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The association between internet addiction and psychiatric co-morbidity: a meta-analysis

Roger C Ho1, Melvyn WB Zhang1, Tammy Y Tsang1, Anastasia H Toh1, Fang Pan2, Yanxia Lu1, Cecilia Cheng3, Paul S Yip4, Lawrence T Lam5, Ching-Man Lai6, Hiroko Watanabe7 and Kwok-Kei Mak8*

Author Affiliations

1 Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

2 Department of Medical Psychology, Shandong University, Shandong, China

3 Department of Psychology, University of Hong Kong, Hong Kong

4 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong

5 Discipline of Pediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia

6 Department of Psychology, Chinese University of Hong Kong, Hong Kong

7 Department of Children and Women’s Health, Osaka University Graduate School of Medicine, Osaka, Japan

8 Department of Community Medicine and School of Public Health, Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong

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BMC Psychiatry 2014, 14:183  doi:10.1186/1471-244X-14-183

Published: 20 June 2014



This study evaluates the association between Internal Addiction (IA) and psychiatric co-morbidity in the literature.


Meta-analyses were conducted on cross-sectional, case–control and cohort studies which examined the relationship between IA and psychiatric co-morbidity. Selected studies were extracted from major online databases. The inclusion criteria are as follows: 1) studies conducted on human subjects; 2) IA and psychiatric co-morbidity were assessed by standardised questionnaires; and 3) availability of adequate information to calculate the effect size. Random-effects models were used to calculate the aggregate prevalence and the pooled odds ratios (OR).


Eight studies comprising 1641 patients suffering from IA and 11210 controls were included. Our analyses demonstrated a significant and positive association between IA and alcohol abuse (OR = 3.05, 95% CI = 2.14-4.37, z = 6.12, P < 0.001), attention deficit and hyperactivity (OR = 2.85, 95% CI = 2.15-3.77, z = 7.27, P < 0.001), depression (OR = 2.77, 95% CI = 2.04-3.75, z = 6.55, P < 0.001) and anxiety (OR = 2.70, 95% CI = 1.46-4.97, z = 3.18, P = 0.001).


IA is significantly associated with alcohol abuse, attention deficit and hyperactivity, depression and anxiety.

Internet addiction; Depression; Anxiety; Alcohol abuse; Attention deficit; Hyperactivity