Objectives: Internet addiction is an ever-increasing problem among adolescents and young adults and it impairs life quality and functionality. Although a relationship between inattention/ hyperactivity symptoms and internet addiction has been reported, there is no previous study that assessed the contribution of biological rhythm variables to ADHD and internet addiction comorbidity. In this study, we hypothesized that internet and social media addictions are frequent in adult ADHD patients and this comorbidity is associated with impairment in biological rhythm variables. We also hypothesized that eveningness chronotype is frequent among adult ADHD patients and this trait is associated with Internet addiction.
Method: Sixty adult subjects, who were being followed at the Adult ADHD outpatient unit, were included in this study. They were administered a sociodemographic form, Adult ADHD Self Report Scale (ASRS), Biological Rhythm Interview of Assessment In Neuropsychiatry (BRIAN), Internet Addiction Test (IAT), Bergen Facebook Addiction Scale and Motives For Using Facebook Scale. Internet-addicted group consisted of patients, who had 50 or more score in IAT. Eveningness group consisted of patients whose sum of nineteenth and twenty first items in BRIAN were five or more. Comparisons were made between internet addicted/non-addicted, eveningness/morningness chronotype groups with Chi square and Mann Whitney U tests. Correlations were calculated with Spearman test.
Results: Mean age of the whole sample was 22.9 (75% male). 20.9% of the sample was grouped as internet-addicted. 47.7% of the sample had eveningness chronotype. Total ASRS score was correlated with total BRIAN score (r=0.70, p=0.001) and its subscales, internet (r=0.50, p=0.001) and Facebook (r=0.40, p=0.009) addiction scores. Inattention (p=0.038), hyperactivity (p=0.021) and total ASRS (p=0.005) scores were higher in internet addicted group. Facebook addiction scores were also higher in internet-addicted group (p=0.02). Internet addiction score was correlated with eating, activity and social subscales of BRIAN. Internet addiction scores were correlated with inattention (r=0.43, p=0.004), hyperactivity (r=0.42, p=0.004) and Facebook addiction (r=0.48, p=0.001). Total BRIAN score (p=0.003) and subscales were higher in eveningness chronotype group. No differences were found in motives for using Facebook between groups.
Conclusion: To our knowledge, this is the first study assessing the relationship between ADHD, internet addiction, Facebook addiction and biological rhythm variables. We found 20.9% prevalence of internet addiction in adult ADHD patients. Impairment in biological rhythm variables was associated with both ADHD and internet addiction. Assessing and targeting internet and social media addiction may improve treatment response and functionality in adult ADHD patients.