Problematic internet use and its association with depression and social anxiety among medical students: A cross-sectional study
DOI:
https://doi.org/10.14748/ajeb4v89Keywords:
Problematic internet use, behavioral addiction, medical students, depression, social anxietyAbstract
Introduction: Problematic internet use (PIU) has become an important behavioral health concern among university students and has been associated with various adverse mental health outcomes. Medical students may be particularly vulnerable because of intensive academic demands and psychosocial stressors.
Aim: This study aimed to determine the prevalence of problematic internet use among medical students and to examine its relationship with depressive symptoms, social anxiety, and sociodemographic characteristics.
Materials and Methods: This cross-sectional study was conducted with 437 students (230 females, 207 males; mean age 22.37 ± 1.86) enrolled at the Faculty of Medicine of Kocaeli University. Participants completed a sociodemographic questionnaire, the Young Internet Addiction Scale (YIAS), the Beck Depression Inventory (BDI), and the Liebowitz Social Anxiety Scale (LSAS). Data were analyzed using the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman correlation analysis.
Results: Among participants, 95.0% (n = 415) were classified as average internet users and 5.0% (n = 22) as at-risk users; no participant met the threshold for internet addiction. The rate of at-risk use was higher among males (5.8%) than females (4.3%), though the difference was not statistically significant. At-risk users had significantly higher Beck Depression Inventory (p < 0.0005) and Liebowitz Social Anxiety Scale total scores (p < 0.0005) compared to average users. Internet Addiction Scale total scores were positively correlated with BDI (r = 0.21, p < 0.01) and LSAS total scores (r = 0.20, p < 0.01).
Conclusion: Problematic internet use is significantly associated with depressive symptoms and social anxiety among medical students. These findings support the routine assessment of problematic internet use during mental health screening of medical students.
References
[1] Young KS. Internet addiction: A new clinical phenomenon and its consequences. Am Behav Sci. 2004;47(4):402-15. doi:10.1177/0002764204270278. DOI: https://doi.org/10.1177/0002764204270278
[2] Caplan SE. A social skill account of problematic internet use. J Commun. 2005;55(4):721-36. doi:10.1111/j.1460-2466.2005.tb03019.x. DOI: https://doi.org/10.1111/j.1460-2466.2005.tb03019.x
[3] Ko CH, Yen JY, Yen CF, et al. The association between internet addiction and psychiatric disorder: a review of the literature. Eur Psychiatry. 2012;27(1):1-8. doi:10.1016/j.eurpsy.2010.04.011. DOI: https://doi.org/10.1016/j.eurpsy.2010.04.011
[4] American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington (DC): American Psychiatric Association; 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596
[5] Fineberg NA, Demetrovics Z, Potenza MN, et al. Global action on problematic internet use: announcing a Lancet Psychiatry Commission. Lancet Psychiatry. 2025;12(1):11-13. doi:10.1016/S2215-0366(24)00354-8. DOI: https://doi.org/10.1016/S2215-0366(24)00323-7
[6] Moreno MA, Jelenchick L, Cox E, et al. Problematic internet use among US youth: a systematic review. Arch Pediatr Adolesc Med. 2011;165(9):797-805. doi:10.1001/archpediatrics.2011.58. DOI: https://doi.org/10.1001/archpediatrics.2011.58
[7] Salpynov Z, Kosherova Z, Sarría-Santamera A, et al. The worldwide prevalence of internet addiction among medical students: a systematic review and meta-analysis. Int J Environ Res Public Health. 2024;21(9):1146. doi:10.3390/ijerph21091146. DOI: https://doi.org/10.3390/ijerph21091146
[8] Jiang Q, Wang X, Zhang Y. Associations between problematic internet use and mental health outcomes among students: a meta-analytic review. J Affect Disord. 2023;324:61-69. doi:10.1016/j.jad.2022.11.079. DOI: https://doi.org/10.1016/j.jad.2022.11.079
[9] Cai Y, Song Y, Li Y, et al. The symptom network of internet gaming addiction, depression, and anxiety among children and adolescents. Sci Rep. 2024;14:29494. doi:10.1038/s41598-024-80644-4. DOI: https://doi.org/10.1038/s41598-024-81094-7
[10] Ding H, Cao B, Sun Q. The association between problematic internet use and social anxiety among adolescents and young adults: a systematic review and meta-analysis. Front Public Health. 2023;11:1275723. doi:10.3389/fpubh.2023.1275723. DOI: https://doi.org/10.3389/fpubh.2023.1275723
[11] Sserunkuuma J, Kaggwa MM, Muwanguzi M, et al. Problematic use of the internet, smartphones, and social media among medical students and its relationship with depression: an exploratory study. PLoS One. 2023;18(5):e0286424. DOI: https://doi.org/10.1371/journal.pone.0286424
[12] Sayili U, Kara B, Aydin SN, et al. Are depression, quality of life and life satisfaction associated with internet addiction? A cross-sectional study among Turkish university students. BMC Psychiatry. 2025;25:644. doi:10.1186/s12888-025-07097-4. DOI: https://doi.org/10.1186/s12888-025-07097-4
[13] Young KS. Internet addiction: The emergence of a new clinical disorder. CyberPsychol Behav. 1998;1(3):237-44. doi:10.1089/cpb.1998.1.237. DOI: https://doi.org/10.1089/cpb.1998.1.237
[14] Bayraktar F. The role of internet use in adolescent development [master's thesis]. Izmir (TR): Ege University, Institute of Social Sciences; 2001.
[15] Beck AT. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561-71. doi:10.1001/archpsyc.1961.01710120031004. DOI: https://doi.org/10.1001/archpsyc.1961.01710120031004
[16] Hisli N. Beck Depresyon Envanteri'nin üniversite öğrencileri için geçerliği, güvenirliği [Validity and reliability of the Beck Depression Inventory for university students]. Psikoloji Dergisi. 1989;7(23):3-13.
[17] Safren SA, Heimberg RG, Horner KJ, et al. Factor structure of social fears: The Liebowitz Social Anxiety Scale. J Anxiety Disord. 1999;13(3):253-70. doi:10.1016/S0887-6185(99)00003-1. DOI: https://doi.org/10.1016/S0887-6185(99)00003-1
[18] Soykan C, Ozgüven HD, Gençöz T. Liebowitz Social Anxiety Scale: the Turkish version. Psychol Rep. 2003;93(3 Pt 2):1059-69. doi:10.2466/pr0.2003.93.3f.1059. DOI: https://doi.org/10.2466/pr0.2003.93.3f.1059
[19] Özarıcı E, Cangöl Söğüt S. The relationship between internet addiction and risky health behaviors in university students: a cross-sectional study in Turkey. Perspect Psychiatr Care. 2022;58(1):214-220. doi:10.1111/ppc.12872. DOI: https://doi.org/10.1111/ppc.12872
[20] Ergin A, Uzun SU, Bozkurt AI. Tıp fakültesi öğrencilerinde internet bağımlılığı sıklığı ve etkileyen etmenler [Internet addiction prevalence and contributing factors in medical faculty students]. Pamukkale Tıp Dergisi. 2013;6(3):134-142. DOI: https://doi.org/10.5505/ptd.2013.41713
[21] Mari E, Biondi S, Varchetta M, et al. Gender differences in internet addiction: a study on variables related to its possible development. Comput Hum Behav Rep. 2023;9:100247. doi:10.1016/j.chbr.2022.100247. DOI: https://doi.org/10.1016/j.chbr.2022.100247
[22] Hayat AA, Kojuri J, Amini M. Academic procrastination of medical students: The role of Internet addiction. J Adv Med Educ Prof. 2020;8(2):83-89. doi:10.30476/JAMP.2020.85000.1159.
[23] Çelik DÖ, Haney MÖ. The relationship between depression, healthy lifestyle behaviors and internet addiction: a cross-sectional study of the athlete university students in Turkey. Front Psychiatry. 2023;14:1222931. doi:10.3389/fpsyt.2023.1222931. DOI: https://doi.org/10.3389/fpsyt.2023.1222931
[24] Yang X, Guo WJ, Tao YJ, et al. A bidirectional association between internet addiction and depression: a large-sample longitudinal study among Chinese university students. J Affect Disord. 2022;299:416-424. doi:10.1016/j.jad.2021.12.013. DOI: https://doi.org/10.1016/j.jad.2021.12.013
[25] Kılıç Z, Durat G. Üniversite öğrencilerinde problemli internet kullanımının genel psikolojik belirtileri ve sosyal fobi ile ilişkisi [The relationship between problematic internet use and general psychological symptoms and social phobia among university students]. Sakarya Tıp Dergisi. 2017;7(2):97-104. doi:10.31832/smj.332753. DOI: https://doi.org/10.31832/smj.332753
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Data Availability Statement
The datasets generated and/or analyzed during the current study are not publicly available due to ethical and privacy considerations but are available from the corresponding author on reasonable request.
