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Eur Neuropsychopharmacol. 2018 Nov;28(11):1232-1246. doi: 10.1016/j.euroneuro.2018.08.004. Epub 2018 Oct 10.

Manifesto for a European research network into Problematic Usage of the Internet.

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Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL8 6HG, UK; Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK. Electronic address:
Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
Department of Psychiatry and Mental Health at the University of Cape Town and South African MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa.
Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK.
Connecticut Mental Health Center and Departments of Psychiatry, Neuroscience and Child Study Center, Yale School of Medicine, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Department of Computer Science and Applied Cognitive Science Faculty of Engineering, University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland.
School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
School of Psychology, University of Adelaide, Adelaide, Australia.
Department of Psychiatry, University of Chicago, Chicago, USA.
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.
Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda and CRC "Aldo Ravelli" for neurotechnology and experimental brain therapeutics, Milan, Italy; Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy.
University of Lübeck, Department of Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, Lübeck, Germany.
Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
Department of Psychiatry and Compulsive, Impulsive and Autism Spectrum Program, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
Department of Psychiatry, Academisch Medisch Centrum (AMC), University of Amsterdam, Amsterdam, Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Meibergdreef 9, Amsterdam, Netherlands; Arkin, Amsterdam, The Netherlands.
Department of Psychiatry, Bellvitge University, Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain.
Sackler Medical School, Tel Aviv University, and Chaim Sheba Medical Center Tel Hashomer, Tel Aviv, Israel.
Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
Department of Neuroscience, Imaging, Clinical Science, University G.d'Annunzio of Chieti-Pescara, Chieti, Italy.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada.
Albert Einstein College of Medicine, New York, USA; University of Florence, Italy.


The Internet is now all-pervasive across much of the globe. While it has positive uses (e.g. prompt access to information, rapid news dissemination), many individuals develop Problematic Use of the Internet (PUI), an umbrella term incorporating a range of repetitive impairing behaviours. The Internet can act as a conduit for, and may contribute to, functionally impairing behaviours including excessive and compulsive video gaming, compulsive sexual behaviour, buying, gambling, streaming or social networks use. There is growing public and National health authority concern about the health and societal costs of PUI across the lifespan. Gaming Disorder is being considered for inclusion as a mental disorder in diagnostic classification systems, and was listed in the ICD-11 version released for consideration by Member States ( More research is needed into disorder definitions, validation of clinical tools, prevalence, clinical parameters, brain-based biology, socio-health-economic impact, and empirically validated intervention and policy approaches. Potential cultural differences in the magnitudes and natures of types and patterns of PUI need to be better understood, to inform optimal health policy and service development. To this end, the EU under Horizon 2020 has launched a new four-year European Cooperation in Science and Technology (COST) Action Programme (CA 16207), bringing together scientists and clinicians from across the fields of impulsive, compulsive, and addictive disorders, to advance networked interdisciplinary research into PUI across Europe and beyond, ultimately seeking to inform regulatory policies and clinical practice. This paper describes nine critical and achievable research priorities identified by the Network, needed in order to advance understanding of PUI, with a view towards identifying vulnerable individuals for early intervention. The network shall enable collaborative research networks, shared multinational databases, multicentre studies and joint publications.


Behavioural addiction; Compulsive; Pornography; Problematic internet use; Video gaming

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