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As numerous psychological and neurobiological correlates of excessive Internet gaming have been elucidated, such as impulsivity, reward sensitivity, and altered brain structure and function, the revised version of the Diagnostic and Statistical Manual of Mental Disorder, fifth edition (DSM-5) has listed the phenomenon of Internet gaming disorder (IGD) as a condition for further research. Excessive use and loss of control over gaming has brought about various mental health and social concerns. Though gaming is a pleasurable and stimulatory activity, the dark side of excessive gaming is evident as well. According to a Korean national survey conducted in 2016, 67.9% of the general population aged from 10 to 65 years old played online games. Playing online games is one of the most popular recreational activities. Our findings suggest that gaming device usage patterns may be associated with the occurrence, course, and prognosis of IGD. Smartphone only gamers had the lowest prevalence of IGD, spent the least time and money on gaming, and showed lowest scores of Internet and smartphone addiction. These subjects were more prone to develop IGD than reference group (computer only gamers) (B = 0.457, odds ratio = 1.579). Combined users, especially those who played computer and smartphone games evenly, had higher prevalence of IGD, depression, anxiety disorder, and substance use disorder. Data on demographics, gaming-related behaviors, and scales for Internet and smartphone addiction, depression, anxiety disorder, and substance use were collected. Responders of an online survey regarding smartphone and online game usage were classified by different gaming device usage patterns: (1) individuals who played only computer games (2) individuals who played computer games more than smartphone games (3) individuals who played computer and smartphone games evenly (4) individuals who played smartphone games more than computer games (5) individuals who played only smartphone games. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD).
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