PROBLEMATIC INTERNET USE AMONG ADULT JAPANESE PSYCHIATRIC PATIENTS

Abstract

BackgroundA large number of studies have reported the high prevalence of problematic internet use (PIU) among adolescents and students (13-50%)1, and PIU has been associated with many psychiatric symptoms2. In contrast, only a few studies have investigated its prevalence among the adult population. To the best of our knowledge, there have been no studies investigating the prevalence and comorbidity of PIU in a psychiatric population although psychiatric symptoms might either induce PIU in patients with psychiatric illnesses, or PIU might induce or aggravate psychiatric symptoms. The aims of this study are to investigate the prevalence of PIU and psychiatric co-morbidity among adult psychiatric patients. MethodsThree hundred thirty-three adult psychiatric patients with internet access were recruited at the outpatient clinic of psychiatry at the University Hospital, Kyoto Prefectural University of Medicine over a three-month period. Two hundred thirty-one of them completed the survey (response rate: 69.4%; Male/Female/Transgender: 90/139/2; mean age = 42.2). We divided participants into “normal internet users” and “problematic internet users” using a combination of Young’s Internet Addiction Test (IAT) and the Compulsive Internet Use Scale (CIUS), using established cut-off values. Demographic data and comorbid psychiatric symptoms were compared between the two groups, using self-rating scales measuring insomnia (Athens Insomnia Scale, AIS), depression (Beck Depression Inventory, BDI), anxiety (State-trait Anxiety Inventory, STAI), attention deficit hyperactivity disorder (ADHD) (Adult ADHD Self-report Scale, ASRS), autism (Autism Spectrum Quotient, AQ), obsessive-compulsive disorder (OCD) (Obsessive-Compulsive Inventory, OCI), social anxiety disorder (SAD) (Liebowitz Social Anxiety Scale, LSAS), alcohol abuse, and impulsivity (Barratt Impulsive Scale, BIS). ResultsOf our 231 respondents, 58 (25.1%) were defined as problematic internet users, as they scored high on either the IAT (40 or more) or CIUS (21 or more). The age of problematic internet users was significantly lower than that of normal internet users (35.9 vs 43.6, p<0.001, Mann-Whitney U test). The problematic internet users scored significantly higher on scales measuring sleep problems (AIS, 8.8 for problematic internet users vs 6.3 for normal internet users, p<0.001), depression (BDI, 27.4 vs 18.3, p<0.001), trait anxiety (STAI, 61.8 vs 53.9, p<0.001), ADHD (ASRS, part A 3.1 vs 1.8 and part B 3.5 vs 1.8, p<0.001), autism (AQ, 25.9 vs 21.6, p<0.001), OCD (OCI, 63.2 vs 36.3, p<0.001), SAD (LSAS, 71.4 vs 54.0, p<0.001), and impulsivity (BIS, 67.4 vs 63.5, p=0.004). ConclusionsThe prevalence of PIU among adult psychiatric patients is relatively high (25%). As previous studies reported in the general population, PIU among adult psychiatric patients was associated with lower age and higher psychiatric comorbidity. Longitudinal research is needed to determine any causal relations between problematic internet use and psychopathological illnesses.