phobia can be a debilitating condition that can significantly impact an individual’s quality of life. As such, clinicians should be aware of the potential risk factors associated with social phobia, such as excessive gaming and certain sociodemographic factors.

Overall, the present study highlights the complex and multifaceted nature of IGD and social phobia. The findings suggest that sociodemographic factors play an important role in predicting levels of these conditions, and as such, clinicians should take into account the individual’s sociodemographic background when assessing and treating these conditions. Additionally, it is important for clinicians to be aware of the potential negative impact of excessive gaming and work with patients to establish healthy gaming habits.

The findings of this study have important theoretical implications for the field of psychiatry. The diagnostic criteria for Internet Gaming Disorder (IGD) according to the DSM-5 are based on the presence of symptoms such as preoccupation, withdrawal, tolerance, loss of control, giving up other activities, continuation, deception, escape, and negative consequences (21). Our study found that the COVID-19 pandemic has led to an increase in dependency and tolerance towards gaming, which is consistent with the definition of IGD as a progressive loss of control over gaming, tolerance, and withdrawal symptoms. Additionally, our patients reported a cluster of behavioral and cognitive symptoms associated with IGD, including increased social phobia scores, anxiety, nervousness, and loss of self-confidence (22–24).

Although gaming can be a healthy way to relieve stress in the moment, it should not be used as a long-term solution (25, 26). Developing a gaming disorder or other related issues can arise if it becomes a habit rather than a means of relieving pressure (27, 28). Due to the infeasibility of many contingency plans during the COVID-19 pandemic, the maladaptive use of gaming has increased in frequency (15, 29–32). The increased dependency on playing video games during the pandemic observed in our study agrees with reports from other populations (15, 29–32).

We found that increasing playing hours was associated with increasing social phobia scores and aggravating the severity of social phobia (24). Moreover, the onset of playing video games at a younger age is strongly associated with an increased risk of developing social phobia and IGD (33, 34). Our results also revealed that increasing playing time was associated with a higher IGD score, as reported previously (24). However, we observed a worsening in IGD scores in participants who played for a long time due to COVID-19 and in participants with increasing dependency on gaming due to isolation, which is consistent with observations from other studies in different populations (35–38).

This study’s practical implications highlight the need to monitor the increasing prevalence of IGD since the beginning of COVID-19, as it can cause further damage to the psychosocial situation, which is already damaged by the pandemic (1, 5, 13, 30). The results of our study contradict the World Health Organization’s advice to the general population to play video games to reduce COVID-19’s psychosocial effects (10).

The present study adds to the growing body of literature on the impact of COVID-19 on mental health and online gaming behavior. Our findings suggest that the COVID-19 pandemic has led to an increase in online gaming activities, and this increase is associated with an increased risk of developing IGD and social phobia symptoms. Therefore, it is crucial to address this issue and provide adequate support to individuals who are at risk of developing IGD. Future studies should investigate the long-term impact of the pandemic on gaming behavior and the effectiveness of different interventions in mitigating the risk of IGD. Overall, this study highlights the importance of recognizing the potential negative impact of COVID-19 on mental health and emphasizes the need for proactive measures to address this issue.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving human participants were reviewed and approved by Ethics Committee, Faculty of Medicine, Alexandria University. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

AS and NS contributed equally to the conceptualization, methodology, formal analysis, writing-original draft, review, editing, and data collection. ME, OA, AM, SaS, AR, MM, AZ, and ShS contributed to writing-review and editing. All authors contributed to the article and approved the submitted version.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1071764/full#supplementary-material