Problematic internet use and sleep quality in adolescents with major depressive disorder

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ABSTRACT This study aims to compare adolescents newly diagnosed with major depressive disorder (MDD) and healthy controls in terms of problematic internet use (PIU) and sleep quality. The study sample consisted of 50 newly diagnosed MDD patients aged 12–18 years and 50 healthy controls. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) was administered to all cases by a child psychiatrist and sociodemographic data were collected. Children’s Depression Inventory (CDI), Pittsburgh Sleep Quality Index (PSQI), and Internet Addiction Test (IAT) were administered to all participants. Data of the MDD and control groups were compared using Student’s t-test or Mann-Whitney U test and the total scores of the IAT (z = −6.23, p < 0.001) and PSQI (t =–11.42, p < 0.001) scales were found to be significantly higher in MDD cases compared to the control group. The results of analysis of covariance demonstrated that there was a significant positive correlation between CDI and IAT, as well as CDI and PSQI total scores in patients with MDD. While no correlation was observed between the total scores of the IAT and PSQI scales in the MDD group, a significant positive correlation was found between the total scores of the IAT and PSQI scales in the healthy control group. Furthermore, there was a significant difference between the PSQI habitual sleep efficiency subscale score and the IAT total score (r = 0.36, p = 0.009), and the IAT responsibility (r = 0.34, p = 0.015), relationship (r = 0.36, p = 0.01), and mood subscale scores (r = 0.30, p = 0.03). A significant positive correlation was also found between the IAT duration subscale score and PSQI sleep disorder subscale score (r = 0.35, p = 0.013). In addition, binary logistic regression analysis showed that PSQI total score (B = 0.79, p < 0.001) and IAT total scores (B = 0.08, p = 0.001) could be significant predictors of MDD. The findings of this study indicate that the prevalence of PIU and poor sleep quality is higher in adolescents with newly diagnosed MDD compared to healthy controls. The results of our study indicated that the severity of depression, PIU, and sleep quality were significantly correlated in adolescents with newly diagnosed MDD, while PIU and sleep quality were correlated in adolescents without any psychiatric disorders. In addition, this study suggests that poor sleep quality and PIU may be risk factors for MDD.