Psychiatry and Clinical Psychopharmacology

Where does Internet addiction fit psychiatry? Conceptual and etiological discussions about Internet addiction

Psychiatry and Clinical Psychopharmacology 2013; 23: Supplement S45-S46
Read: 579 Published: 21 March 2021

The Internet is an integral and inescapable part of many individuals’ daily lives. However, some people may develop a pathological pattern of Internet use, which is popularly known as ‘Internet addiction’. The condition has attracted increasing attention in the popular media and among researchers for more than a decade. Internet addiction is characterized by excessive preoccupations, urges, or behaviors regarding Internet use that lead to impairment or distress. Excessive gaming, text messaging, and sexual preoccupations are the most extensively investigated types of Internet addiction. All of these types share the following components: Withdrawal, including feelings of tension and/or anger when the Internet is inaccessible; tolerance, associated with the need for more hours of use; excessive use, often associated with a loss of sense of time or a neglect of basic duties; and adverse consequences, including lying, progressive deterioration in work, and social and family functioning. Although a considerable amount of literature published so far on Internet addiction reveals that it is a worldwide phenomenon, prevalence rates are inconsistent due to the variability of diagnostic criteria used. The concept of Internet addiction as a diagnosis, however, is controversial. While some experts claim that Internet addiction could not be regarded as a psychiatric disorder, others agree that trivializing this condition might hamper the treatment of affected individuals. Non-substance-related patterns of excessive behavior have gained interest over recent years. For some researchers, not only Internet addiction but also hypersexual disorder, pathological gambling, and eating pathologies are considered as behavioral addictions. A debate has begun about how these phenomena might best be conceptualized. Some categorize excessive behavioral patterns as addictive disorders, whereas others suggest they should be classified as obsessive-compulsive spectrum disorders or as impulse control disorders. Pathological gambling, as a behavioral addiction, served as the model for the concept of Internet addiction in DSM-5. It was renamed as ‘gambling disorder’ and moved from ‘impulse-control’ cluster to ‘substance-related and addictive disorders’ category. Internet addiction was also considered for inclusion into the same category, however, the term ‘Internet use disorder’ was preferred and proposed to be classified in Section 3 of the DSM-5 and thereby recommended for further study. At this time, the criteria for this condition are limited to ‘Internet gaming’ and do not other types of Internet addiction. While some mental health professionals accept Internet use disorder as an independent entity, others see excessive Internet use as a symptom of another disorder such as major depression or generalized anxiety disorder. Furthermore, there is not a consensus about the psychiatric cluster of Internet use disorder. Although the debate over whether Internet use–related problems should be classified as an addiction, an impulse-control disorder, or an obsessive–compulsive disorder continues, there is strong overlap of the symptoms mainly associated with behavioral addictions. According to a growing body of evidence, excessive Internet use is one of the most rapidly increasing mental health problems. Further research is needed to investigate whether Internet addiction is a distinct psychiatric disorder or not. Additionally, consistent diagnostic criteria are essential for diagnosing different types of Internet use disorders.

EISSN 2475-0581