Suicidality, psychopathology, resilience, and psychosocial correlates of internet addictive disorder among the internet users: An online questionnaire survey

Background: Internet addiction (IA) has become a major public health issue worldwide and is closely linked to psychiatric disorders and suicide. The American Psychiatric Association has published the diagnostic criteria for  Internet Gaming Disorder (IGD) in the 5th Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The present study aimed to investigate the associated psychosocial and psychopathological determinants, insight and  seeking behavior of Internet Addictive Disorder (IAD) among internet users of different age groups. Methods: The study was a cross-sectional online survey. The participants were recruited from the general public who completed  a series of self-reported measures, including 9-item Internet Addictive Disorder Questionnaire (IAD-9), Five-item Brief Symptom Rating Scale (BSRS-5), Neuroticism Scale (NS), Brief Resilience Coping Scale (BRCS),  suicide assessment and internet use habits. Results: We enrolled 1012 respondents (52.2% of females; 76.1% aged 15-24). Based on the cutoff for IAD-9, the prevalence rate of IAD among internet users was 23.7%.  Participants with higher scores of IAD-9 were characterized as female, unemployed, with higher neuroticism, lower resilience, life impairment due to internet use, more time for internet use, online gaming, high BSRS-5 score,  recent suicidal ideation, and past suicide attempts. Stepwise multiple regression on the IAD-9 score revealed that neuroticism, BSRS-5 score, and resilience accounted for 36.2% of the variance for IAD-9 score. Further, logistic regression indicated that neuroticism, life impairment, psychiatric morbidity, and resilience were the four main predictors for IAD. Compared to those without IAD, the IAD individuals presented higher rates of  psychiatric morbidity (74.6%), recent suicidal ideation (64.2%), lifetime suicide attempts (27.1%), and suicide attempts in a year (32.5%). Although the majority (77.1%) of IAD individuals had a positive insight toward IAD, only  16.3% of them sought help from mental health services. Conclusions: Neurotic  personality traits, psychopathology, low resilience, and life impairment were significant predictors of IAD. The IAD individuals had a high  prevalence of psychiatric morbidity and suicide risks. The findings provide important information for further investigation and prevention of IAD and its mental health co-morbidity.