DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.012

Pages: 2717-2721

Introduction: Autism Spectrum Disorder (ASD) is characterized by difficulties in social communication and the presence of restricted and repetitive interests (RI). Video game use is frequent in this population, raising the question of whether it constitutes a behavioral addiction or the expression of a typical RI of ASD. Case report: M.S., 17 years old, diagnosed in childhood with ASD and normal intelligence, was brought to consultation for irritability, social withdrawal, and school absenteeism, linked to an almost exclusive investment in mobile video games. The initial presentation suggested video game addiction, with several criteria present (preoccupation, loss of control, irritability upon cessation, interference with daily life). A depressive syndrome was observed during the psychiatric interview. After multidisciplinary follow-up and treatment with sertraline 50 mg/day, mood improvement and progressive cessation of gaming were observed after four months. This evolution led to reconsidering the behavior as a restricted interest rather than an addiction. Discussion: The distinction between video game addiction and restricted interests in ASD remains complex. Intensive gaming behaviors may reflect a search for predictability, structure, and sensory stimulation, characteristics of RIs, rather than pathological loss of control. Studies show that adolescents with ASD, especially at a high functioning level, have an increased risk of excessive use, often modulated by comorbidities such as ADHD and mood disorders. Individualized assessment, integrating cognitive, emotional, and familial dimensions, is therefore essential to differentiate addiction from RI. Conclusion: This case illustrates the clinical difficulty of distinguishing a restricted interest from an addiction in adolescents with ASD. Favorable evolution under treatment and follow-up supports the hypothesis of an exacerbated RI rather than an addictive disorder.