AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science. METHODS: Over the last 15 years, the number of Internet users has increased by 1000%, and at the same time, research on addictive Internet use has proliferated. Internet addiction has not yet been understood very well, and research on its etiology and natural history is still in its infancy. In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) as condition that requires further research prior to official inclusion in the main manual, with important repercussions for research and treatment. To date, reviews have focused on clinical and treatment studies of Internet addiction and Internet Gaming Disorder. This arguably limits the analysis to a specific diagnosis of a potential disorder that has not yet been officially recognised in the Western world, rather than a comprehensive and inclusive investigation of Internet-use related addictions (including problematic Internet use) more generally. RESULTS: The systematic literature review identified a total of 46 relevant studies. The included studies used clinical samples, and focused on characteristics of treatment seekers and online addiction treatment. Four main types of clinical research studies were identified, namely research involving (1) treatment seeker characteristics; (2) psychopharmacotherapy; (3) psychological therapy; and (4) combined treatment. CONCLUSION: A consensus regarding diagnostic criteria and measures is needed to improve reliability across studies and to develop effective and efficient treatment approaches for treatment seekers.

Internet addiction and problematic Internet use: A systematic review of clinical research.

The relationship between parental mediation and Internet addiction among adolescents, and the association with cyberbullying and depression

A contribution to the clinical characterization of Internet addiction in a sample of treatment seekers: Validity of assessment, severity of psychopathology and type of co-morbidity

Comorbidity of psychiatric disorders with Internet addiction in a clinical sample: the effect of personality, defense style and psychopathology.

Objective: This study aims to address possible associations between excessive use of the Internet and ADHD and Depression. As most of the studies on this topic were conducted in Asia, the aim of this investigation is to review the literature on this subject from Germany and examine problematic Internet use for potential associations with the propensity for Depression and Attention Deficit/Hyperactivity Disorder (ADHD) in a new, distinct German sample.
Methods: A review of the literature was conducted. Subsequently, a total of N = 895 healthy participants from Germany (413 males, 482 females) took part in a new study. Participants filled in questionnaires on their Internet usage, propensity for depression and ADHD.
Results: The review of the literature revealed predominantly positive associations between problematic Internet use and depression, whereas only one study on the relationship between problematic Internet use and ADHD from Germany was found. The results from the current study showed that male participants had significantly higher scores on the Internet Addiction Test (IA-T) than female participants. Finally, the IA-T scores of the participants were linked to both the propensity for depression (r = .247, p < .01) and ADHD (r = .335, p < .01). This association was stronger for ADHD and in particular for the subscale “attention deficit”, as revealed by a post-hoc analysis.
Conclusion: The results of this study are consistent with most of the research on this topic in other cultural circles and highlight the role of ADHD and depression when it comes to problematic Internet use. This study provides a basis for consideration about the clinical implications and treatment of comorbid problematic Internet use.

Attention Deficit/Hyperactivity Disorder is a Better Predictor for Problematic Internet use than Depression: Evidence from Germany

Addictive Internet use has recently been proposed to be included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Still, little is known about its nosological features, including comorbidity with other mental disorders and disorder-specific psychopathological symptoms. To investigate whether Internet addiction (IA) is an issue in patients in addiction treatment, 1826 clients were surveyed in 15 inpatient rehabilitation centers. Male patients meeting criteria for comorbid IA (n = 71) were compared with a matched control group of male patients treated for alcohol addiction without addictive Internet use (n = 58). The SCL-90-R, the Patient Health Questionnaire, and the seven-item Generalized Anxiety Disorder were used to assess associated psychiatric symptoms and further comorbid disorders. Comorbid IA was associated with higher levels of psychosocial symptoms, especially depression, obsessive-compulsive symptoms, and interpersonal sensitivity. Moreover, the patients with IA more frequently met criteria for additional mental disorders. They display higher rates of psychiatric symptoms, especially depression, and might be in need of additional therapeutic treatment. In rehabilitation centers, a regular screening for IA is recommended to identify patients with this (non-substance-related) addiction and supply them with additional disorder-specific treatment.

Comorbid internet addiction in male clients of inpatient addiction rehabilitation centers: psychiatric symptoms and mental comorbidity.

Anliegen: Die exzessive Nutzung des Internets wird als substanzungebundene Form einer Abhangigkeitserkrankung diskutiert. Laut Pravalenzschatzungen ist 1 % der deutschen Bevolkerung betroffen. Ungeklart ist, inwieweit Internetsucht komorbid unter Patienten der stationaren Suchtrehabilitation auftritt. Methode: In 15 Kliniken wurden alle innerhalb eines halben Jahres aufgenommenen Patienten auf das Vorliegen von Internetsucht gescreent. Ergebnisse: 4,2 % der Patienten erfullten die Kriterien. Diese waren haufiger mannlich mit den Primardiagnosen Cannabisabhangigkeit und pathologisches Glucksspiel. Schlussfolgerungen: Dies verdeutlicht den Bedarf an entsprechenden Routinescreenings innerhalb von Reha-Kliniken.

[Internet addiction as a co-morbid disorder among patients of german addiction rehabilitation facilities: an exploratory investigation of clinical prevalence].

According to the World Health Organization well-being has been defined as one outcome parameter indicating successful recovery from diseases. One disease causing significant psychosocial problems and distress is Gambling Disorder that is being characterized as a poorly controlled excessive engagement in gambling activities. While there are several studies investigating treatment-effects in patients with Gambling Disorder, the role of well-being as a complementary treatment outcome has not been studied so far. In our research project it was aimed to fill this gap by gathering data on changes of eudaimonic dimensions of well-being from 76 patients with Gambling Disorder before and 1 year after receiving inpatient treatment. At both waves (pretreatment and follow-up) we collected data regarding well-being (Ryff Scales of Well-being), psychopathological symptoms (SCL-9), and diagnostic criteria for Gambling Disorder (Lie/Bet-Questionnaire). We found some dimensions of well-being changing 1 year after treatment and that patients recovered from Gambling Disorder displayed significant increments in Autonomy and Environmental Mastery. In contrast, patients still meeting criteria for Gambling Disorder displayed well-being increments only in Environmental Mastery and decreases in Personal Growth and Positive Relations with Others. Only changes in Environmental Mastery and Self-Acceptance were significantly associated with decreases in psychosocial distress indicating that well-being is an additional indicator for treatment outcome. It was also intended to identify factors predicting increments in well-being. However, no relationships were found regarding demographics, clinical variables, or treatment parameters. It is proposed to acknowledge well-being as an additional indicator for treatment effects and suggested to implement therapeutic strategies for an early enhancement of well-being.

Psychological Well-Being as an Additional Outcome Parameter in the Treatment of Patients with Gambling Disorder: Results from a Clinical Multicenter Follow-Up Study

Andreas Koch

Papers

Comorbid internet addiction in male clients of inpatient addiction rehabilitation centers: psychiatric symptoms and mental comorbidity.

[Internet addiction as a co-morbid disorder among patients of german addiction rehabilitation facilities: an exploratory investigation of clinical prevalence].

Psychological Well-Being as an Additional Outcome Parameter in the Treatment of Patients with Gambling Disorder: Results from a Clinical Multicenter Follow-Up Study