Ergenlik Döneminde Problemli Video Oyun Oynama Davranışının Kemik Mineral Dansitesi Üzerine Etkisi

Abstract

Problematic video gaming behavior (PGB) refers to individuals who are at risk but do not fully meet the diagnostic criteria of Internet gaming disorder (IGD) and whose functional impairement has not yet been evident. Bone health might be negatively affected due to factors such as long video game screen time, decreased physical activity, accompanying depressive symptoms, and increased tobacco, alcohol, and caffeine consumption. This study aims to evaluate the effect of PGB on the bone mass of adolescents. Between May 2019 and August 2021, 110 adolescents playing video games for at least two hours, aged 10 to 18 years, who applied to the Hacettepe University İhsan Doğramacı Children’s Hospital adolescent medicine clinic were included in the study. Data about screen time, game genre, and presence of exercise, alcohol, tobacco, drug, and caffeine consumption were recorded. PGB was measured with Internet Gaming Disorder-Short Form (IGDS9-SF), sleep was evaluated with Pittsburgh Sleep Quality Index and depressive symptoms were analyzed with Children’s Depression Inventory. Serum vitamin D levels were analyzed and femoral neck and lumbar spine bone mineral densities (BMD) were measured by dual-energy X-ray absorptiometry. The mean age of adolescents was 14.22±1.78 years, and 86.4% were males. The ratio of adolescents at risk for IGD (IGDS9-SF >16) was 71.8%, and diagnosed with IGD (IGDS9-SF >32) was 10%. The femoral neck BMD (p=0.021) and z scores (p=0.013) of the at-risk group were lower than the controls. The ratio of adolescents with femur z scores lower than -2 and -1 were also higher amongst adolescents at risk. Lumber spine measurements were not different. While the video game screen time and multiplayer online battle arena, action, and strategy game genre ratios were higher in risky adolescents; the recreational screen time other than video gaming was similar between the groups. Depressive symptoms and sleep quality were also poorer among adolescents at risk. Logistic regression analysis revealed that, in addition to PBG, body mass index, total screen time, video game screen time, and multiplayer online and battle royale game genres also have an impact on femoral neck bone mass. Among all risk factors associated with PGB, video game time and exercise amount were the most significant parameters on femoral neck bone mass. In conclusion, this study showed that PGB has a deteriorating effect on femoral neck bone mass by increasing screen time and limiting physical activity. On the other hand, depressive symptoms, sleep quality, and alcohol, tobacco, and caffeine use were not effective. However, the negative impact of IGD-related risk factors might become more prominent in adulthood. The results of this study highlight that adolescents with PGB should be evaluated significantly for lower extremity bone health and supported to decrease sedentary behaviors and increase physical activity.