Abstract: Objective: Internet gaming disorder (IGD) is an emerging psychiatric disorder that has received attention over the past decade. Few studies have attempted to describe this disorder in the Saudi population. This study aimed to examine the prevalence of IGD and associated factors. A cross-sectional study was conducted using translated Arabic and a validated questionnaire targeting both genders in Saudi Arabia. Methodology: A cross-sectional study using a validated questionnaire (IGD-20) and targeting Arabic-speaking children, youth, and transitional age including both genders. A snowball approach was used to sample our population using an electronic survey. Logistic regression was used to examine factors associated with IGD diagnosis. The study was guided by the STROBE statement. Results: Among 419 individuals who participated in the study, 171 were classified as non-IGD, 167 were at risk for IGD (RIGD), and 72 were IGD. There is no significant association between IGD diagnosis and gender, nationality, residence, and family income. Time playing per week was significantly associated with IGD diagnosis (X2=49.256, p<0.01). There is a significant association between IGD-20 groups and categorical age groups (X2=10.096, p<0.01). Among our sample, the percentages of males (54.2%) and females (45.8%) who met the criteria for IGD were comparable. Conclusion: IGD and RIGD prevalence was significantly high in both age groups. Both males and females were affected similarly.

The mechanism of immune activation and de-activation is very important. Host should trigger effective immunity against pathogen infection. And, host cannot trigger immunity against self-antigens that will lead to detrimental autoimmune disorders. Spleen and liver have opposite roles in mediating immune responses. Spleen is the organ involving in immune activation, and liver is the organ involving in immune de-activation. Sympathetic nerve system and parasympathetic nerve system have opposite roles in mediating immune responses. Sympathetic nerve system is involving in pro-inflammatory, and parasympathetic nerve system is involving in anti-inflammatory. ACTH and glucocorticosteroid have opposite roles in mediating immune responses. ACTH is involving in activating adaptive immunity with inhibiting innate immunity, and glucocorticosteroid is involving in activating innate immunity with inhibiting adaptive immunity. The molecular chaperons, heat shock proteins, which are induced by fever, have the vital roles in immune activation. On the contrary, IgD B cells and gamma-delta T cells are causing immune de-activation via the mechanism of clonal anergy. These mechanism can help us the know the work of immunological pathways better for better control of infectious diseases and autoimmune disorders.