Pathological internet use among teens may lead to depression

Teens who use the Internet pathologically appear more likely to develop depression than those who do not, according to a report posted online today that will appear in the October print issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Since the mid-1990s, pathological (uncontrolled or unreasonable) Internet use has been identified as a problematic behavior with signs and symptoms similar to those of other addictions, according to background information in the article. Such use has been associated with relationship problems, physical ill health, aggressive behaviors and other psychiatric symptoms.

Lawrence T. Lam, Ph.D., of the School of Medicine, Sydney, and the University of Notre Dame, Fremantle, Australia, and Zi-Wen Peng, M.Sc., of the Ministry of Education and SunYat-Sen University, Guangzhou, China, studied pathological Internet use and later mental health problems among 1,041 teens in China (average age 15). Participants were assessed for depression and anxiety using previously validated scales. They also completed a questionnaire to identify pathological Internet use, including questions that reflect typical behaviors of addiction (for instance, "How often do you feel depressed, moody or nervous when you are off-line, which goes away once you are back online?).

At the beginning of the study, 62 participants (6.2 percent) were classified as having moderately pathological use of the Internet, and two (0.2 percent) were severely at risk. Nine months later, the adolescents were re-assessed for anxiety and depression; eight (0.2 percent) had significant anxiety symptoms and 87 (8.4 percent) had developed depression. The risk of depression for those who used the Internet pathologically was about two and a half times that of those who did not. No relationship was observed between pathological Internet use and anxiety.

"This result suggests that young people who are initially free of mental health problems but use the Internet pathologically could develop depression as a consequence," the authors write.

"As we understand that mental health problems among adolescents bear a significant personal cost as well as costs to the community, early intervention and prevention that targets at-risk groups with identified risk factors is effective in reducing the burden of depression among young people," they continue. "Screening for at-risk individuals in the school setting could be considered an effective early prevention strategy according to recent meta-analysis. Hence, a screening program for pathological use of the Internet could also be considered in all high schools to identify individuals at risk for early counseling and treatment."

(Arch Pediatr Adolesc Med. Published online August 2, 2010. doi:10.1001/archpediatrics.2010.159. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.