Pathological media use (PMU) seems to emerge as a major mental health problem in children and adolescents.

Although not yet broadly recognised by addiction research, there exist clinical and neurobiological implications, that PMU resembles classical adolescent addiction patterns such as with marihuana or alcohol.

As part of either the dependency or of the out-patient psychotherapy programs in a large mental hospital covering inner-city Berlin a diagnostic and treatment system was established in April 2009 for internet addicted youth.

From 4–9/2009 we could administer 27 severe male “PMU”-cases with all signs of clinical dependency, both neuropsychological and somatic, including cardiovascular problems, severe craving and pseudo-hallucinations. 12 patients showed severe identity conflicts apart from their psychiatric disorders and chronic family conflicts.

There seems to be a small but severely ill subgroup of multiple media users that develop social isolation, craving and other features of addiction.

Using the clinical diagnosis PMU offering an out-patient approach must consider severe chronic intrapsychic conflict as well as psychiatric disorders.

Obviously intense research as well in epidemiology as in clinical treatment is needed in this worldwide broadening area.