Li Sihong, Jin Xingyue, Song Lintong, Fan Tianqing, Shen Yanmei, Zhou Jiansong
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.
J Med Internet Res. 2025 Jan 3;27:e52083. doi: 10.2196/52083.
Suicide is a critical public health issue in adolescents worldwide. Internet addiction may play a role in the increased rate of suicide attempts in this population. However, few studies have explored the relationship between pathological internet use and suicide attempts among adolescents.
This study aimed to conduct a prospective cohort study to examine whether higher severity of pathological internet use was associated with an increased risk of suicide attempts among Chinese adolescents.
A total of 782 adolescents were recruited from a middle school from November 2020 to December 2020 and followed up for 6 months. An online self-reported questionnaire was used to collect the participants' demographic data and assess their mental health. The Depression, Anxiety, and Stress Scale-21 items (DASS-21) was used to evaluate depression, anxiety, and stress. The Chen Internet Addiction Scale-Revised (CIAS-R) was used to assess the symptoms and severity of pathological internet use. χ test and ANOVA were used for intergroup comparison, and logistic regression analysis was used to examine the relationship between the severity of pathological internet use and suicide attempts. We also used a restricted cubic splines model to investigate the pattern of the association.
The participants had an average age of 12.59 (SD 0.64) years, with the majority being of Han ethnicity (743/782, 95.01%) and more than half being male (426/782, 54.48%). Most participants had no previous history of depression (541/782, 69.18%), anxiety (415/782, 53.07%), or stress (618/782, 79.03%). The rate of newly reported suicide attempts was 4.6% (36/782). A significant positive association was observed between internet addiction and suicide attempts (odds ratio 3.88, 95% CI 1.70-8.82), which remained significant after adjusting for age, sex, ethnicity, anxiety, depression, and stress (odds ratio 2.65, 95% CI 1.07-6.55). In addition, this association exhibited a linear pattern in the restricted cubic spline regression model.
This study suggested that internet addiction, rather than internet overuse, was associated with a higher likelihood of suicide attempts, which highlighted the importance of addressing internet addiction symptoms among Chinese adolescents for suicide prevention.
自杀是全球青少年中一个关键的公共卫生问题。网络成瘾可能在该人群自杀未遂率上升中起作用。然而，很少有研究探讨青少年病理性网络使用与自杀未遂之间的关系。
本研究旨在进行一项前瞻性队列研究，以检验中国青少年中病理性网络使用的更高严重程度是否与自杀未遂风险增加相关。
2020年11月至2020年12月从一所中学招募了782名青少年，并随访6个月。使用在线自我报告问卷收集参与者的人口统计学数据并评估他们的心理健康。使用21项抑郁、焦虑和压力量表（DASS-21）来评估抑郁、焦虑和压力。使用修订后的陈网络成瘾量表（CIAS-R）来评估病理性网络使用的症状和严重程度。χ检验和方差分析用于组间比较，逻辑回归分析用于检验病理性网络使用严重程度与自杀未遂之间的关系。我们还使用受限立方样条模型来研究这种关联的模式。
参与者的平均年龄为12.59（标准差0.64）岁，大多数为汉族（743/782，95.01%），超过一半为男性（426/782，54.48%）。大多数参与者既往无抑郁（541/782，69.18%）、焦虑（415/782，53.07%）或压力（618/782，79.03%）病史。新报告的自杀未遂率为4.6%（36/782）。观察到网络成瘾与自杀未遂之间存在显著正相关（优势比3.88，95%置信区间1.70 - 8.82），在调整年龄、性别、种族、焦虑、抑郁和压力后仍显著（优势比2.65，95%置信区间1.07 - 6.55）。此外，在受限立方样条回归模型中这种关联呈现线性模式。
本研究表明，网络成瘾而非网络过度使用与更高的自杀未遂可能性相关，这凸显了在中国青少年中解决网络成瘾症状以预防自杀的重要性。
