Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan.
WinShine Clinics in Specialty of Psychiatry, Kaohsiung City, Taiwan.
J Clin Psychiatry. 2018 Jun 5;79(4):17r11761. doi: 10.4088/JCP.17r11761.
To perform a systematic review and meta-analysis of observational studies that investigated the putative association between internet addiction and suicidality.
Major electronic databases (PubMed, Embase, ClinicalKey, Cochrane Library, ProQuest, Science Direct, and ClinicalTrials.gov) were searched using the following keywords (internet addiction OR internet gaming disorder OR internet use disorder OR pathological internet use OR compulsive internet use OR problematic internet use) AND (suicide OR depression) to identify observational studies from inception to October 31, 2017.
We included 23 cross-sectional studies (n = 270,596) and 2 prospective studies (n = 1,180) that investigated the relationship between suicide and internet addiction.
We extracted the rates of suicidal ideation, planning, and attempts in individuals with internet addiction and controls.
The individuals with internet addiction had significantly higher rates of suicidal ideation (odds ratio [OR] = 2.952), planning (OR = 3.172), and attempts (OR = 2.811) and higher severity of suicidal ideation (Hedges g = 0.723). When restricted to adjusted ORs for demographic data and depression, the odds of suicidal ideation and attempts were still significantly higher in the individuals with internet addiction (ideation: pooled adjusted OR = 1.490; attempts: pooled adjusted OR = 1.559). In subgroup analysis, there was a significantly higher prevalence rate of suicidal ideation in children (age less than 18 years) than in adults (OR = 3.771 and OR = 1.955, respectively).
This meta-analysis provides evidence that internet addiction is associated with increased suicidality even after adjusting for potential confounding variables including depression. However, the evidence was derived mostly from cross-sectional studies. Future prospective studies are necessary to confirm these findings.
对调查网络成瘾与自杀关联性的观察性研究进行系统回顾和荟萃分析。
主要电子数据库（PubMed、Embase、ClinicalKey、Cochrane Library、ProQuest、Science Direct 和 ClinicalTrials.gov）使用以下关键词（网络成瘾、网络游戏障碍、网络使用障碍、病理性网络使用、强迫性网络使用、问题性网络使用）和（自杀、抑郁）进行搜索，以确定从研究开始到 2017 年 10 月 31 日的观察性研究。
我们纳入了 23 项横断面研究（n=270596）和 2 项前瞻性研究（n=1180），这些研究调查了自杀与网络成瘾之间的关系。
我们提取了网络成瘾者和对照组中自杀意念、计划和尝试的发生率。
网络成瘾者自杀意念（优势比[OR]=2.952）、计划（OR=3.172）和尝试（OR=2.811）的发生率以及自杀意念的严重程度显著更高（Hedges g=0.723）。当限制为针对人口统计学数据和抑郁的调整后 OR 时，网络成瘾者自杀意念和尝试的可能性仍然显著更高（意念：汇总调整后的 OR=1.490；尝试：汇总调整后的 OR=1.559）。在亚组分析中，儿童（年龄小于 18 岁）自杀意念的发生率明显高于成人（OR=3.771 和 OR=1.955）。
本荟萃分析提供了证据，表明即使在调整了包括抑郁在内的潜在混杂变量后，网络成瘾与自杀意念增加有关。然而，这些证据主要来自横断面研究。需要进一步进行前瞻性研究以证实这些发现。
