[Internet Addiction and Suicidality - A Comparison of Internet-Dependent and Non-Dependent Patients with Healthy Controls]. / Internetabhängigkeit und Suizidalität ­ ein Vergleich Internet-abhängiger und nicht abhängiger Patienten mit einer gesunden Population.

BACKGROUND: Internet addiction (IA) is associated with a high level of comorbid mental disorders and significant distress. With regard to the resulting hazardous potential, the present study examines the prevalence of suicidal ideation and behavior in a population with IA compared to a clinical and a healthy sample. METHODS: 60 patients with Internet addiction, 29 with and 31 without comorbid mental disorder were compared to an outpatient sample with other mental disorders (n=35) and 57 healthy controls regarding symptom load and suicidality. RESULTS: 48.3% of the patients with Internet addiction (with and without comorbidity) exhibited significantly more often suicidal symptoms as compared to healthy controls (3.5%). The level of both suicidal symptoms was significantly higher in all clinical samples in comparison to healthy controls , whereas no significant differences were shown between the clinical samples. For patients with Internet addiction and comorbid disorders a significant positive correlation between the level of Internet addiction and the extent of suicidal ideations were found. DISCUSSION: The results contribute to the notion that Internet addiction is associated with an increased risk for suicidal ideation and therefore represents a serious mental illness. Internet addiction is comparable to other mental disorders in terms of symptom load, impaired quality of life and suicidality. Larger samples have to be examined to clarify the question of mediating and moderating variables with regard to suicidality. CONCLUSION: A diagnostic workup and treatment regime for patients with Internet addiction should include an exploration of suicidality, not least because of possible risks in withdrawl.

[Internet Addiction, Suicidality and Non-Suicidal Self-Harming Behavior - A Systematic Review]. / Internetabhängigkeit, Suizidalität und selbstverletzendes Verhalten ­ Ein systematisches Review.

BACKGROUND: Internet addiction (IA) is associated with a high rate of co-morbid mental disorders, especially depression, anxiety disorders, ADHD and personality disorders and a considerable level of psychological strain. In terms of risk assessment, the present work investigates the current research literature on suicidal behavior and non-suicidal self-injurious behavior (NSSI). METHODS: We performed a systematic literature search in 14 databases on title and abstract level for the most common keywords for IA, NSSI and suicidality. After deduction of multiple items, 2334 articles remained. They were filtered per inclusion and exclusion criteria. We identified studies that examined the relationship between IA, NSSI and suicidality, which were assessed by validated psychometric instruments. This allowed a total of 15 studies to be included. RESULTS: The relationship between IA and suicidality was examined in 10 studies, four studies examined the relationship of IA, suicidality, and NSSI, and one study exclusively focused on IA and NSSHB. All studies showed higher prevalence for NSSI and respectively suicidality of the subjects with an IA compared to subjects without IA, with point prevalence varying considerably between 1.6-18.7%. DISCUSSION: The results of the included publications suggest that Internet dependency is associated with an increased rate of non-suicidal self-harming behavior and increased suicidality, with suicidal ideation being more closely related to IA than suicidal actions. In order to develop a better understanding of causal relationships between IA, NSSI and suicidality, further longitudinal studies are required. CONCLUSION: Against the background of the presented studies NSSHB and suicidality need to be explicitly addressed within the assessment and treatment of IA patients.

Quality of Life in Internet Use Disorder Patients With and Without Comorbid Mental Disorders.

Introduction: Evidence from clinical studies on quality of life (QoL) in patients suffering from internet use disorders (IUD) is still limited. Furthermore, the impact of additional mental comorbidities on QoL in IUD patients has rarely been investigated yet. Materials and Methods: In a cross-sectional clinical study 149 male subjects were analyzed for the presence and severity of an IUD as well as other mental disorders by experienced clinicians. The sample consisted of 60 IUD patients with and without comorbid mental disorders, 34 non-IUD patients with other mental disorders, and 55 healthy participants. Standardized clinical interviews (M.I.N.I. 6.0.0) and questionnaires on IUD symptom severity (s-IAT), QoL (WHOQOL-BREF), depression and anxiety symptoms (BDI-II and BAI), and general psychological symptoms (BSI) were used. Results: Internet use disorder patients showed significantly reduced QoL compared to healthy controls (Cohen's d = 1.64-1.97). Furthermore, IUD patients suffering from comorbid mental disorders showed significantly decreased levels of physical, social, and environmental QoL compared to IUD patients without any comorbidity (p < 0.05-0.001). Multiple linear regression analyses revealed that low levels of psychological, social and environmental QoL were mainly predicted by symptoms of depression. IUD factors were only significant predictors for the social and physical QoL. Discussion: Internet use disorder patients with comorbid mental disorder reported the lowest QoL. Depression symptom severity was the most significant predictor of low QoL in IUD. Strategies to reduce depressive symptoms should therefore be considered in IUD treatment to increase patients' QoL.

Comorbidity of Internet use disorder and attention deficit hyperactivity disorder: Two adult case-control studies.

Objectives There is good scientific evidence that attention deficit hyperactivity disorder (ADHD) is both a predictor and a comorbidity of addictive disorders in adulthood. These associations not only focus on substance-related addictions but also on behavioral addictions like gambling disorder and Internet use disorder (IUD). For IUD, systematic reviews have identified ADHD as one of the most prevalent comorbidities besides depressive and anxiety disorders. Yet, there is a need to further understand the connections between both disorders to derive implications for specific treatment and prevention. This is especially the case in adult clinical populations where little is known about these relations so far. This study was meant to further investigate this issue in more detail based on the general hypothesis that there is a decisive intersection of psychopathology and etiology between IUD and ADHD. Methods Two case-control samples were examined at a university hospital. Adult ADHD and IUD patients ran through a comprehensive clinical and psychometrical workup. Results We found support for the hypothesis that ADHD and IUD share psychopathological features. Among patients of each group, we found substantial prevalence rates of a comorbid ADHD in IUD and vice versa. Furthermore, ADHD symptoms were positively associated with media use times and symptoms of Internet addiction in both samples. Discussion Clinical practitioners should be aware of the close relationships between the two disorders both diagnostically and therapeutically. When it comes to regain control over one's Internet use throughout treatment and rehabilitation, a potential shift of addiction must be kept in mind on side of practitioners and patients.