Internet addiction and its association with quality of life in patients with major depressive disorder: a network perspective

doi:10.1038/s41398-022-01893-2

Multicenter Study

. 2022 Apr 4;12(1):138.

doi: 10.1038/s41398-022-01893-2.

Internet addiction and its association with quality of life in patients with major depressive disorder: a network perspective

Wei Bai^#^{1

2

3}, Hong Cai^#^{1

2

3}, Siqi Wu^#^{4

5}, Ling Zhang^#⁶, Ke-Xin Feng^#⁷, Yu-Chen Li^#⁸, Huan-Zhong Liu^#^{9

10}, Xiangdong Du⁵, Zhen-Tao Zeng⁶, Chang-Mou Lu⁶, Wen-Fang Mi¹¹, Lan Zhang¹¹, Yan-Hong Ding¹¹, Juan-Juan Yang^{9

10}, Todd Jackson¹², Teris Cheung¹³, Feng-Rong An¹⁴, Yu-Tao Xiang^{1

2

3}

Affiliations

¹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
² Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
³ Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
⁴ School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, Hebei Province, China.
⁵ Guangji Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, China.
⁶ Nanning Fifth People's Hospital, Nanning, Guangxi Province, China.
⁷ School of Public Health, Lanzhou University, Lanzhou, Gansu Province, China.
⁸ Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China.
⁹ Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.
¹⁰ School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
¹¹ Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China.
¹² Department of Psychology, University of Macau, Macao SAR, China.
¹³ School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
¹⁴ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. afrylm@sina.com.

^# Contributed equally.

PMID: 35379778
PMCID: PMC8977829
DOI: 10.1038/s41398-022-01893-2

Multicenter Study

Internet addiction and its association with quality of life in patients with major depressive disorder: a network perspective

Wei Bai et al. Transl Psychiatry. 2022.

. 2022 Apr 4;12(1):138.

doi: 10.1038/s41398-022-01893-2.

Authors

Affiliations

¹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
² Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
³ Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
⁴ School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, Hebei Province, China.
⁵ Guangji Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, China.
⁶ Nanning Fifth People's Hospital, Nanning, Guangxi Province, China.
⁷ School of Public Health, Lanzhou University, Lanzhou, Gansu Province, China.
⁸ Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China.
⁹ Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.
¹⁰ School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
¹¹ Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China.
¹² Department of Psychology, University of Macau, Macao SAR, China.
¹³ School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
¹⁴ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. afrylm@sina.com.

^# Contributed equally.

PMID: 35379778
PMCID: PMC8977829
DOI: 10.1038/s41398-022-01893-2

Abstract

Depressive disorders and internet addiction (IA) are often comorbid. The aims of this study were to examine the network structure of IA in patients with major depressive disorders (MDD) and explore the association between IA and quality of life (QoL) in this population. This was a multicenter, cross-sectional survey. IA and QoL were assessed with the Internet Addiction Test (IAT) and the World Health Organization Quality of Life-brief version, respectively. Node expected influence (EI) was used to identify central symptoms in the network model, while the flow network of QoL was generated to examine its association with IA. A total of 1,657 patients with MDD was included. "Preoccupation with the Internet," "Job performance or productivity suffer because of the Internet," and "Neglect chores to spend more time online" were central symptoms. The symptom "Form new relationships with online users" had the strongest direct positive relation with QoL, while "Spend more time online over going out with others" and "Job performance or productivity suffer because of the Internet" had the strongest direct negative relations with QoL. Neglecting work caused by IA correlated with QoL, while making friends online appropriately was related to better QoL among MDD patients. Appropriate interventions _targeting the central symptoms may potentially prevent or reduce the risk of IA in MDD patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1. Network structure of internet addiction symptoms in patients with major depressive disorder.**
IAT internet addiction test.

**Fig. 2. The flow diagram of network showing how the quality of life is connected to internet addiction symptoms.**
Note: items in the middle of the figure indicate the direct connection to quality of life and items located on the right represent the indirect connection.

**Fig. 3. Estimation of node expected influence difference by bootstrapped difference test.**
Note: Gray boxes indicate nodes that do not significantly differ from one-another. Black boxes represent nodes that differ significantly from one another (α = 0.05). White boxes show the values of node strength.

See this image and copyright information in PMC

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1. Karatoprak S, Donmez YE. Internet addiction and comorbid pyschiatric disorders in adolescents. Ann Med Res. 2020;27:504–9.

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[1] Anderson EL, Steen E, Stavropoulos V. Internet use and problematic internet use: a systematic review of longitudinal research trends in adolescence and emergent adulthood. Int J Adolesc Youth. 2017;22:430–54.

[2] Anderson EL, Steen E, Stavropoulos V. Internet use and problematic internet use: a systematic review of longitudinal research trends in adolescence and emergent adulthood. Int J Adolesc Youth. 2017;22:430–54.

[3] Christakis DA. Internet addiction: a 21st century epidemic? BMC Med. 2010;8:61. - PMC - PubMed

[4] Christakis DA. Internet addiction: a 21st century epidemic? BMC Med. 2010;8:61. - PMC - PubMed

[5] Pan YC, Chiu YC, Lin YH. Systematic review and meta-analysis of epidemiology of internet addiction. Neurosci Biobehav Rev. 2020;118:612–22. - PubMed

[6] Pan YC, Chiu YC, Lin YH. Systematic review and meta-analysis of epidemiology of internet addiction. Neurosci Biobehav Rev. 2020;118:612–22. - PubMed

[7] Young KS. Internet addiction: the emergence of a new clinical disorder. Cyberpsychol Behav. 1998;1:237–44.

[8] Young KS. Internet addiction: the emergence of a new clinical disorder. Cyberpsychol Behav. 1998;1:237–44.

[9] Karatoprak S, Donmez YE. Internet addiction and comorbid pyschiatric disorders in adolescents. Ann Med Res. 2020;27:504–9.

[10] Karatoprak S, Donmez YE. Internet addiction and comorbid pyschiatric disorders in adolescents. Ann Med Res. 2020;27:504–9.

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Internet addiction and its association with quality of life in patients with major depressive disorder: a network perspective

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Internet addiction and its association with quality of life in patients with major depressive disorder: a network perspective

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