The association between internet addiction, sleep quality, and health-related quality of life among Iranian medical students

Global prevalence of internet addiction among university students: a systematic review and meta-analysis

PURPOSE OF REVIEW

The prevalence of internet addiction among university students has been extensively studied worldwide, however, the findings have been mixed. This meta-analysis aimed to examine the global prevalence of internet addiction in university students and identify its potential moderators.

RECENT FINDINGS

A total of 101 eligible studies, comprising 128020 participants across 38 countries and territories, were included. The pooled global prevalence of internet addiction among university students was 41.84% [95% confidence interval (95% CI): 35.89-48.02]. Significant differences in the prevalence were observed across different income levels, regions, periods of COVID-19 pandemic, and cut-off values of the Internet Addiction Test (IAT). Sample size was negatively associated with internet addiction prevalence, while depression prevalence was positively associated with internet addiction prevalence. Male students had a significantly higher risk of internet addiction compared to female students [pooled odd ratio (OR): 1.32, 95% CI: 1.19-1.46].

SUMMARY

This meta-analysis found that the prevalence of internet addiction was high among university students, which has increased since the COVID-19 pandemic. Screening and intervention measures to address internet addiction should prioritize students with an increased risk including male students, those from lower-income regions and those with depression.

Social Media Addiction and Poor Mental Health: Examining the Mediating Roles of Internet Addiction and Phubbing

Many researchers have examined the potential detrimental role of problematic social media use (often referred as 'social media addiction') on mental health. The present study investigated how social media addiction is associated with three components of mental health: depression, anxiety, and stress. In addition, structural equation modeling was used to test the mediating roles of internet addiction and phubbing among a sample of young adults (N = 603). Results showed that social media addiction was associated with poorer mental health via internet addiction and phubbing. More specifically, associations between social media addiction and stress, and social media addiction and anxiety were explained by both internet addiction and phubbing. The association between social media addiction and depression was explained by internet addiction only. These results remained consistent after controlling for gender, age, frequency of internet use, frequency of social media use, and frequency of smartphone use. These findings extend the extant literature by providing evidence for the dual roles of internet addiction and phubbing in explaining the relationship between social media addiction and poor mental health. Social media addiction did not directly influence poorer mental health but did via internet addiction and phubbing. Therefore, greater awareness of the inter-relationships between technology-based behaviors and their impact on mental health is needed among a wide range of stakeholders, and these inter-relationships need considering in the prevention and treatment of technology-based disorders.

The relationship between nurses' Internet addictions, sleep quality and sleepiness

Objectives. This study aimed to investigate the relationship between nurses' Internet addiction, sleep quality and sleepiness. Methods. Research data were collected with an online and face-to-face introduction form, the Internet addiction scale (IAS), the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS) between January and April 2022. In data analysis, descriptive statistics, correlation and multiple regression analysis were performed. Results. The general average scores for the participants were IAS 41.99 ± 16.03, PSQI 5.90 ± 3.27 and ESS 9.53 ± 5.44. It was observed that 58.9% had poor sleep quality and 38.7% had an increased prevalence of daytime sleepiness. Conclusion. There was a positive relationship between Internet addiction, sleep quality and sleepiness. Accordingly, it was determined that as the level of Internet addiction in nurses increases, sleep quality decreases and daytime sleepiness increases.

Association between internet addiction and musculoskeletal disorders in Iranian medical sciences students

BACKGROUND

The utilization of the Internet can lead to adverse outcomes in students' lives. Prolonged Internet usage may result in academic failure, an elevated risk of musculoskeletal problems, and the emergence of issues impacting the lives of students and their peers. This study aimed to explore the relationship between Internet addiction and musculoskeletal disorders (MSDs) among students in the field of medical sciences.

METHODS

In this cross-sectional study, 314 medical sciences students in Semnan, Iran, were assessed using the census sampling method. The participants' Internet addiction status and the presence of MSDs were determined through Young's Internet Addiction questionnaire and the Nordic self-report questionnaire, respectively. Data underwent analysis employing logistic regression test to ascertain the relationship between Internet addiction and MSDs.

RESULTS

Among the 314 participating students in this research, about 21% and 1.6% of the participants were lay open to and suffered from Internet addiction, respectively. Internet addiction was associated with the presence of pain, discomfort, burning, or numbness in the neck, wrist, upper back, hips, and thighs. For each unit increase in the Internet addiction score, the chance of neck and wrist pain rises by 3% compared to a 2% increase in upper back and hip/thigh pain.

CONCLUSION

The findings of this study indicate that excessive Internet use is linked to a heightened risk of MSDs in medical sciences students. Consequently, it is imperative to raise awareness about these complications and promote the adoption of proper posture when using the Internet. Further research is also warranted among diverse student populations to investigate the impact of Internet addiction.

Turning Lemons into Lemonade: Social Support as a Moderator of the Relationship Between Technostress and Quality of Life Among University Students

Purpose

The overuse of internet-based technologies as a means of coping with the stress they generate has resulted in an alarming level of addiction, adversely impacting the quality of life and overall health of younger individuals. This social detachment, in turn, contributes to both physical and mental health deterioration. The potential remedy for this predicament lies in the application of social support as an antidote to internet addiction. In this context, our present study employs the Stress-Strain-Outcome model to explore the indirect effects of internet addiction and the moderating role of social support in relation to the influence of technostress on the quality of life of adults.

Methods

We adopted a time-lagged design to collect data from university graduates and evaluated our study hypotheses using Mplus.

Results

Our empirical findings highlight the significant influence of technostress on internet addiction, with the latter significantly mediating the relationship between technostress and quality of life. Furthermore, our results reveal that social support effectively moderates the indirect effects of technostress on quality of life through its impact on internet addiction.

Conclusion

These findings can help researchers and educators better understand the underlying mechanisms between technostress and quality of life with social support as the silver lining. This form of social support holds the potential not only to alleviate internet addiction but also to positively enhance the quality of life and overall wellbeing of individuals facing these challenges. The implications of these findings and avenues for future research are also discussed.

Problematic Internet use and attitudes towards persons with disabilities - cross-sectional research among Polish students

BACKGROUND

Problematic Internet use (PIU) can have detrimental effects on physical, emotional, psychological, and social functioning. Besides well-described PIU correlations in psychological domains such as personality traits, or life satisfaction, and self-assessment, the social aspect of PIU risk also appeared to be important. This study aimed to investigate the association between PIU and attitudes towards persons with disabilities.

METHODS

A total of 595 Polish students aged 18-29 participated in this research by completing the Internet Addiction Test, Multidimensional Attitudes Scale Towards Persons With Disabilities, and personal information form.

RESULTS

The findings revealed that 30.6% of the respondents were at high risk for PIU. Moreover, heightened levels of PIU were more prevalent among male participants and students in technical fields of study than in those in medical and social fields of study. Increased PIU was also associated with more negative attitudes towards persons with disabilities in general and in the domains of emotions and behaviours. Additionally, prior personal contact with individuals with disabilities was related to both PIU rates and attitudes towards persons with disabilities in the domain of emotions and beliefs.

CONCLUSIONS

This study highlights the prevalence of PIU among Polish students and emphasizes the need for preventive measures, particularly targeting male students and those in technical fields of study. The results indicate a relationship between PIU and attitudes towards individuals with disabilities. Further research is required to determine the direction of the relationship. It is recommended that educational programs provide opportunities for interaction with individuals with disabilities to promote understanding and acceptance.

Internet Addiction and Sleep Disorders among Medical Students

Background

Considering the increasing use of the Internet in Iranian society, especially among students, and the importance of sleep quality, the present study investigated the relationship between sleep quality and Internet addiction among medical students in Shiraz.

Methods

In this descriptive-analytical study, the sample included students of the Shiraz University of Medical Sciences who were selected by a multistage sampling method in 2018. Each faculty was considered to be stratified, and the samples were selected from all strata by simple random sampling. A total of 400 student questionnaires were eligible for analysis. The level of sleep disturbance was measured using the Pittsburgh Sleep Quality Index (PSQI), and Young's Internet Addiction Test (IAT) was used to evaluate Internet addiction. Cronbach's alpha for PSQI and IAT was 0.77 and 0.93, respectively.

Results

109 (%28.9) and 58 (%14.4) of all the people under study were at risk of Internet addiction or poor sleep quality, respectively. The highest percentage of poor sleep quality was in those who were addicted to the Internet (60%), but the lowest percentage was observed in the group without addiction (27%). In addition, there was a significant correlation between Internet addiction and subjective sleep quality (r = 0.191, p = 0.05), sleep latency (r = 0.129, p = 0.01), sleep duration (r = 0.119, p = 0.01), habitual sleep efficiency (r = 0.186, p = 0.05), sleep disturbances (r = 0.169, p = 0.01), use of sleeping medication (r = 0.203, p = 0.05), and daytime dysfunction (r = 0.188, p = 0.05).

Conclusion

These findings help national health officials and planners in Iran to design appropriate and effective interventions to improve students' health and prevent Internet addiction.

Latent profile analysis for health-related quality of life, sleep quality, morning and evening type, and internet addiction among medical students

Health-related quality of life, sleep quality, morning and evening types, and internet addiction are of significant importance to the development of medical students, yet they have rarely been studied. Taking this into consideration, the study aimed to confirm latent profiles in health-related quality of life, sleep quality, morning and evening types, and internet addiction in medical students and investigate the characteristics of participants in each profile to provide suggestions for students' health. This was an observational cross-sectional study including 1221 medical student subjects at China Medical University in 2019. Multiple correspondence analysis was the initial step to verify the correspondence, dispersion, and approximation of variable categories. Latent profile analysis was used to identify the multiple correspondences between the levels of variables. Three profiles were found, including: (1) The Low sleep quality profile was characterized by the lowest sleep quality among the three existing profiles. (2) The High health-related quality of life and Low internet addiction profile was characterized by the highest level of health-related quality of life but the lowest level of internet addiction. (3) The Low health-related quality of life and High internet addiction profile was characterized by the highest standardized values of internet addiction but the lowest standardized values of health-related quality of life. This study had important implications for improving student health and supported the medical universities and hospitals in implementing targeted policies based on distinctive student characteristics.

Depression mediates the relationship of experiential avoidance and internet addiction: a cross-lagged mediation analysis

Previous research has identified the contemporaneous association between experiential avoidance, depression, and Internet addiction. However, the mechanisms underlying this association are not well acknowledged. The present study aimed to use cross-lagged panel modeling to examine whether depression mediates the relation between experiential avoidance and Internet addiction and whether gender plays a role in the relation. A total of 2731 participants (934 male, Meanage=18.03) were recruited from a university at the baseline study (December 2019). Data was collected at all 3 time points across one year (2019?2020), using 6-month intervals. Experiential avoidance, depression and Internet addiction were assessed using the Acceptance and Action Questionnaire-II (AAQ-II), the Beck Depression Inventory-II (BDI-II) questionnaire, and Young?s Internet Addiction Test (IAT), respectively. Cross-lagged panel models were used to evaluate the longitudinal association and the mediating effect. Multigroup analyses were conducted to examine gender differences in the models.Cross-lagged models indicated that experiential avoidance significantly predicted subsequent depression, and depression significantly predicted subsequent Internet addiction. Furthermore, mediation analyses showed that depression has a mediating effect in the relation between experiential avoidance and Internet addiction (? = 0.010, 95%CI[0.003, 0.018], p>0.001). Multigroup analyses demonstrated that the pattern of structural relations stayed consistent across gender. The findings indicated that experiential avoidance is indirectly related to Internet addiction through depression, suggesting that treatments targeted at reducing experiential avoidance could help relieve depression and thus decrease the risk of Internet addiction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04511-6.

Internet addiction, insomnia, and violence tendency in adolescents

INTRODUCTION

There is limited information on how the tendency to violence in adolescents is affected by internet addiction and insomnia. This study will contribute to the literature in revealing the effect of internet addiction on insomnia and violence tendency in adolescents.

METHODS

The data were collected between 26/May/2021 and 06/July/2021. A total of 2,502 adolescents studying in 9th and 12th grades were included in the study. Data were collected with the adolescent information form, Internet Addiction Scale-Short Form, Bergen Insomnia Scale, and Violence Tendency Scale. Descriptive statistics, independent samples t-test, one-way analysis of variance, correlation, and simple linear regression analyzes were used in the analysis of data.

RESULTS

Participants were 15.92 ± 1.19 years old and 70.80% were women. While internet addiction do not change according to gender, and violence tendency mean scores do not change according to having a device to use the internet, the study variable mean score changes according to all the other socio-demographic variables included in our study. There is a positive relationship between internet addiction, violence tendency, and insomnia. Furthermore, while internet addiction explained 22.1% of insomnia scores, 18.8% of the variance changes in the violence tendency scores, insomnia explained 11.8% of violence tendency scores.

CONCLUSION

Although the scale scores of the adolescents in our study were below the average, internet addiction is common problem necessitates working on the subject. In our study, there is a significant relationship between internet addiction, insomnia and tendency to violence, and internet addiction predicts other variables.

Association of Smartphone Use and Digital Addiction with Mental Health, Quality of Life, Motivation and Learning of Medical Students: A Two-Year Follow-Up Study

Background: Despite studies evaluating the insertion of technology and the use of smartphones in the mental health and learning of medical students, few have investigated these outcomes longitudinally. This study aims to investigate the association between smartphone use and digital addiction with mental health, quality of life, learning, and academic motivation of medical students. Methods: This is a longitudinal study conducted between 2016 and 2018. Socio-demographics, smartphone use, digital dependence (Internet Addiction Test), surface and deep learning approach (Biggs), motivation (Academic Motivation Scale), evaluation of symptoms of depression, anxiety, and stress (DASS- 21) and Quality of Life (WHOQOL-BREF) were assessed. Adjusted regression models were used for data analysis. Results: A total of 269 students were included(51.4% of the total). In the two-year follow-up, despite an increase in the frequency of smartphone use in general and also in the classroom for non-educational activities, no increase in digital dependence was found. In the adjusted models, the frequency of smartphone use and digital dependence were predictors of lower academic motivation and greater surface learning after two years of follow up. However, only digital dependence was a predictor of worse mental health (anxiety, depression, and stress) and worse quality of life. Conclusion: Greater use of smartphones and high addiction scores were associated with worse educational outcomes. Digital dependence was another marker of outcomes in mental health and quality of life. It is important that educators are aware of these negative effects and can guide students on the proper and safe use of these devices.

Digital addiction, academic performance, and sleep disturbance among nursing students

PURPOSE

This study aimed to examine the relationship between digital addiction, academic performance, and sleep disturbance among nursing students.

DESIGN AND METHODS

The study was a correlational and cross-sectional design. Four hundred twenty-nine nursing students were enrolled in this study.

FINDINGS

There was a positive significant relationship between the mean Sleep Disturbance (SD) T-scores and Digital Addiction Scale (DAS) scores (r = 0.203, p < 0.01). Furthermore, a positive correlation was found between the mean SD T-scores and DAS subscale scores (p < 0.01) PRACTICE IMPLICATIONS: This study demonstrated that digital addiction had an influence on sleep disturbance. It is recommended that nursing students be provided with training to inform them about negative effects of digital addiction.

The Mediating Roles of Anxiety, Depression, Sleepiness, Insomnia, and Sleep Quality in the Association between Problematic Social Media Use and Quality of Life among Patients with Cancer

The present study examined the mediating role of anxiety, depression, sleepiness, insomnia, and sleep quality in the association between problematic social media use and quality of life (QoL) among patients with cancer. This cross-sectional survey study recruited 288 patients with cancer to respond to measures on anxiety, depression, sleepiness, insomnia, sleep quality, problematic social media use, and QoL. Structural Equation Modeling was used for the mediation analysis. There were significant relationships between all of the variables used in the study. It was revealed that problematic social media use did not directly influence the QoL of patients with cancer except via anxiety, depression, sleepiness, and insomnia. Sleep quality did not mediate the association between problematic social media use and QoL. Healthcare workers managing cancer should pay attention to the mental health needs of their patients even as they treat their cancer so as to improve their quality of life. Future studies may examine other variables that affect the QoL of patients with cancer as well as other mediating and moderating variables.

Effect of Exercise Intervention on Internet Addiction and Autonomic Nervous Function in College Students

Objective

To investigate the effects of 12-week physical exercise (jogging, basketball, and outdoor training) on sleep quality, harmful mood, and heart rate variability (HRV) in college students with Internet addiction.

Methods

46 college students with Internet addiction were chosen and then randomly assigned to the Internet addiction group (IA, n = 23) and the Internet addiction exercise group (IA+EX, n = 23). The subjects in the IA+EX group underwent physical exercise for 12 weeks (three times per week), and the IA group did not perform regular physical exercise during the experiment. Then, the degree of Internet addiction, depression, and sleep quality were evaluated by using Young's Internet Addiction Test (IAT) scale, Center for Epidemiologic Studies Depression (CES-D) scale, and Pittsburgh sleep quality index (PSQI); HRV were measured by using Polar Team 2 before and after physical exercise intervention.

Results

(1) After the 12-week exercise, compared to preexercise intervention, the scores of IAT, CES-D, and PSQI significantly decreased (t = 12.183, 9.238, 5.660; P < 0.01) in the IA+EX group; compared with the IA group, the scores of IAT, CES-D, and PSQI significantly decreased (t = 2.449, 3.175, 4.487; P < 0.05, P <0.01) in IA+EX group college students with Internet addiction. (2) After the 12-week exercise, compared to preexercise intervention, LFn and the ratio of LF/HF significantly decreased (t = 5.650, 3.493; P < 0.01) and HFn significantly increased (t = −2.491, P < 0.05) in the IA+EX group; there were no significant differences in the above indexes before and after the experiment in the IA group (P > 0.05). Compared with the IA group, HFn significantly increased (t = 3.616, P < 0.01) and the ratio of LF/HF significantly decreased (t = 2.099, P < 0.01) in IA+EX group college students with Internet addiction; there was no significant difference in LFn between the two groups.

Conclusion

Long-term physical exercise could significantly reduce the degree of Internet addiction and depression, improve sleep quality, and balance sympathetic parasympathetic function of college students with Internet addiction, indicating that exercise-based intervention might be an effective way to alleviate or even eliminate Internet addiction.

Investigating Internet Addiction and Sleep Quality Correlation Among Students of Isfahan University of Medical Sciences in 2021

Background: The quality of sleep plays an important role in physical development, as well as maintaining physical and mental health. Approximately 20% of Iranian students suffer from Internet addiction, and 56% suffer from insomnia. Objectives: This study aimed to investigate the relevance of Internet addiction and sleep quality among Isfahan University of medical sciences students. Methods: This cross-sectional study was conducted as a questionnaire at the Medical Sciences University of Isfahan. The collected data had three components: (1) Demographic information, (2) sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and (3) amount of internet use with a questionnaire of 20 Internet Addiction Tests (IAT). Logistic regression was used to find any association between Internet Addiction and Sleep quality. Results: A total of 562 female and male students participated in the study, with a mean age of 21.41 ± 1.87. Internet users with moderate and mild addiction had poorer sleep quality than those with normal and severe Internet addiction. Logistic regression analysis showed an association between Internet addiction scores and sleep quality (OR = 1.035: 1.02, 1.04, P < 0.001). In addition, poor sleep quality was also predicted by the subgroups "excessive internet use" and "anticipation". Conclusions: The relationship between internet addiction and sleep quality was significantly negative. Universities and all educational institutions can use it to control the effects of Internet abuse and the quality of sleep of students.

Is Problematic Internet and Smartphone Use Related to Poorer Quality of Life? A Systematic Review of Available Evidence and Assessment Strategies

Purpose of Review

Previous studies have explored the links between problematic Internet use (PIU) or problematic smartphone use (PSU) and quality of life (QOL). In this systematic review, we (i) describe the instruments used to assess QOL or health-related quality of life (HRQOL) in these studies, (ii) critically examine the content validity of the instruments used, and (iii) examine the relationships between PIU, PSU, QOL, and HRQOL.

Recent Findings

We identified 17 PIU and 11 PSU studies in a systematic search. Evidence suggests that PIU and PSU negatively correlate with either QOL or HQOL and most of their domains (especially mental and physical health). Multiple instruments were used to assess QOL or HRQOL in these studies. Our analysis showed an important heterogeneity in the domains covered by these instruments.

Summary

Because of the widespread prevalence of PIU and PSU, which tend to be linked with lower QOL or HRQOL, in particular poor mental and physical health, a more systematic public health campaign is required to target the healthy use of these communication devices. Prevention programs should also target vulnerable individuals, focusing on the most affected domains of QOL and HRQOL (i.e., physical and psychological health). Among the existing instruments, the World Health Organization Quality of Life for adults and the Pediatric Quality of Life Inventory for adolescents (aged 13-18 years) proved to be the most relevant, although new measurement instruments are needed to target domains that are specifically relevant in the context of PIU and PSU (e.g., physical and psychological health domains such as sleep, loneliness, and quality of familial relations).

The Effect of Problematic Social Media Use on Happiness among Adolescents: The Mediating Role of Lifestyle Habits

Background: Although the relationship between problematic social media use (PSMU) and happiness has been already explored, less is known about the mechanisms that translate PSMU into lower happiness through lifestyle habits. Therefore, the current study focuses on the association between PSMU and happiness, exploring a mediating effect of lifestyle habits (e.g., difficulties in getting to sleep and frequency of physical activity) among Italian adolescents. Methods: A total of 58,976 Italian adolescents (mean age = 13.6, SD = 1.63; age range = 10.5−16.5; 49.4% females) were included. The pattern of relationships specified by the theoretical model was examined through path analysis. Results: Difficulties in getting to sleep (β = −0.037, p < 0.001) and frequency of physical activity (β = −0.012, p < 0.001) were mediators in the relationship between PSMU and happiness. Multi-group analyses across gender and age groups (11, 13, and 15 years old) showed that the chain mediating effect of the frequency of physical activity on the difficulties in getting to sleep was not significant for females but significant for males and for all of the three age groups. Overall, females and older ages were sensitive to the whole model. Conclusion: Along with difficulties in getting to sleep and the frequency of physical activity, lifestyle habits may contribute to the association between PSMU and happiness. We also recommend that future studies focus on PSMU in females and older adolescents, as they show more general sleep problems and reduced physical activity.

Prevalence, correlates, and network analysis of Internet addiction symptoms among Chinese pregnant and postpartum women

OBJECTIVE

Excessive Internet use is a common health problem globally. This study aimed to assess the prevalence, correlates, and network structure of Internet addiction symptoms (Internet addiction hereafter) among Chinese pregnant and postpartum women.

METHODS

This was a multicenter cross-sectional study using Internet Addiction Test (IAT) and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) to evaluate Internet addiction and quality of life (QOL), respectively. Univariate analyses, multivariate logistic regression analyses, and network analyses were performed.

RESULTS

Of a total of 1,060 women who completed the study, 320 (30.19%, 95% CI=27.42%-32.96%) women reported Internet addiction during or after pregnancy. Women with previous adverse pregnancy experiences (OR=1.831, P=0.001) and physical comorbidities (OR=1.724, P=0.004) had a higher likelihood of developing Internet addiction. Internet addiction was significantly associated with poor QOL in all domains. Network analyses revealed that IAT item 16 (request an extension for longer time spent online) was the most central symptom in the analyses, and also one of the strongest bridging symptoms linking the Internet addiction and QOL communities.

LIMITATIONS

This was a cross-sectional study, all study findings were based on self-reported data, and possible recall bias and selection bias may exist.

CONCLUSION

Internet addiction is common among Chinese pregnant and postpartum women, and is significantly associated with lower QOL. Effective strategies, especially focusing on central symptoms, are needed to reduce the impact of Internet addiction and improve QOL in pregnant and postpartum women.

Symptoms of Nomophobia, Psychological Aspects, Insomnia and Physical Activity: A Cross-Sectional Study of ESports Players in Saudi Arabia

(1) Background: ESports is a new trend of sports, which has gained considerable popularity worldwide. There is a scarcity of evidence that focuses on the lifestyle of ESports players (eSP) particularly on symptoms of nomophobia, level of anxiety, sleep quality, food consumption and physical activity. (2) Objective: to determine the prevalence and relationship between symptoms of nomophobia, psychological aspects, insomnia and physical activity of eSP in Saudi Arabia. (3) Methods: A cross-sectional study was conducted between March and April 2021 using a convenient self-selection adult sample. A total of 893 (216 eSP vs. 677 non-eSP (NeSP)) participants aged over 18 years were included. All participants answered a seven-part validated questionnaire that included: (i) sociodemographic questions; (ii) a symptoms of nomophobia questionnaire; (iii) general anxiety disorder questions, (iv) an insomnia severity index, (v) an Internet addiction scale, (vi) the Yale food addiction scale 2.0 short form and (vii) an international physical activity questionnaire. (4) Results: Among the entire population, the prevalence of moderate to severe nomophobia, anxiety, insomnia, Internet addiction and low physical activity were 29.8%, 13.9%, 63.3%, 27% and 2.8%, respectively. The eSP and NeSP differed significantly in nomophobia scale, anxiety and insomnia values. Compared to NeSP, eSP had a higher level of severe nomophobia p = 0.003, a severe level of anxiety p = 0.025 and symptoms of insomnia p = 0.018. Except for food addiction and physical activity, a positive correlation was identified between symptoms of nomophobia, anxiety and insomnia among eSP. (5) Conclusion: This study reported high prevalence of nomophobia, anxiety and insomnia among eSP compared to NeSP.

Prevalence and Clinical Correlates of Internet Addiction Symptoms and Their Association With Quality of Life in Adolescents With Major Depressive Disorder: A Multicenter Cross-Sectional Study

BACKGROUND

Internet addiction (IA) symptoms are common among adolescents and negatively impact their academic performance and development. These symptoms are also associated with lower quality of life (QOL) and increased suicidality. This study aimed to examine the prevalence and the sociodemographic and clinical correlates of IA symptoms in adolescents with major depressive disorder (MDD) and their association with QOL.

METHODS

This cross-sectional study was conducted in three general and four psychiatric hospitals in Anhui Province, China, from January to July 2021. Sociodemographic and clinical data were collected. The Internet Addiction Test (IAT), Center for Epidemiologic Studies of Depression Symptom Scale (CES-D), and World Health Organization Quality of Life Brief version (WHOQOL-BREF) were utilized to examine IA, depressive symptoms, and QOL, respectively.

RESULTS

In a multicenter sample of 278 adolescents with MDD, the prevalence of IA symptoms in adolescents with MDD was 46.8% (95% CI: 40.9-52.7%). Logistic regression analysis showed that patients with more severe depressive symptoms (odds ratio [OR] = 1.05, 95% CI: 1.03-1.08), those living in a rural area (OR = 1.94, 95% CI: 1.15-3.27), and those with poor academic performance (OR = 2.90, 95% CI: 1.42-5.95) were more likely to have IA symptoms. After controlling for confounding factors, patients with IA symptoms had significantly poorer QOL in the physical, psychological, and environmental domains than those without IA symptoms.

CONCLUSION

IA symptoms are common in adolescents with MDD and appear to be associated with clinical symptoms. We could not infer a causal relationship between IA and depression because this was a cross-sectional study. Considering the positive association between IA symptoms and lower QOL, screening for IA symptoms should be conducted, and effective measures should be implemented for adolescents with MDD.

Quality of Life in Internet Use Disorder Patients With and Without Comorbid Mental Disorders

INTRODUCTION

Evidence from clinical studies on quality of life (QoL) in patients suffering from internet use disorders (IUD) is still limited. Furthermore, the impact of additional mental comorbidities on QoL in IUD patients has rarely been investigated yet.

MATERIALS AND METHODS

In a cross-sectional clinical study 149 male subjects were analyzed for the presence and severity of an IUD as well as other mental disorders by experienced clinicians. The sample consisted of 60 IUD patients with and without comorbid mental disorders, 34 non-IUD patients with other mental disorders, and 55 healthy participants. Standardized clinical interviews (M.I.N.I. 6.0.0) and questionnaires on IUD symptom severity (s-IAT), QoL (WHOQOL-BREF), depression and anxiety symptoms (BDI-II and BAI), and general psychological symptoms (BSI) were used.

RESULTS

Internet use disorder patients showed significantly reduced QoL compared to healthy controls (Cohen's d = 1.64-1.97). Furthermore, IUD patients suffering from comorbid mental disorders showed significantly decreased levels of physical, social, and environmental QoL compared to IUD patients without any comorbidity (p < 0.05-0.001). Multiple linear regression analyses revealed that low levels of psychological, social and environmental QoL were mainly predicted by symptoms of depression. IUD factors were only significant predictors for the social and physical QoL.

DISCUSSION

Internet use disorder patients with comorbid mental disorder reported the lowest QoL. Depression symptom severity was the most significant predictor of low QoL in IUD. Strategies to reduce depressive symptoms should therefore be considered in IUD treatment to increase patients' QoL.