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(but not associated with anxiety)

"People who are susceptible to depression are already more prone to social isolation and withdrawal and therefore more likely to develop problematic Internet usage because the Internet provides an outlet for them," Dr. Christakis observed. "So the findings from the study are highly plausible, and because it was longitudinal and adjusted for baseline levels of depression and Internet use, the findings are both novel and robust."

medscape report posted August 10, 2010
prospective study published online August 2 in the Archives of Pediatrics & Adolescent Medicine
(Arch Pediatr Adolesc Med.)
researcher: Lawrence Lam, PhD
School of Medicine, Sydney, & U of Notre Dame, Fremantle, Australia et al

THE STUDY
anxiety measured using the Zung Self-rating Anxiety Scale
depression measured by the Zung Self-rating Depression Scale
pathologic use of the Internet measured by the Internet Addiction Test aka Young's Internet Addiction Scale
n = 1618 high school students in Guangzhou, Southeast China, in July 2008
mostly 13-16 yoa, mean age 15, max 18
even distribution between males/females, urban/nonurban schools
73% of families resided in the city
93.6% of responders were "normal" Internet users
6.2% exhibited "moderate" pathologic use
2 users (0.2%) exhibited severely pathologic Internet use
45.5% used the Internet for entertainment
28% used the Internet for information and knowledge
roughly similar numbers to communicate with school mates, making friends, and avoiding boredom

FINDINGS
teens w/o mental health problems who use the Internet pathologically are at risk for depression
significantly incr in risk for incident depression (adjusted rate ratio, 2.5; 95% CI, 1.3 - 4.3)
no significant association with anxiety risk
students who used the Internet pathologically at baseline-->2.3x more depression at 9 mo followup
compared with students not using Internet pathologically
adjusted for confounders (which ones?)-->different number: 1.5x more depression on pathol surfers

PATHOLOGIC INTERNET USE
new phenomenon
pathological use = addictive
increasing amount, longer than planned, obsessing when offline
staying up late, missing sleep
used for entertainment instead of for information
pathol internet use = another form of nonpharmacological behavioral addiction (like gambling)
has been previous linked to mood disorders, causality not clear
"vicious cycle": problematic Internet-->incr social isolation and withdrawal-->more problematic Internet use
O'Reilly article in June 15, 1996, issue of the Canadian Medical Association Journal gave criteria:
increasing Internet use to achieve the same level of satisfaction
withdrawal symptoms, such as agitation, when not online
longer Internet sessions than planned
time spent offline focused on Internet issues
failure in attempts to cut back or stop the use of the Internet
and problems with work or social activities related to the use of the Internet

WHY?
lots of questions:
youth more at risk than adults?
youth more "reactive"?
youth more likely to be involved in gaming
games highly competitive, failure-->seems like real life failure

"Young people who used the Internet pathologically were more likely to use it for entertainment and less likely to use it for information, and at the 9-month follow-up, 8 students (0.2%) were classified as having significant anxiety symptoms and 87 (8.4%) scored higher than the cutoff of 50 on the depression scale."

implications
recent meta-analysis shows at-risk teens can be screened at school
several different screening instruments have been used, many studies
schoolkids can be effectively screened for early signs of depression

1122 didn't have depression or anxiety at baseline
of 1122, 1041 responded at 9 mo followup
mean age of respondents at 9 months was 15 years
53% were girls
most participants' parents had completed at least a secondary school education
most students said they were under a heavy burden with their studies
most stated that their parents had high expectations of them

SOURCE
Medscape http://cme.medscape.com/viewarticle/726625?src=cmemp&uac=89474MT

Comments

( 5 comments — Leave a comment )
neptunia67
Aug. 24th, 2010 01:36 pm (UTC)
I feel depression symptoms when I spent too much time on the 'net.
liveonearth
Aug. 24th, 2010 03:33 pm (UTC)
Yep, me too. That's why I have an alarm set to remind me when to turn off the computer. And I take a page out of your book and take entire days off when I can.
neptunia67
Aug. 24th, 2010 05:06 pm (UTC)
The whole days off are so nice. The day seems so much longer when I'm not checking the computer.
newedition
Aug. 25th, 2010 09:44 pm (UTC)
I wonder if internet use is an unconscious attempt at self-treatment. Often with online gaming people can make friends and at least have some form of "socialization" that might not be met at school. (This isn't to say I encourage internet use as a treatment, just that I wonder if internet addiction is the cause or the effect of depression?)
liveonearth
Aug. 25th, 2010 11:32 pm (UTC)
Pretty much all the researchers that spoke about it mentioned the chicken and egg question. I myself would say that it is an accelerating decline once started, as the isolation supports internet obsession, and internet obsession supports isolation. We know that isolation causes low serotonin levels and depression. We don't know if a person who is internet obsessed but also has social contacts is likely to be depressed.
( 5 comments — Leave a comment )

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