ObjectivesZZBased on the debate between online game addiction and aggressive behaviors view, the aim of this study was to investigate the factors for aggression in patients with on-line game addiction. MethodsZZA total of 107 adolescent patients with on-line game addiction were enrolled in an online game clinic and research center, OO hospital. In order to rule out psychiatric Axis I comorbidity, all participants were interviewed by a psychiatrist. In addition, their symptoms were assessed using the Young Internet Assessment Scale-Korean (YIAS-K), Korean Attention-Deficit Hyperactivity Disorder (ADHD) Rating Scale, Child depression index, Aggression scale extracted from Korean child behavior checklist, and Behavioral inhibition system (BIS)/Behavioral activation system (BAS). The participants were classified according to three groups ; pure on-line game addiction group (pure-Game), on-line game addiction with attention-deficit hyperactivity syndrome (ADHD-Game) group, and on-line game addiction with depression group (Dep-Game). ResultsZZThirty seven subjects in the pure-Game group, 53 subjects in the ADHD-Game group, and 39 subjects in the Dep-Game group showed significant differences in severity of on-line game addiction and aggression. Both the ADHD-Game and Dep-Game groups showed higher YIAS-K and aggression scale scores, compared to the pure on-line game addiction group. Aggression scale showed positive correlation with BAS-drive in the ADHD-Game group. Aggression also showed positive correlation with BIS in the Dep-Game group. ConclusionZZThe current results suggested that the comorbidity of online game addiction would be a critical factor in aggression and impulsivity in patients with on-line game addiction
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