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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Dec 20, 2019
Open Peer Review Period: Dec 20, 2019 - Feb 14, 2020
Date Accepted: Jun 3, 2020
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Associations of Internet Addiction Severity With Psychopathology, Serious Mental Illness, and Suicidality: Large-Sample Cross-Sectional Study

Guo W, Tao Y, Li X, Lin X, Meng Y, Yang X, Wang H, Zhang Y, Tang W, Wang Q, Deng W, Zhao L, Ma X, Li M, Chen T, Xu J, Li J, Hao W, Lee S, Coid JW, Greenshaw AJ, Greenshaw A, Li T

Associations of Internet Addiction Severity With Psychopathology, Serious Mental Illness, and Suicidality: Large-Sample Cross-Sectional Study

J Med Internet Res 2020;22(8):e17560

DOI: 10.2196/17560

PMID: 32780029

PMCID: 7448182

Internet addiction severity is strongly associated with psychopathology, serious mental illness and suicidality: a large-sample cross-sectional study

  • Wanjun Guo; 
  • Yujie Tao; 
  • Xiaojing Li; 
  • Xia Lin; 
  • Yajing Meng; 
  • Xia Yang; 
  • Huiyao Wang; 
  • Yamin Zhang; 
  • Wanjie Tang; 
  • Qiang Wang; 
  • Wei Deng; 
  • Liansheng Zhao; 
  • Xiaohong Ma; 
  • Mingli Li; 
  • Ting Chen; 
  • Jiajun Xu; 
  • Jing Li; 
  • Wei Hao; 
  • Sing Lee; 
  • Jeremy W. Coid; 
  • Andrew J Greenshaw; 
  • Andraw Greenshaw; 
  • Tao Li

ABSTRACT

Background:

Internet addiction (IA) has become a major global concern and a burden on mental health. However, there is a lack of consensus on its link to mental health outcomes.

Objective:

To investigate the associations between detailed internet addiction severity and adverse mental health outcomes.

Methods:

First-year undergraduates enrolled in Sichuan University during September 2015, 2016, 2017 and 2018, were invited to participate in the current study survey, and 86.8% of them (n=32,269) fully responded. Young's 20-item IA Test, the Patient Health Questionnaire-15, the Patient Health Questionnaire-9, the Symptom Checklist 90, the Six-item Kessler Psychological Distress Scale and the Suicidal Behaviors Questionnaire-Revised were used to evaluate IA and four psychopathologies, (including high somatic symptom severity (HSSS), clinically significant depression (CSD), psychoticism and paranoia), serious mental illness (SMI), and lifetime suicidality.

Results:

The rates of those with mild, moderate and severe IA were 37.97%, 6.37% and 0.21%, respectively. The prevalence rates of HSSS, depression, psychoticism, paranoid ideation and SMI were 6.58%, 4.11%, 0.51%, 0.52%, and 1.90%; the lifetime prevalence rates of suicidal ideation, suicidal plan and suicidal attempt were 36.41%, 5.16% and 1.00%, respectively. The prevalence rates and odds ratios (ORs) of the four psychopathologies and their comorbidities, screened SMI and suicidalities in the group without IA were much lower than the average levels of the surveyed population, and most of them in the group with mild IA were similar to or mildly higher than the average rates; however, these rates sharply increased in the moderate and severe IA groups. The prevalence of CSD, among the four psychopathologies that was most strongly associated with IA after adjusting for the confounding effects of demographics and other psychopathologies, increased from 1.0% in the students with no addiction to 4.9%, 24.8%, and 56.7% in the students with mild, moderate, and severe addiction, respectively; the proportions of those with any of the four psychopathologies increased from 4.1% to 11.7%, 36.8%, and 67.2%, respectively. The rates of those with lifetime suicidal ideation increased from 25.0% to 47.7%, 67.6% and 71.6%, respectively; those with a suicidal plan increased from 2.6% to 6.8%, 16.5% and 32.8%; and those with a suicidal attempt increased from 0.5% to 1.3%, to 3.6% and 11.9%.

Conclusions:

Moderate and severe IA were strongly associated with a broad group of adverse mental health outcomes, including somatic symptoms that are the core features of many medical illnesses, though CSD was the most strongly associated. This finding supports the illness validity of moderate and severe IA, in contrast to mild IA. This study is thus meaningful for health policy-makers and service suppliers from the perspective of resolving the overall human health burden in the current era of the ‘Internet Plus’ and ‘artificial intelligence’.


 Citation

Please cite as:

Guo W, Tao Y, Li X, Lin X, Meng Y, Yang X, Wang H, Zhang Y, Tang W, Wang Q, Deng W, Zhao L, Ma X, Li M, Chen T, Xu J, Li J, Hao W, Lee S, Coid JW, Greenshaw AJ, Greenshaw A, Li T

Associations of Internet Addiction Severity With Psychopathology, Serious Mental Illness, and Suicidality: Large-Sample Cross-Sectional Study

J Med Internet Res 2020;22(8):e17560

DOI: 10.2196/17560

PMID: 32780029

PMCID: 7448182

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