Internet Addiction and Its Relationship with Depression and Academic Performance: A Cross-Sectional Study at a Medical School in Pakistan

Authors

  • Farrukh Ansar Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan https://orcid.org/0000-0002-9056-5245
  • Waqar Ali Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.
  • Adil Zareef Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.
  • Noman Masud Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.
  • Sawar Zahab Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.
  • Huma Iftekhar Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.

DOI:

https://doi.org/10.5195/ijms.2020.740

Keywords:

Depression, Academic Performance, Medical Schools, Public Health, Internet addiction disorder, Public health

Abstract

Background: Excessive Internet use may induce depression, influence relationships, and decrease academic performance. There is scarce information about Internet addiction in Pakistan. This study aimed to determine prevalence of Internet addiction and its relationship with depression and academic performance.

Methods: A study based on a self-administered survey was carried out at a medical school in Peshawar, Pakistan. Participants were medical students (MBBS) and a non-randomized convenience sampling technique was utilized for data collection. We collected demographic information, last professional exam score, Internet addiction, and depression scores using the Young’s Internet Addiction Test (YIAT) and the Beck’s Depression Inventory (BDI), respectively. The analysis included binomial 95% confidence intervals (95% CI) estimations and linear and logistic regressions to assess variables relations.

Results: We analyzed responses from 231 participants (380 students approached and 250 responded: response rate=65.79%, 19 excluded), 64.07% were male and the age average was 21±2 years. Profound and slight addiction to the Internet was found in 9.09% (95%CI=5.71-13.56) and 41.99% (95%CI=35.55-48.64) of students, respectively. Frequency of depression (mild-severe) was 59.74% (95%CI=53.11-66.12). Levels of Internet addiction and depression were found associated after adjusting by sex and age (?=0.27, R2=0.03, p-value=0.009). Internet addiction (OR=0.54, 95%CI=0.2-1.49, p-value=0.23) and depression (OR=0.62, 95%CI=0.36-1.09, p-value=0.10) were not significantly associated with low grades after adjusting by sex and age.

Conclusion: More than half of the students are having excessive Internet usage which could result in despondency and academic performance deterioration. Internet addiction should be considered an emerging challenge and appropriate mitigation measures should be taken opportunely.

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Author Biographies

Farrukh Ansar, Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan

MBBS student.

4th year MBBS student at Northwest School of Medicine, Peshawar, Pakistan of a 5-year MBBS program. The author is Bebras silver medalist and acting as a student editor at the Northwest journal of student research (NJSR).

Waqar Ali, Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.

MBBS, MPH, HRM, PhD.

Adil Zareef, Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.

MBSS, MPH.

Assistant professor Community Medicine Department.

Noman Masud, Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.

MBBS Students.

Sawar Zahab, Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.

MBBS student.

Huma Iftekhar, Northwest school of Medicine, affiliated with Khyber Medical University, Peshawar, Pakistan.

MBBS Student.

References

Shaw M, Black DW. Internet addiction: Definition, assessment, epidemiology and clinical management. CNS Drugs. 2008; 22(5):353–365.

Yang SY, Fu SH, Chen KL, Hsieh PL, Lin. Relationships between depression, health-related behaviors, and internet addiction in female junior college students. PLoS One 2019 Aug; 14(8): e0220784.

Meerkerk GJ, Van Den Eijnden RJ, Vermulst AA, Garretsen HF. The Compulsive Internet Use Scale (CIUS): some psychometric properties. Cyberpsychol Behav. 2009 Feb;12(1):1-6.

Davis R.A. A cognitive-behavioral model of pathological Internet use. Comput. Hum. Behav, 2001 Mar; 17(2):187-195.

Cash H, Rae CD, Steel AH, Winkler A. Internet Addiction: A Brief Summary of Research and Practice. Curr Psychiatry Rev. 2012 Nov;8(4):292-298.

Chaudhari B, Menon P, Saldanha D, Tewari A, Bhattacharya L. Internet addiction and its determinants among medical students. Ind Psychiatry J. 2015 Jul-Dec;24(2):158-162.

Young KS. Internet addiction: The emergence of a new clinical disorder. Cyberpsychology Behav. 1998 Jan; 1(3):237–244.

Kuss DJ, Lopez-Fernandez O. Internet addiction and problematic Internet use: A systematic review of clinical research. World J Psychiatry. 2016 Mar;6(1):143-176.

Kumar M, Mondal A. A study on Internet addiction and its relation to psychopathology and self-esteem among college students. Ind Psychiatry J 2018; 27(1):61-66.

Winkler A, Dörsing B, Rief W, Shen Y, Glombiewski JA. Treatment of Internet addiction disorder: Clin psychol rev. 2013 Jan;33(2):317-329.

Samaha AA, Fawaz M, El Yahfoufi N, Gebbawi M, Abdallah H, Baydoun SA, Ghaddar A, Eid AH. Assessing the Psychometric Properties of the Internet Addiction Test (IAT) Among Lebanese College Students. Front Public Health. 2018 Dec 17;6:365.

Demetrovics Z, Király O, Koronczai B, Griffiths MD, Nagygyörgy K, Elekes Z, Tamás D, Kun B, Kökönyei G, Urbán R. Psychometric Properties of the Problematic Internet Use Questionnaire Short-Form (PIUQ-SF-6) in a Nationally Representative Sample of Adolescents. PLoS One. 2016 Aug 9;11(8):e0159409.

Kimberly S. Young, Eric Griffin-shelley, Al Cooper, James O'mara & Jennifer Buchanan. Online infidelity: A new dimension in couple relationships with implications for evaluation and treatment. Sex Addict Compulsivity 2000; 7: 59–74.

Daneback K, Mansson SA, Ross MW. Technological advancements and internet sexuality: Does private access to the internet influence online sexual behavior? Cyberpsychology, Behav Soc Netw 2012 Aug; 15(8): 386–390.

Davis, R. A. “A cognitive-behavioral model of pathological Internet use.” Comput. Hum. Behav. 2001 Mar; 17(2):187-195.

Kim SH, Baik SH, Park CS, Kim SJ, Choi SW, Kim SE. Reduced striatal dopamine D2 receptors in people with Internet addiction. Neuroreport. 2011 Jun;22(8):407-411.

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 May; 55(2): 140–143.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013. https://www.psychiatry.org/patients-families/depression/what-is-depression (accessed 21 October 2020).

Henriksen IO, Ranøyen I, Indredavik MS, Stenseng F. The role of self-esteem in the development of psychiatric problems: a three-year prospective study in a clinical sample of adolescents. Child Adolesc Psychiatry Ment Health. 2017 Dec 29;11:68.

Ha JH, Kim SY, Bae SC, Bae S, Kim H, Sim M, Lyoo IK, Cho SC. Depression and Internet addiction in adolescents. Psychopathology. 2007;40(6):424-30.

Internet users in the world 2020 | Statista, https://www.statista.com/statistics/617136/digital-population-worldwide/ (accessed 27 November 2020)

Sharma A, Sahu R, Kasar P, Sharma R. Internet addiction among professional courses students: A study from central India. Int J Med Sci Public Health. 2014; 3(9): 1069-1073.

Zhang MWB, Lim RBC, Lee C, Ho RCM. Prevalence of Internet Addiction in Medical Students: a Meta-analysis. Acad Psychiatry. 2018 Feb;42(1):88-93.

Research Ethics Review Committee, https://www.who.int/groups/research-ethics-review-committee/guidelines-on-submitting-research-proposals-for-ethics-review/templates-for-informed-consent-forms (accessed 5 December 2020)

Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Braz J Psychiatry. 2013 Oct-Dec;35(4):416-31.

Rabadi L, Ajlouni M, Masannat S, Bataineh S, Batarseh G, Yessin A, Haddad K, Nazer MK, Hmoud S, Rabadi G. The Relationship between Depression and Internet Addiction among University Students in Jordan. J Addict Res Ther 2017; 08: 1–8.

Chakraborty K, Basu D, Vijaya Kumar KG. Internet addiction: Consensus, controversies, and the way ahead. East Asian Arch Psychiatry. 2010 Sep; 20(3):123–132.

Haroon MZ, Zeb Z, Javed Z, Awan Z, Aftab Z, Talat W. Internet Addiction In Medical Students. J Ayub Med Coll Abbottabad. 2018 Oct-Dec;30(Suppl 1)(4):S659-S663.

Kumar S, Kumar A, Badiyani B, Singh SK, Gupta A, Ismail MB. Relationship of internet addiction with depression and academic performance in Indian dental students. Clujul Med. 2018 Jul;91(3):300-306.

Taha MH, Shehzad K, Alamro AS, Wadi M. Internet Use and Addiction Among Medical Students in Qassim University, Saudi Arabia. Sultan Qaboos Univ Med J. 2019 May;19(2):e142-e147.

Xin M, Xing J, Pengfei W, Houru L, Mengcheng W, Hong Z. Online activities, prevalence of Internet addiction and risk factors related to family and school among adolescents in China. Addict Behav Rep. 2017 Oct 19;7:14-18.

Cheng C, Li AY. Internet addiction prevalence and quality of (real) life: a meta-analysis of 31 nations across seven world regions. Cyberpsychol Behav Soc Netw. 2014 Dec;17(12):755-60.

Aghakhani N, Sharif Nia H, Eghtedar S, Rahbar N, Jasemi M, Mesgar Zadeh M. Prevalence of depression among students of urmia university of medical sciences. Iran J Psychiatry Behav Sci. 2011 Fall;5(2):131-5.

Ediz, B., Ozcakir, A., & Bilgel, N. Depression and anxiety among medical students: Examining scores of the beck depression and anxiety inventory and the depression anxiety and stress scale with student characteristics. Cogent Psychology, 2017 4(1): 1283829.

Mak KK, Jeong J, Lee HK, Lee K. Mediating Effect of Internet Addiction on the Association between Resilience and Depression among Korean University Students: A Structural Equation Modeling Approach. Psychiatry Investig. 2018 Oct;15(10):962-969.

Ahmad Bhat S, Hussain Kawa M. A Study of Internet Addiction and Depression among University Students. Int J Behav Res Psychol 2015 Jun;3(4) 105–108.

Davis NM. Depression in children and adolescents. J Sch Nurs 2005 Dec; 21(6):311–317.

Morrison CM, Gore H. The relationship between excessive internet use and depression: A questionnaire-based study of 1,319 young people and adults. Psychopathology 2010; 43(2): 121–126.

Seki T, Hamazaki K, Natori T, et al. Relationship between internet addiction and depression among Japanese university students. J Affect Disord 2019 Sep; 256: 668–672.

Kuladee S, Boonvisudhi T. Association between Internet addiction and depression in medical students, faculty of medicine in Thailand. Eur Psychiatry 2017 Apr; 41: S310–S310.

Javaeed A, Zafar MB, Iqbal M, Ghauri SK. Correlation between Internet addiction, depression, anxiety and stress among undergraduate medical students in Azad Kashmir. Pak J Med Sci. 2019 Mar-Apr;35(2):506-509.

Sachitra V. Internet Addiction, Academic Performance and University Students. International Knowledge Press. 2015 Jun; 3(4):179-186.

Hassan Rahnaward Ghulami, Mohd Rashid Ab Hamid, Mohd Reza Ibrahim. Relationship between Internet addictions and academic performance among Afghan universities students. Int J Innov Res Sci Stud. 2018 Dec; 1(4):63–72.

Javaeed A, Jeelani R, Gulab S, Ghauri SK. Relationship between internet addiction and academic performance of undergraduate medical students of Azad Kashmir. Pak J Med Sci. 2020 Jan-Feb;36(2):229-233.

Ma HK. Internet addiction and antisocial internet behavior of adolescents. ScientificWorldJournal 2011 Nov; 11: 2187–2196.

Christakis DA. Internet addiction: A 21st century epidemic? BMC Med. 2010 Oct; 8(1):61.

Published

2020-12-17

How to Cite

Ansar, F., Ali, W., Zareef, A. ., Masud, N., Zahab, S., & Iftekhar, H. (2020). Internet Addiction and Its Relationship with Depression and Academic Performance: A Cross-Sectional Study at a Medical School in Pakistan. International Journal of Medical Students, 8(3), 251–256. https://doi.org/10.5195/ijms.2020.740

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