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 Table of Contents  
Year : 2021  |  Volume : 26  |  Issue : 2  |  Page : 161-163

Esport: Is it a sport or clinical entity?

1 Department of Clinical Psychology, SHUT Clinic( Service for Healthy Use of Technology), Bengaluru, Karnataka, India
2 Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India

Date of Submission22-Feb-2021
Date of Decision13-May-2021
Date of Acceptance29-May-2021
Date of Web Publication02-Feb-2022

Correspondence Address:
Manoj Kumar Sharma
Service for Healthy Use of Technology Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmhhb.jmhhb_36_21

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Esports is being seen as equivalent to sport. Subsequent to diagnostics started treating gaming as mental health condition or a research category. The need is being felt to explore the mental health perspective of Esports. Thus, for people who are engaged in Esports, there is a possibility that they may develop certain physical or mental health concerns if the gaming pattern is problematic. It implies the need for research to identify the status of their clinical condition or a career option as a sport player.

Keywords: Esports, mental health, research, sport

How to cite this article:
Thakur PC, Sharma MK, Sagar Kommu JV, Anand N. Esport: Is it a sport or clinical entity?. J Mental Health Hum Behav 2021;26:161-3

How to cite this URL:
Thakur PC, Sharma MK, Sagar Kommu JV, Anand N. Esport: Is it a sport or clinical entity?. J Mental Health Hum Behav [serial online] 2021 [cited 2023 Mar 28];26:161-3. Available from: https://www.jmhhb.org/text.asp?2021/26/2/161/337171

  Introduction Top

Esports, a short form of “electronic sport,” variant of video gaming that is collaborative and competitive and popular gaming culture among young adults and adolescents. Nowadays, youths are drawn toward esports as a professional endeavor to generate income. Esports has a global audience of 453 million in 2019[1] growing every year which is broadcasted through live-streaming platforms (Twitch, YouTube) with amateur and professional players participating in it. The events have considerable prize money of 100–200 million dollar[2] that lures amateur players to pursue it professionally. The global revenue generated is in billion dollars thereby making it a profitable scheme for gaming developers and shareholders and a good platform for business investment. As a result, esport events are highlighted by commercial organizations to attract audiences.

Pro-gamers versus amateur gamers

Professional gamers (pro-gamers) playing esports need to have certain attributes that distinguish them from casual gamers. For successful performance, knowledge of the game, quick and strategic decision-making, positive attitude, focused attention, proper communication among teammates, and trust among members are required.[3] Specific skills such as refined motor movements, hand-eye coordination and consistent practice, along with quality of coping with adversity, separating daily life from gaming and warm up before performance is utmost important. The motivation for playing among professional and casual gamers also differed where in the former played for competition and the latter mostly for leisure and relaxation.[4]

Esports as a formal sport

Any sports involve voluntary play comprising skills and the events are organized and governed by rules involving competition with the outcome of a winner and loser. Corresponding to this definition, esport tournaments are competitive events where teams or players fight for victory determined through given points system.[5] Esports and established sports have underlying psychological similarities as athletes from both domains need high level of sustained attention and have to make important decisions under time constraints. Several organizations, like the International e-Sports Federation, exist like any other federal organization of a recognized sport that regulates and stabilizes the rules of the game. Countries such as USA, China, Korea, and Hong Kong provide active government support for Esports, and China has even hold a formal Esport event in 2018 Asian Games.[2]

Arguments against esports as a sport

Many experts disagree regarding the view of integrating esports into existing sport organizations. One critique from organizational perspective is that game settings are designed by gaming companies allowing sport federation to have limited freedom over the rules and rendering them less authority. Furthermore, the fact that game publishers earn money from the competitions is not compatible with the core purpose of any sporting organization that the revenue generated should be in the interest of the organization.[6] Esports was being considered as a potential event in the 2024 Olympics, but the proposal was rejected citing the violent features of the video games.[7] Other argument against Esports as a sport is that it takes place in a virtual platform, represented by Avatars controlled by players rather than players actually doing physical movement or competitive actions.[6] Such characteristics are contrary to the norms of mainstream sports.

When gaming becomes problematic

Gaming becomes a concern when it follows a pattern reflecting impaired control, precedence over other interests and basic daily living activities as well as impairment in personal, family, educational, occupational, and other important areas of functioning.[8] Researches establish that problematic gaming can result in several negative physical and psychosocial consequences such as obesity, sleep disruption, increased aggression, along with that there might be cessation of hobbies, social isolation, worsened relationship with parents over time, academic decline, decreased life satisfaction, and attention problems.[9] Other associated psychological factors can be depression, impulsivity, and poor quality of interpersonal relationships.[10] Both diagnostic systems, DSM and ICD in their latest editions, respectively, have recognized gaming disorder as a clinical condition that requires further empirical evidence.[11],[12] Further, DSM-5 has considered Internet Gaming Disorder having addictive features and proposes to categorize it as “Nonsubstance related addictions” based on available data on upcoming research.[13]

Probable harms due to esports

The promotion of gaming activity in the name of Esports warrants examining whether this phenomenon is leading to an increase in problematic gaming. The present literature mentioned limited number of researches regarding potential harms associated with Esports, however, few media publications reported common hazards related to gaming such as musculoskeletal problems, visual disturbance, carpel tunnel syndrome, deep vein thrombosis due to continuous clicking on mouse, and mental fatigue.[14] To perform better in tournaments, professional players spend around 12–15 h training on the game without much gross motor movements. Due to lack of physical activity and sedentary lifestyle, risk of obesity also increases among players. Since younger players are more at advantage in Esports owing to their age and reflexes, early initiation into game training is observed, which might result in neglect of academics and school dropout.[2] Thus, uncertain career path in esports and low educational level might lead to probable hampering of life. The common psychological issues found among Esport players are depression, aggressive behavior and hostility, psychological and social stress, sleep disturbance, emotional problem,[15] and lowered psychological well-being.[16] Gaming disorder as per DSM 5 is proposed to be categorized as nonsubstance-related addiction/behavioral addiction that needs more research consideration. There are data available that all addictive disorders have the same neurocircuitry as any other substance-related addiction. Hence, there might be association between gaming problem and substance use. Esports is medium to promote online gaming, and thereafter, it depends upon the psychological profile of the gamers that what pattern of gaming they choose to play healthy or unhealthy.

Is esports a sport

The purpose of this article is to address the main question which is of two-fold – “Whether Esports can be considered a sport or it is an induction to clinical entity?.” For the first part, literature shows that there is still an open and ongoing debate on whether Esports can be considered a sport. Esport athletes are disciplined skilled players and the manner in which Esports are organized makes it very comparable to a sport event. However, certain inherent features of video gaming such as virtuality, violent content, and esport being a huge business avenue stand as a barrier for yielding it a “Sport” status. PlayerUnkown Battlegrounds (PUBG) is a famous multiplayer online game and many people play this game. Some play it as a casual activity but some play it on a competitive level. Hence, PUBG itself is not an esports. However, when it is played as a tournament, the whole event is Esports which involves playing PUBG. Same as cricket or kabaddi, both of them can be played casually among friends as a street-based game but when played on a competitive level, it becomes sports. Nonetheless, empirical studies applying the tools and methodologies of sport psychology are required to find the position of Esports in the domain of sport activities. The response to the second concern of whether Esports leads to clinical condition is met with the barrier of significant dearth in literature related to studies on psychosocial impact of playing Esports, psychological vulnerability of Esport players and whether the training process leads to addictive pattern among players. We conclude that gaming activities are promoted under the branding of “Esports” and it is practical to expect increased problematic gaming as a result of such promotions. However, it does not imply that all Esport players have gaming disorder. Moreover, pro-gamers are disciplined and adopt healthy measures to improve their performance,[2] yet not every amateur gamer aspiring to play Esports might be able to follow such healthy pattern. Hence, as reported in several studies, a large proportion of young players are exhibiting problematic gaming behaviors and it can be inferred that popularization of gaming culture has led to an increasing demand for treatment services for gaming addiction. Further, this acknowledgment justifies the requirement of empirically testing the gaming behaviors of youth who are involved in Esports.

Perspective form tertiary specialty service

An increasing trend in tertiary specialty clinic treating addictive gaming has been observed, wherein parents bring their adolescent children for gaming-related behavior. On the one hand, the teenagers feel that they are doing well and do not see the gaming as problematic. They perceive it as one of the career opportunities and treat it as technology version of sport. They do acknowledge certain problematic symptoms related to gaming such as continuous craving to play or watch gaming videos, sleep disturbance, unstructured daily schedule, academic decline, and marked irritability when interrupted during gaming. The mentioned behaviors also corroborate with given criteria for gaming disorder, but they rationalize this pattern to improve their gaming skills. The parents on the other hand are completely distressed and worried about the gaming behaviors and observed dysfunctions. The families report significant interpersonal distress due to their inability to manage the user's interest in Esport as well as whether the observed interest will make them gaming addict. It definitely poses a challenge for psychotherapist to guide for lifestyle changes and garner ways to limit this interest from becoming pathological. As overall research on Esports is limited, the researcher could not find any literature comparing Indian and Western gamers. However, as per researcher's understanding based on reading interviews of gamers, very few Indian gamers become successful due to parental constraints and society's emphasis on education.

  Conclusions Top

The commercially driven propaganda of Esports attracts many teenagers into it, however, very few among them might have the potential to master the skills required. As a result of their investment in gaming, they might develop unhealthy habits and neglect their academics which might lead to probable failure in life and associated distress. Thus, for people who are engaged in Esports, there is a possibility that they may develop certain physical or mental health concerns if the gaming pattern is problematic. Thus, an extensive research focusing on the gaming pattern of Esport players is imperative need of the hour to identify the status of their clinical condition or the feasibility of playing Esports as a career option.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Global Esports Market Report; 2019 July, 06. Available from: https://strivesponsorship.com/2019/06/18/newzoo-global-esports-market-report-2019/. [Last accessed on 2020 Jul 20].  Back to cited text no. 1
Chung T, Sum S, Chan M, Lai E, Cheng N. Will esports result in a higher prevalence of problematic gaming? A review of the global situation. J Behav Addict 2019;8:384-94.  Back to cited text no. 2
Bányai F, Griffiths MD, Király O, Demetrovics Z. The psychology of esports: A systematic literature review. J Gambl Stud 2019;35:351-65.  Back to cited text no. 3
Vorderer P, Hartmann T, Klimmt C. Explaining the enjoyment of playing video games: The role of competition. In: Paper Presented at the Proceedings of the Second International Conference on Entertainment Computing. Pittsburgh, Pennsylvania, USA: Association for Computing Machinery; 2003.  Back to cited text no. 4
Guttmann A. From Ritual to Record: The Nature of Modern Sports. New York: Columbia University Press; 2004.  Back to cited text no. 5
Thiel A, John JM. Is eSport a 'real' sport? Reflections on the spread of virtual competitions. Eur J Sport Soc 2018;15:311-5.  Back to cited text no. 6
Moosa, T. ESports are Real Sports. It's Time for the Olympic Video Games | Tauriq Moosa. Available from: https://www.theguardian.com/commentisfree/2017/aug/11/esports-olympic-video-games-ioc-gaming. [Last accessed on 2020 Jul 20].  Back to cited text no. 7
Nielsen RK, Karhulahti VM. The problematic coexistence of internet gaming disorder and esports. In: Proceedings of the 12th International Conference on the Foundations of Digital Games-FDG'17; Hyannis, Massachusetts. USA: ACM Press; 2017. p. 1-4.  Back to cited text no. 8
Sharma M, Archana R, Kumar K, Marimuthu P. Internet gaming disorder and psychiatric symptoms in BENGALURU, India: Treatment implication for promotion of user mental health. Indian J Soc Psychiatry 2019;35:135.  Back to cited text no. 9
Stevanovic D, Djoric A, Balhara Y, Cirovic N, Arya S, Ransing R, et al. Assessing the symptoms of internet gaming disorder among college/university students: An international validation study of a self-report. Psihologija 2020;53:43-63.  Back to cited text no. 10
American Psychiatric Association [APA]. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.  Back to cited text no. 11
WHO. Gaming Disorder; 2016. Available from: http://id.who.int/icd/entity/1448597234. [Last accessed on 2020 Jul 20].  Back to cited text no. 12
Grant JE, Chamberlain SR. Expanding the definition of addiction: DSM-5 vs. ICD-11. CNS Spectr 2016;21:300-3.  Back to cited text no. 13
Schütz M. Science Shows that eSports Professionals are Real Athletes: DW; 12.03.2016. Available from: https://www.dw.com/en/science-shows-that-esports-professionals-are-real-athletes/a-19084993. [Last accessed on 2020 Jul 20].  Back to cited text no. 14
Palanichamy T, Sharma MK, Sahu M, Kanchana DM. Influence of Esports on stress: A systematic review. Ind Psychiatry J 2020;29:191-9.  Back to cited text no. 15
  [Full text]  
Kocadağ M. An eSport research: Psychological well-being differences of teenagers in terms of several variables. Psychol Res Educ Soc Sci 2020;1:31-9.  Back to cited text no. 16


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