Taikang Tongji (Wuhan) Hospital, Wuhan, China.
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Med Internet Res. 2023 Aug 30;25:e44514. doi: 10.2196/44514.
There is growing evidence that the internet has beneficial effects on the mental health of middle-aged and older people (≥45 years), but the evidence is inconclusive, and the underlying mechanisms are less known.
This study aims to explore the relationship between multidimensional (devices, frequency, and purpose) internet use and depression in middle-aged and elderly Chinese, as well as the mediating effect of social participation. Moreover, this study will explore the moderating effect of the regional informatization development level (RIDL) on the relationships between individual internet use, social participation, and depression.
Data on 17,676 participants aged 45 years or older were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2018 data set. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to identify the presence of depression. Logistic regression was used to explore the relationship between each dimension of internet use and depression. Multiple linear regression was used to explore the mediating effect of social participation and the moderating effect of the RIDL.
The results showed that 28.33% (5008/17,676) of the total population had depression. In terms of regional subgroups, respondents living in the western region exhibited the highest proportion of depression (2041/5884, 34.69%). Internet use was negatively associated with depression (odds ratio 0.613, 95% CI 0.542-0.692; P<.001). Various dimensions of internet use positively contributed to individual social participation and reduced individual depression (devices: β=-.170, 95% CI -0.209 to -0.127; frequency: β=-.065, 95% CI -0.081 to -0.047; and purpose: β=-.043, 95% CI -0.053 to -0.031). In addition, the RIDL weakened the relationship between individual-level internet use and social participation (internet use: F=7.55, P<.001; devices: F=5.23, P=.005; frequency: F=6.62, P=.001; and purpose: F=6.80, P=.001), and negatively moderated the relationship between the frequency of internet use and depression (frequency: F=3.51, P=.03).
This study found that different dimensions of internet use are associated with lower levels of depression. Social participation partially mediates the association between multidimensional internet use and depression in the eastern, central, and western regions, respectively. Additionally, the RIDL helps individuals further their internet use and social participation, reducing the impact of depression. However, this effect weakens sequentially from the western region to the central region and then to the eastern region.
越来越多的证据表明，互联网对中年和老年人（≥45 岁）的心理健康有有益影响，但证据尚不明确，其潜在机制也知之甚少。
本研究旨在探讨中国中老年人群多维（设备、频率和目的）互联网使用与抑郁之间的关系，以及社会参与的中介作用。此外，本研究还将探讨区域信息化发展水平（RIDL）对个体互联网使用、社会参与和抑郁之间关系的调节作用。
本研究使用中国健康与养老追踪调查（CHARLS）2018 年数据集，获取了 17676 名年龄在 45 岁及以上的参与者的数据。采用 10 项中心流行病学研究抑郁量表（CES-D-10）来确定抑郁的存在。采用 logistic 回归来探讨各维度互联网使用与抑郁之间的关系。采用多元线性回归来探讨社会参与的中介作用和 RIDL 的调节作用。
研究结果显示，总人群中有 28.33%（5008/17676）存在抑郁。在区域亚组中，西部地区的受访者表现出最高的抑郁比例（2041/5884，34.69%）。互联网使用与抑郁呈负相关（比值比 0.613，95%置信区间 0.542-0.692；P<.001）。各种维度的互联网使用均有助于个体的社会参与，并降低个体的抑郁程度（设备：β=-.170，95%置信区间 -0.209 至 -0.127；频率：β=-.065，95%置信区间 -0.081 至 -0.047；目的：β=-.043，95%置信区间 -0.053 至 -0.031）。此外，RIDL 削弱了个体互联网使用与社会参与之间的关系（互联网使用：F=7.55，P<.001；设备：F=5.23，P=.005；频率：F=6.62，P=.001；目的：F=6.80，P=.001），并负向调节了互联网使用频率与抑郁之间的关系（频率：F=3.51，P=.03）。
本研究发现，不同维度的互联网使用与较低水平的抑郁相关。社会参与部分中介了东部、中部和西部地区多维互联网使用与抑郁之间的关系。此外，RIDL 有助于个体进一步进行互联网使用和社会参与，降低抑郁的影响。然而，这种影响从西部地区到中部地区再到东部地区依次减弱。
