Symptom-Level Comorbidity Patterns Between Depression and Internet Gaming Disorder Among Adolescents: Evidence from Longitudinal Network Analysis with Gender Considerations

Adolescence is a period with an increased risk for the co-occurrence of depression and Internet gaming disorder (IGD), yet we still know little about how specific symptoms of these two conditions influence each other over time. In this study, we applied cross-lagged panel network analysis to two-wave data from a community sample of 538 adolescents (Mean age = 12.51 years; 53.7 percent female). Potential gender differences in the network structure were examined. In the overall sample and in both gender groups, depressive symptoms consistently predicted later gaming-related problems, whereas no reverse cross-disorder pathways were retained. In particular, suicidal ideation and psychomotor symptoms emerged as bridge symptoms linking depression and IGD, while sleep problems showed moderate outgoing expected influence in the overall symptom network. While boys and girls showed broadly similar patterns, some differences emerged in how specific symptoms were connected and which symptoms were most influential. These findings clarify the longitudinal symptom-level associations between depression and IGD in adolescents, suggesting that addressing key depressive symptoms may help reduce the risk of later IGD.