Associations between Internet Addiction, Psychiatric Comorbidity, and Maternal Depression and Anxiety in Clinically Referred Children and Adolescents

Abstract

Purpose

Internet addiction (IA) has become a global problem and is one of the most common reasons for children to be referred for intervention because IA results in social and educational dysfunction and conflict with parents. IA is associated with various comorbid psychiatric disorders, with notable association between IA and family factors. However, little is known about parental psychopathology. This study aimed to examine the prevalence of IA and association between IA and maternal depression and anxiety in clinical samples after adjusting for comorbidities.

Patients and Methods

A cross-sectional study was conducted between April 2020 and August 2021 at the Department of Neuropsychiatry of Osaka Metropolitan University Hospital in Japan. A total of 218 clinically referred children and adolescents (aged 8 to 15 years) were assessed using the Internet Addiction Test, which is one of the most popular questionnaires to evaluate IA, the Child Behavior Checklist (CBCL), and The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version. IA was defined as a total score on the Internet Addiction Test ≥ 50. Of those, for the evaluation of maternal depression and anxiety, the 132 mothers of the children who were referred after January 2021 completed K6 as well.

Results

A total of 68 participants (31.2%) presented with IA and had higher total and externalizing scores of CBCL, social anxiety disorder, and oppositional defiant disorder compared to those without IA. IA was associated with the six-item Kessler scale scores of mothers, being raised by single parents, and anxiety disorders after adjusting for age, sex, and family income (95% CI: 1.023–1.215).

Conclusion

Maternal depression and anxiety may be one of the risk factors for children and adolescents to develop IA. Care for maternal depression and anxiety may contribute to intervention for children and adolescents with IA.

Keywords:

• internet addiction
• children
• maternal depression
• oppositional defiant disorder
• social anxiety disorder

Abbreviations

ADHD, attention-deficit hyperactivity disorder; CBCL, Child Behavior Checklist; DSM-IV-TR, Diagnostic and Statistical Manual of Mental disorders-IV-Text Revision; IA, internet addiction; IAT, Internet Addiction Test; JIAT, Japanese version of the Internet Addiction Test; K6, six-item Kessler scale; K-SADS-PL, Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version; ODD, oppositional defiance disorder; SAD, social anxiety disorder; WMH, World Mental Health.

Data Sharing Statement

The original contributions presented in the study are included in the article, and further inquiries can be directed to the corresponding author.

Ethics Approval and Informed Consent

All children and their mothers provided written informed assent/consent before participating in the study. This study was approved by the Institutional Review Board at Osaka Metropolitan University Graduate School of Medicine. The research was performed according to the principles of the Declaration of Helsinki and its later amendments.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work

Additional information

Funding

This work was supported by JSPS KAKENHI (Grant Number JP20K03002).