The mitigation of COVID-19's transmission prompted nations to implement closures of educational establishments, including schools. Consequently, the conventional in-person instructional techniques underwent a transformation into virtual online education, necessitating extended durations of screen exposure. Concurrently, children and adolescents increasingly turned to digital devices for recreational and social purposes [22]. This surge in screen time has significant adverse implications for the physical and mental well-being of young individuals. These repercussions encompass disruptions in sleep patterns and psychological equilibrium, an escalation in sedentary behaviors coupled with diminished physical activity, and a potential detrimental impact on ocular health [23]. Comparatively, the extent of the rise in non-academic screen time in our study appeared to surpass that reported in some studies conducted in Singapore, the USA, and China [24]. This discrepancy could be attributed to a range of factors, including variations in educational policies, cultural attitudes toward technology, and the availability of digital infrastructure. Moreover, the dynamic nature of the pandemic, including fluctuating infection rates and the evolving impact on daily life, adds an additional layer of complexity to the comparative analysis.

The imposition of home confinement measures, including the closure of educational institutions, has directed the focus of children toward indoor pursuits, particularly the engagement in electronic video gaming. In the present study, a noteworthy escalation in the duration spent on video gaming was observed during the period of closure, supporting the findings of previous studies [19, 25]. Early in the course of the pandemic, the hashtag “Play Apart Together” garnered widespread attention, gaining prominence as part of a campaign endorsed by the World Health Organization (WHO) in collaboration with major gaming industries. This initiative encouraged video gaming to foster social connections while adhering to physical distancing recommendations [26]. Notably, discussions emerged around whether this campaign signaled a change in WHO's perspective on gaming disorders. More recently, the WHO's “Healthy At Home” campaign highlighted the significance of maintaining an appropriate balance between online activities, including video games, and offline pursuits [27]. Despite the potential merits associated with video gaming, excessive gaming is time consuming and has deleterious implications for health. A new term “videogame vision syndrome” has been introduced to specifically address vision issues related to long periods of continuous use of screen-enabled devices to play videogames [17].

The observed prevalence of 8.6% indicates that an unignorable portion of students aged 8–15 years within the sample meets the criteria for IGD. This figure emphasizes the significance of IGD as a pertinent issue affecting a considerable segment of children and adolescents. This finding aligns with prior research studies that have highlighted the growing concern of excessive internet-based activities, particularly in the context of gaming, among adolescents [28, 29]. However, it is crucial to approach these findings with caution due to the methodological variability in assessing gaming addiction.

Our findings indicate a higher propensity for the development of Internet Gaming Disorder (IGD) among male students in comparison to their female counterparts, aligning with established literature on the subject. This observation supports the notion that gender may play a role in susceptibility to IGD [30, 31]. However, it is important to note that this gender difference was not observed in our multivariate regression analysis, indicating that when controlling for other variables, the direct effect of gender on IGD may be less pronounced or potentially mediated by other factors. On the other hand, male gender was found as a significant predictor in other studies [32]. The greater likelihood of males developing gaming addiction in comparison to females observed in the literature can be partially attributed to gender-related variations in neural responses to cravings, a significant precursor to addictive behaviors. Previous research has revealed that neural activations linked to cravings, such as in the insula and dorsolateral prefrontal cortex, show gender-specific differences, that are particularly evident in substance addictions like cocaine and gambling, suggesting distinct underlying mechanisms that might contribute to addictive tendencies in males and females [33]. This trend could also be elucidated by considering the prevalent competitive nature of video games, which tends to be more appealing to boys than girls [34].

Remarkably, expatriate students demonstrated a higher likelihood of developing Internet Gaming Disorder (IGD) in comparison to their local Qatari counterparts in this study. This contrast could be attributed to several factors, including potential differences in cultural backgrounds, social support systems, and coping mechanisms. Expatriate students often come from diverse cultural backgrounds, which may influence their leisure activities and coping strategies. The role of video games in their home cultures, along with varying norms and attitudes toward gaming, could contribute to higher engagement in gaming as a familiar and accessible form of entertainment in a foreign setting. Moreover, the transition to a new country often disrupts traditional social networks, leaving expatriate students more reliant on virtual communities for social interaction. Online gaming platforms can offer a sense of community and belonging, potentially leading to increased gaming time as a substitute for real-world social interactions. It is expected that expatriates may face unique stressors such as homesickness, cultural adjustment challenges, and academic pressures in an unfamiliar environment. Gaming might serve as an escape mechanism, providing relief from these stressors but also increasing the risk of developing IGD. Additionally, the language barrier, a significant challenge for many expatriates, may have been less of an impediment in the gaming context, further encouraging engagement in online gaming activities. The lack of direct family supervision or guidance, particularly for those expatriates living away from their families, might have also contributed to less regulated gaming habits. Expatriate students may face challenges such as feelings of isolation due to being away from their home country particularly in the setting of travel restrictions imposed during the pandemic, leading them to turn to online gaming as a means of connection and stress relief. Further research is warranted to thoroughly investigate the underlying dynamics driving this divergence in IGD susceptibility between expatriate and local students.

A recent meta-analysis conducted globally demonstrated an inverse linkage between IGD and individuals' emotional well-being [35]. These findings suggest that individuals susceptible to IGD tend to exhibit heightened levels of loneliness, sleep disturbances, and compromised concentration [36]. Furthermore, such individuals are more likely to engage in aggressive behaviors, display impulsivity, and demonstrate inclinations toward self-harm [36]. While these observations are globally recognized, their implications in the local and regional context of our study, particularly in the Middle East, warrant further discussion.

In our region, the unique social, cultural, and economic dynamics may exacerbate these mental health challenges associated with IGD. Factors such as social isolation, which can be intensified by cultural integration challenges faced by expatriate populations, and the rapid pace of modernization impacting traditional social structures, are likely to contribute to the heightened levels of loneliness and sleep disturbances observed [37]. Additionally, regional differences in the perception and handling of mental health issues could influence the manifestation and recognition of symptoms like aggression and impulsivity, which are associated with IGD [38].

The impact of these regional factors is particularly pertinent considering the backdrop of the COVID-19 pandemic, which has further amplified issues of social isolation and disrupted traditional support systems. This context provides a critical lens through which to interpret the global findings on IGD and emotional well-being, stressing upon the need for region-specific strategies in addressing these challenges.

In order to address the issue of IGD, it is imperative to adopt a multifaceted approach involving various stakeholders, as suggested by the WHO [39]. Parents and guardians, as primary caregivers, should empower children with information on safe online practices and encourage a balanced blend of online and offline activities. In Bangkok, a school and family-based intervention program significantly reduced gaming addiction in 4th and 5th graders, with an 8-week curriculum focusing on self-regulation, parental guidance, and teacher training [40]. Clear rules and boundaries regarding screen time usage should be established, alongside the installation of appropriate software safeguards on devices and the encouragement of physically active gaming experiences. A recent study evaluating apps designed to reduce mobile phone use demonstrated that features like self-tracking, goal setting, and usage limits were effective in managing phone usage and preventing maladaptive behaviors [41]. Health and social care providers play a crucial role in disseminating information about the risks associated with excessive screen time or gaming to families. Regular assessments should incorporate considerations of screen time and video gaming habits, alongside the provision of psychological support and counseling for those dealing with gaming disorders.

Digital technology and gaming companies can contribute by incorporating safety features and parental controls into their products. Furthermore, they should consider the development of gaming programs that encourage physical activity, thereby promoting healthier gaming habits. The use of active video games, or exergaming, can effectively enhance physical activity in adolescents, offering a more acceptable and sustainable alternative to traditional methods [42]. Moreover, it can reduce both the body mass index percentile and total cholesterol in overweight and obese adolescents [43]. By prioritizing balanced screen time, implementing protective measures, and offering psychological support, a comprehensive approach can mitigate the negative consequences of excessive online gaming, thereby fostering healthier digital engagement and overall well-being among children and adolescents.