internet addiction

Internet Addiction Increases Suicidality – Nancy

Internet addiction increases suicidality, according to a recent meta-analysis that looks at 25 published studies on the topic.  Definitions of internet addiction, and other related disorders such as internet gaming disorder are still in flux, and the subject of much debate, but the broad outlines of a serious disorder are gradually being filled in.

Several studies have documented links between internet addiction and suicidal thoughts and behaviors, but how they are related, or whether there is another cause, such as severe depression remains unclear.

Nonetheless, there is sufficient evidence for the authors to warn of a real risk of suicidality connected with internet addiction, and especially with gaming.  They call for all individuals with internet addiction disorder to be screened for the risk of suicide, even if they are not being treated for depression.

The meta-analysis showed that “prevalence rates of suicidal ideation, planning, and attempts were all significantly higher in study participants with internet addiction than in the controls (odds ratios [OR] of 2.952, 3.172, and 2.811, respectively). When the authors only used data from studies that adjusted for demographics and depression, they found that the prevalence rates of suicide attempts and ideation, though reduced, remained significantly higher in the participants with internet addiction than in the controls (attempts: adjusted OR = 1.559; ideation: adjusted OR = 1.490).”

The authors also found that adolescents had higher rates of suicidal behavior associated with internet gaming addiction, compared with other types of online behavior.

There is no standard criteria for Internet Addiction or Internet Use Disorder. The DSM-5 workgroup on substance use reviewed the literature and suggested that a new disorder be included in the list of conditions for further study.

Internet Gaming Disorder

Proposed Criteria

Persistent and recurrent use of the Internet to engage in games, often with other players, leading to clinically significant impairment or distress as indicated by five (or more) of the following in a 12-month period:

  1. Preoccupation with Internet games.

  2. Symptoms when Internet gaming is removed. (irritability, anxiety, or sadness, however there are no physical signs of withdrawal.)

  3. Needing to spend increasing time playing Internet games to get the same effect.

  4. Unsuccessful attempts to reduce time spent on gaming.

  5. Losing interest in previous hobbies and entertainment due to gaming.

  6. Continued excessive use of Internet games despite knowing that it is causing problems in daily functioning (relationships, work, school, health, etcetera)

  7. Lying about the amount of Internet gaming.

  8. Using gaming to escape or relieve a negative mood (e.g., feelings of helplessness, guilt, anxiety).

  9. Putting at risk or losing a significant relationship, job, or educational or career opportunity because of gaming.

These criteria could be modified to include other internet activities fairly easily.



Yu-Shian Cheng Internet Addiction and Its Relationship With Suicidal Behaviors: A Meta-Analysis of Multinational Observational Studies. J Clin Psychiatry 2018;79(4):17r1176110.4088/JCP.17r11761

DSM-5. Internet Gaming Disorder.