Effect of Pathological Use of the Internet on Adolescent Mental Health

OBJECTIVE: To examine the effect of pathological use of the Internet on the mental health, including anxiety and depression, of adolescents in China. It is hypothesized that pathological use of the Internet is detrimental to adolescents’ mental health. DESIGN: A prospective study with a randomly generated cohort from the population. SETTING: High schools in Guangzhou, China. PARTICIPANTS: Adolescents aged between 13 and 18 years. MAIN EXPOSURE: Pathological use of the Internet was assessed using the Pathological Use of the Internet Test. OUTCOME MEASURES: Depression and anxiety were assessed by the Zung Depression and Anxiety Scales. RESULTS: After adjusting for potential confounding factors, the relative risk of depression for those who used the Internet pathologically was about 21⁄2 times (incidence rate ratio,2.5;95%confidence interval,1.3-4.3) that of those who did not exhibit the targeted pathological internet use behaviors. No significant relationship between pathological use of the Internet and anxiety at follow-up was observed. CONCLUSIONS: Results suggested that young people who are initially free of mental health problems but use the Internet pathologically could develop depression as a consequence. These results have direct implications for the prevention of mental illness in young people, particularly in developing countries.