ObjectivesThere is good scientific evidence that attention deficit hyperactivity disorder (ADHD) is both a predictor and a comorbidity of addictive disorders in adulthood. These associations not only focus on substance-related addictions but also on behavioral addictions like gambling disorder and Internet use disorder (IUD). For IUD, systematic reviews have identified ADHD as one of the most prevalent comorbidities besides depressive and anxiety disorders. Yet, there is a need to further understand the connections between both disorders to derive implications for specific treatment and prevention. This is especially the case in adult clinical populations where little is known about these relations so far. This study was meant to further investigate this issue in more detail based on the general hypothesis that there is a decisive intersection of psychopathology and etiology between IUD and ADHD.MethodsTwo case–control samples were examined at a university hospital. Adult ADHD and IUD patients ran through a comprehensive clinical and psychometrical workup.ResultsWe found support for the hypothesis that ADHD and IUD share psychopathological features. Among patients of each group, we found substantial prevalence rates of a comorbid ADHD in IUD and vice versa. Furthermore, ADHD symptoms were positively associated with media use times and symptoms of Internet addiction in both samples.DiscussionClinical practitioners should be aware of the close relationships between the two disorders both diagnostically and therapeutically. When it comes to regain control over one’s Internet use throughout treatment and rehabilitation, a potential shift of addiction must be kept in mind on side of practitioners and patients.

No abstract

Since internet dependency can be understood as a novel psychopathology of well known psychiatric conditions, every psychiatrist should be able to detect and treat it adequately, as long as there is a willingness to deal with the contents and impacts of cyberspace. Especially with depressed patients, it seems to be crucial to include questions about media usage in psychiatric examination taking.

Fragestellung: Internetabhängigkeit geht bei den zumeist jungen Betroffenen in der Regel mit einem ausgeprägten sozialen Rückzug und Entwicklungsverzögerungen in verschiedenen Lebensbereichen einher. Die vorliegende Untersuchung geht darüber hinaus von der Hypothese aus, dass Internetabhängige vergleichsweise häufig unter Störungen in den Bereichen Identität und Interpersonalität leiden. Methode: 25 Internetabhängige wurden klinisch und mit dem Strukturierten Klinischen Interview nach DSM-IV (SKID-I) auf komorbide Störungen untersucht. Psychometrisch wurden die Betroffenen mit einer gesunden Vergleichsgruppe (n = 25) mit Hilfe der Internetsuchtskala (ISS), der Sense-of-Coherence-Scale (SOC), dem Fragebogen für Dissoziative Symptome (FDS) und dem Inventar für Interpersonale Probleme (IIP-D) verglichen. Ergebnisse: Im Vergleich zeigen die Internetabhängigen neben einer hohen Komorbidität, insbesondere für Depressionen und Angsterkrankungen, signifikant niedrigere Werte für Selbstkohärenz (SOC) und signifikant höhere Werte für Dissoziation (FDS) und interpersonale Probleme (IIP-D). Besonders hohe Werte erzielen die Probanden auf der IIP-D-Subskala Zu selbstunsicher/zu unterwürfig, dies auch in Korrelation mit der Ausprägung der Internetabhängigkeit (ISS). Schlussfolgerungen: Die Ergebnisse sprechen dafür, dass Selbstunsicherheit und soziale Schwierigkeiten bei Internetabhängigen von besonderer Bedeutung sind. Störungen von Identität und Interpersonalität dürften im Hinblick auf die Diagnostik und Therapie von Internetabhängigkeit eine höhere Beachtung finden.

Background and ObjectivesWith the Cyberspace's exponential growth of influence questions arise about its mental impacts. The presented study examines the question whether the dependent use of the Internet can be understood as an impulse control disorder, an addiction or as a symptom of other psychiatric conditions.MethodsInternet dependent patients seeking for psychiatric assistance and fulfilling the criteria for pathological Internet use (PIU) were examined with the Structured Clinical Interview according to DSM-IV (SCID), and a variety of questionnaires including the Barratt Impulsiveness Scale (BIS), the Beck Depression Inventory (BDI) and the Dissociative Experience Scale (DES). The patient group was compared to a matched group of healthy controls.ResultsThe adult patient-group consisted of 25 subjects, 76% male, with a mean age of 29.36 years. Average time spent in Cyberspace was 6.47 h/d, mostly in online-role-playing games. According to SCID I and BDI, 19 patients (76%) suffered from a depressive syndrome, with 10 cases of major depressive disorder (40%) and 8 cases of adjustment disorder with depression (32%). Six patients (24%) suffered from a comorbid anxiety disorder. Compared to controls, the patient group presented significantly higher levels of depression (BDI), impulsivity (BIS) and dissociation (DES).ConclusionsPIU shares common psychopathological features and comorbidities with substance related disorders. Therefore, it might be seen as a diagnostic entity in itself within a spectrum of behavioral and substance dependencies. Especially Internet role play may contain an addictive potential for adolescents and adults with subclinical psychopathology.