A new survey of internet users suggests that people who use the internet excessively may have more mental health problems. Using two scales to evaluate internet use, researchers have found high rates of problematic internet use in a group of primarily college-aged students. The researchers evaluated internet addiction using the Internet Addiction Test, as well as newer scale of their own design, based on updated addiction criteria. This work, which is presented at the ECNP conference in Vienna, may have implications for how psychiatrists approach excessive internet use.

The unstoppable rise of the internet has given rise to fears that increasing numbers people are becoming unable to cope without regularly going online. The Internet Addiction Test (IAT) is the standard test used to measure excessive reliance on the internet, but as Chief Researcher Michael Van Ameringen pointed out: "The IAT was developed in 1998, prior to the widespread use of smartphone technology. In addition, internet use has changed radically over the last 18 years, through more people working online, media streaming, social media, etc. We were concerned that the IAT questionnaire may not have been picking up on problematic modern internet use, or showing up false positives for people who were simply using the internet rather than being over-reliant on it."

Professor Van Ameringen's group, from McMaster University in Canada, surveyed 254 students and correlated internet use with general mental health and wellbeing. Thirty-three of the students met screening criteria for internet addition according to the Internet Addiction Test. However, 107 students met criteria for problematic internet use using Professor Van Ameringen and colleagues' new screening tool. The research team also administered a further series of self-reported tests to see how the internet addicts compared to the others in the survey on areas such as symptoms of depression and anxiety, impulsiveness, inattention and executive functioning, as well as tests for ADHD.

Professor Van Ameringen said: "We found that those screening positive on the IAT as well as on our scale, had significantly more trouble dealing with their day to day activities, including life at home, at work/school and in social settings. Individuals with internet addiction also had significantly higher amounts of depression and anxiety symptoms, problems with planning and time management, greater levels of attentional impulsivity as well as ADHD symptoms. This leads us to a couple of questions: firstly, are we grossly underestimating the prevalence of internet addiction and secondly are these other mental health issues a cause or consequence of this excessive reliance on the internet?

This may have practical medical implications. If you are trying to treat someone for an addiction when in fact they are anxious or depressed, then you may be going down the wrong route. We need to understand this more, so we need a bigger sample, drawn from a wider, more varied population."

Commenting Professor Jan Buitelaar (Radboud University Nijmegen Medical Centre) of the ECNP Child and adolescent disorders treatment Scientific Advisory Panel said: "Excessive use of the internet is an understudied phenomenon that may disguise mild or severe psychopathology; excessive use of the internet may be strongly linked to compulsive behaviour and addiction; as the authors say, further study is needed in larger populations."