Abstract
The effect of problematic use of the Internet on mental health, particularly depression among young people, has been established but without a probable model for the underlying mechanism. In this study, a model is presented to describe possible pathways for the linkage between Internet gaming addiction and depression possibly mediated by sleep problems. A systematic review was conducted to gather epidemiological evidence to support or refute the link between addictive Internet gaming, problematic Internet use, and sleep problems including insomnia and poor sleep quality. Seven studies were identified through a systematic literature search, of these three related to addictive Internet gaming and four on problematic Internet uses and sleep problems. Information was extracted and analysed systematically from each of the studies and tabulated as a summary. Results of the review suggest that additive gaming, particularly massively multiplayer online role-playing games MMORPG, might be associated with poorer quality of sleep. Results further indicated that problematic Internet use was associated with sleep problems including subjective insomnia and poor sleep quality.
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Shotton MA. The costs and benefits of “computer addiction”. Behav Inf Technol. 1991;10:219–30.
Potenza MN, Hollander E. Pathological gambling and impulse control disorders. In: Davis KL et al., editors. Neuropsychopharmacology: the Fifth generation of Progress. 5th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2002. p. 1736–37.
Scherer K. College life on-line: healthy and unhealthy Internet use. JCSD. 1997;38:655–65.
Morahan-Martin J, Schumacher P. Incidence and correlates of pathological Internet use among college students. Comp Human Behav. 2000;16:13–39.
Young KS. Internet addiction: the emergence of a new clinical disorder. Cyberpsychol Behav. 1998;11:237–44.
Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
Wei HT, Chen MH, Huang PC, Bai YM. The association between online gaming, social phobia, and depression: an internet survey. BMC Psychiatry. 2012;12:92.
Ko CH, Yen JY, Yen CF, Chen CS, Chen CC. The association between Internet addiction and psychiatric disorder: a review of the literature. Eur Psychiatry. 2012;27:1–8.
Huang AC. Chen HE. Wang YC: Wang LM. Internet abusers associate with a depressive state but not a depressive trait. Psychiatry Clin Neurosci; 2013. doi:10.1111/pcn.12124.
Goel D, Subramanyam A, Kamath R. A study on the prevalence of internet addiction and its association with psychopathology in Indian adolescents. Indian J Psychiatry. 2013;55:140–3.
Park S, Hong KE, Park EJ, Ha KS, Yoo HJ. The association between problematic internet use and depression, suicidal ideation and bipolar disorder symptoms in Korean adolescents. Aust N Z J Psychiatry. 2013;47:153–9.
Carli V, Durkee T, Wasserman D, Hadlaczky G, Despalins R, Kramarz E, et al. The association between pathological internet use and comorbid psychopathology: a systematic review. Psychopathology. 2013;46:1–13.
Lam LT, Peng ZW. Effect of pathological use of the internet on adolescent mental health: a prospective study. Arch Pediatr Adolesc Med. 2010;164:901–6.
Dong G, Lu Q, Zhou H, Zhao X. Precursor or sequela: pathological disorders in people with Internet addiction disorder. PLoS One. 2011;6:e14703.
Gentile DA, Choo H, Liau A, Sim T, Li D, Fung D, et al. Pathological video game use among youths: a two-year longitudinal study. Pediatrics. 2011;127:e319–29.
Lee MS, Ko YH, Song HS, et al. Characteristics of Internet use in relation to game genre in Korean adolescents. Cyberpsychol Behav. 2007;10:278–85.
Tahiroglu AY, Celik GG, Uzel M, Ozcan N, Avci A. Internet use among Turkish adolescents. Cyberpsychol Behav. 2008;11:537–43.
Smyth JM. Beyond self-section in video game play: an experimental examination of the consequences of massively multiplayer online role-playing game play. Cyberpsychol Behav. 2007;10:717–21.
Schmit S, Chauchard E, Chabrol H, Sejourne N. Evaluation of the characteristics of addiction to online video games among adolescents and young adults. Encephale. 2011;37:217–23.
Wenzel HG, Bakken IJ, Johansson A, Götestam KG, Øren A. Excessive computer game playing among Norwegian adults: self-reported consequences of playing and association with mental health problems. Psychol Rep. 2009;105:1237–47.
Kuss DJ. Inernet gaming addiction: current perspectives. Psycho Research and Behav Management. 2013;6:125–37.
Srinivasan V, Pandi-Perumal SR, Trakht I, Spence DW, Hardeland R, Poeggeler B, et al. Pathophysiology of depression: role of sleep and the melatonergic system. Psychiatry Res. 2009;165:201–14.
Armitage R, Hoffmann RF. Sleep EEG, depression and gender. Sleep Med Reviews. 2001;5:237–46.
Wolfson AR, Carkadon MA. Sleep schedules and daytime functioning in adolescents. Child Dev. 1998;69:875–87.
Johnson EO, Roth T, Breslau N. The association of insomnia with anxiety disorders and depression: exploration of the direction of risk. J Psychiatr Res. 2006;40:700–8.
Bruello N, Armitage R, Feinberg I. Depression and sleep disorders: clinical relevance, economic burden and pharmacological treatment. Neuropsychobiology. 2000;42:107–19.
Riemann D, Voderholzer U. Primary insomnia: a risk factor to develop depression? J Affect Disord. 2003;76:255–9.
Taylor DJ, Lichetein KL, Durrence HH. Insomnia as a health risk factor. Behav Sleep Med. 2003;1:227–47.
Ohayon MM, Roth T. Place of chronic insomnia in the course of depressive and anxiety disorders. J Psychiatr Res. 2003;37:9–15.
Baglioni C, Battagliese G, Frige B, et al. Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disor. 2011;135:10–9.
Moher D, Libertai A. Tetzlaff j, et al. Preferred reporting items for systematic reviews and meta-analysis- the PRISMA statement BMJ. 2009;339:332–6.
Achab S, Nicolier M, Mauny F, Monnin J, Trojak B, Vandel P, et al. Massively multiplayer online role-playing games: comparing characteristics of addict vs non-addict online recruited gamers in a French adult population. BMC Psychiatry. 2011;11:144. The importance of the study by Achab et al. is not so much of the study design, but in the methods of assessing Internet gaming addiction. Achab et al used three different assessing instruments for identifying the addiction status of study participants. This is a very thorough method for ascertaining the exposure status that could potentially minimise the misclassification bias to the minimal. In other studies of better quality in the area, usually only one validated instrument was used.
Lemola S, Brand S, Vogler N, et al. Habitual computer game playing at night is related to depressive symptoms. Pers Indiv Differ. 2011;51:117–22. The Lemola et al. study on the relationship between habitual gaming and depressive symptoms is one of the few studies found in the recent literature that attempted to address the issue of the underlying mechanism between Internet gaming addiction and depression. Although the results obtained from the path-analysis did not support the hypothesis that sleep problems played a significant mediator’s role in the pathway between habitual gaming at night and depressive symptoms, they might not be applicable to addictive Internet gaming. Hence, the hypothesis for the mediating role of sleep problems in the relation between Internet gaming addiction and depression should be examined further.
Yen CF, Ko CH, Yen JY. The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia among Taiwanese adolescents. Sleep. 2008;31:1515–25.
Choi K, Son H, Park M, et al. Internet overuse and excessive daytime sleepiness in adolescents. Psychiat Chin Neuros. 2009;63:455–62.
Cheung LM, Wong WS. The effects of insomnia and internet addiction on depression in Hong Kong Chinese adolescents: an exploratory cross-sectional analysis. J Sleep Res. 2011;20:311–7. In the same token, Cheung and Wong study on the associations among Internet addiction, insomnia, and depression is another few studies that attempted to address the issue of the underlying mechanism of the relationship found in the area.
Cheng SH, Shih CC, Lee IH, et al. A study on the sleep quality of incoming university students. Psychiat Res. 2012;197:270–4.
Chen SH, Weng LJ, Su YJ, et al. Development of a Chinese Internet Addiction Scale and its psychometric study. Chin J Psychol. 2003;45:279–94.
Young KS. Caught in the Net. New York: Wiley; 1998.
Soldatos CR, Dileos DG, Paparrigopoulos TJ. Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000;48:555–60.
Butsse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.
Bastien CH, Valleres A, Morin CM. Validation of the Insomnia Severity Index (ISI) as an outcome measure for insomnia research. Sleep Medicine. 2001;2:297–307.
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Lawrence T. Lam declares that he has no conflict of interest.
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Lam, L.T. Internet Gaming Addiction, Problematic Use of the Internet, and Sleep Problems: A Systematic Review. Curr Psychiatry Rep 16, 444 (2014). https://doi.org/10.1007/s11920-014-0444-1
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DOI: https://doi.org/10.1007/s11920-014-0444-1