I own gizmos, lots of them, and have been deeply involved with technology since my childhood. I’ve sold, programmed, gamed on and constructed computers. I have also studied them: prior to becoming a psychiatrist, I was an engineer. Even before I knew Id from Ego, it was blatantly obvious that technology affected people in deep ways – ways that we had little understanding of. It has been about 30 years since the personal computer was widely introduced into people’s lives – 30 years of a grand social experiment, now in almost every society across the globe. And yet, we still have but a crude understanding of how technology impacts people. What does it do to their relationships, to their sense of self? Since I became a physician more than a decade ago, I’ve been interested in that question.

In the United States, an average of nine computer games are sold every second, every day, 365 days a year. In a nation of 300m people, around 200m play computer and console games. The typical gamer is older than many imagine: 35 years old, according to the industry trade group the Entertainment Software Association. But the future is in the children. “When kids get to the six- to eight-year-old age range is when we see them turn into more serious gamers,” says Anita Frazier, a market research analyst for the NPD Group. “This appears to be a critical age at which to capture the future gamers of the world.”

Capture indeed. In the US, around 2 per cent of the gamers – that is, 4m people – are heavy users. They average around 40 hours a week, some playing less, some much more. One out of three gamers – 66m people – play around 20 hours each week. It is people like these who helped generate a record $18bn (£9.1bn) in US sales last year.

If a physician in Europe or the United States learned that you game on computers for 40-plus hours a week, they would probably be baffled. Dealing with such matters is not part of our training. In Asia, however, you would probably get a psychiatric diagnosis. Because of public health efforts and widespread media reporting, doctors in Asia recognise excessive computer use as a serious issue. There have been three high-profile game-related murders in China, Vietnam and South Korea, where people have killed over virtual objects or access to computers. More importantly there have been 10 natural deaths in young men who were gaming for 60 hours and more in public nternet cafés. It appears that, as with long aeroplane travel, sitting for hours in front of a computer may cause blood to coagulate. The resulting blood clot, if it travels to the lungs, can kill. Of greatest concern, though, is an epidemic in NEETs – people not in education, employment or training. Adolescents and young men (the vast majority of excessive use occurs in males) are simply dropping out of society and living virtually.