Relationship between Internet Addiction and Poor Mental Health among Japanese Adolescents

  • Yuichiro OTSUKA Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Yoshitaka KANEITA Mail Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Osamu ITANI Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Mikiko TOKIYA Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
Internet addiction, Adolescents, Japan, General health questionnaire, Cohort study


Background: Internet addiction and poor mental health are two pervasive problems during adolescence. This study aimed to determine whether Internet addiction and poor mental health status exhibited a bidirectional relationship in which either variable could become a risk factor for the onset of the other.

Methods: Longitudinal school-based survey with a baseline sample of 1547 students among 8 schools (10th graders) in Japan surveyed in 2015 and followed up 1 year later. The schools are located in the middle city. We assessed internet addiction using the Japanese version of the Diagnostic Questionnaire developed by Young and mental health status using the 12-item General Health Questionnaire. Regression analyses including the covariates tested whether Internet addiction was related to the onset of poor mental health among youth who had never internet addiction, and poor mental health was related to the onset of internet addiction.

Results: The incidence for Internet addiction and poor mental health during one year were 22.0% and 8.8%, respectively. Multiple regression analyses showed that poor mental health (adjusted odds ratio: 2.17 [95%CI: 1.45–3.25]) promoted new onset of Internet addiction and Internet addiction (adjusted odds ratio: 2.39 [95%CI: 1.36–4.20]) also promoted new onset of poor mental health.

Conclusion: Internet addiction and poor mental health status each increased the risk of onset of the other. Adolescents, their parents and schools need to take policies to use properly Internet.


1. Van den Bulck J (2004). Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children. Sleep, 27(1), 101-104.
2. Chen YL, Gau SS (2016). Sleep problems and internet addiction among children and adolescents: a longitudinal study. J Sleep Res, 25(4), 458-465.
3. Kim K, Ryu E, Chon MY, et al (2006). Internet addiction in Korean adolescents and its relation to depression and suicidal ideation: a questionnaire survey. Int J Nurs Stud, 43(2), 185-192.
4. Ko CH, Yen JY, Yen CF, Chen CS, Chen CC (2005). Gender differences and related factors affecting online gaming addiction among Taiwanese adolescents. J Nerv Ment Dis, 193(4), 273-277.
5. Kawabe K, Horiuchi F, Ochi M, Oka Y, Ueno S (2016). Internet addiction: Prevalence and relation with mental states in adolescents. Psychiatry Clin Neurosci, 70(9), 405-412.
6. Chakraborty K, Basu D, Vijaya Kumar KG (2010). Internet addiction: consensus, controversies, and the way ahead. East Asian Arch Psychiatry, 20(3), 123-132.
7. Cheng C, Li AY (2014). Internet addiction prevalence and quality of (real) life: a meta-analysis of 31 nations across seven world regions. Cyberpsychol Behav Soc Netw, 17(12), 755-760.
8. Wu X-S, Zhang Z-H, Zhao F, et al (2016). Prevalence of Internet addiction and its association with social support and other related factors among adolescents in China. J Adolesc, 52, 103-111.
9. Lin M-P, Wu JY-W, You J, Hu W-H, Yen C-F (2018). Prevalence of internet addiction and its risk and protective factors in a representative sample of senior high school students in Taiwan. J Adolesc, 62, 38-46.
10. Shek DTL, Yu L (2016). Adolescent Internet Addiction in Hong Kong: Prevalence, Change, and Correlates. J Pediatr Adolesc Gynecol, 29(1 Suppl), S22-30.
11. Mihara S, Osaki Y, Nakayama H, et al (2016). Internet use and problematic Internet use among adolescents in Japan: A nationwide representative survey. Addict Behav Rep, 4, 58-64.
12. Lam LT (2014). Risk factors of Internet addiction and the health effect of internet addiction on adolescents: a systematic review of longitudinal and prospective studies. Curr Psychiatry Rep, 16(11), 508.
13. Chang FC, Chiu CH, Lee CM, Chen PH, Miao NF (2014). Predictors of the initiation and persistence of internet addiction among adolescents in Taiwan. Addict Behav, 39(10), 1434-1440.
14. van den Eijnden RJ, Meerkerk GJ, Vermulst AA, Spijkerman R, Engels RC (2008). Online communication, compulsive Internet use, and psychosocial well-being among adolescents: a longitudinal study. Dev Psychol, 44(3), 655-665.
15. Ko CH, Yen JY, Chen CS, Yeh YC, Yen CF (2009). Predictive values of psychiatric symptoms for internet addiction in adolescents: a 2-year prospective study. Arch Pediatr Adolesc Med, 163(10), 937-943.
16. Cho SM, Sung MJ, Shin KM, Lim KY, Shin YM (2013). Does psychopathology in childhood predict internet addiction in male adolescents? Child Psychiatry Hum Dev, 44(4), 549-555.
17. Lam LT, Peng ZW (2010). Effect of pathological use of the internet on adolescent mental health: a prospective study. Arch Pediatr Adolesc Med, 164(10), 901-906.
18. Young KS (1998). Internet addiction: The emergence of a new clinical disorder. CyberPsychology & Behavior, 1(3), 237-244.
19. Yong Kim-Fong R (2013). The reliability and validity of three internet addiction instruments in the Japanese population (Doctoral dissertation, Tokyo University).
20. Goldberg DP, Rickels K, Downing R, Hesbacher P (1976). A comparison of two psychiatric screening tests. Br J Psychiatry, 129:61-67.
21. Doi Y, Minowa M (2003). Factor structure of the 12-item General Health Questionnaire in the Japanese general adult population. Psychiatry Clin Neurosci, 57(4), 379-383.
22. Kaneita Y, Ohida T, Osaki Y, et al (2006). Insomnia among Japanese adolescents: a nationwide representative survey. Sleep, 29(12), 1543-1550.
23. Biddle L, Gunnell D, Sharp D, Donovan JL (2004). Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey. Br J Gen Pract, 54(501):248-253.
24. Jackson C (2007). The General Health Questionnaire. Occupational Medicine-Oxford, 57(1), 79-79.
25. Takegami M, Suzukamo Y, Wakita T, et al (2009). Development of a Japanese version of the Epworth Sleepiness Scale (JESS) based on item response theory. Sleep Med, 10(5), 556-565.
26. Petry NM, Rehbein F, Gentile DA, et al (2014). An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction, 109(9), 1399-1406.
27. Niemz K, Griffiths M, Banyard P (2005). Prevalence of pathological Internet use among university students and correlations with self-esteem, the General Health Questionnaire (GHQ), and disinhibition. Cyberpsychol Behav, 8(6), 562-570.
28. Yen JY, Ko CH, Yen CF, Wu HY, Yang MJ (2007). The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility. J Adolesc Health, 41(1), 93-98.
29. van den Eijnden RJ, Spijkerman R, Vermulst AA, van Rooij TJ, Engels RC (2010). Compulsive internet use among adolescents: bidirectional parent-child relationships. J Abnorm Child Psychol, 38(1), 77-89.
30. Wastlund E, Norlander T, Archer T (2001). Internet blues revisited: replication and extension of an Internet paradox study. Cyberpsychol Behav, 4(3), 385-391.
31. Strittmatter E, Parzer P, Brunner R, et al (2016). A 2-year longitudinal study of prospective predictors of pathological Internet use in adolescents. Eur Child Adolesc Psychiatry, 25(7), 725-734.
32. Kardefelt-Winther D (2014). A conceptual and methodological critique of internet addiction research: Towards a model of compensatory internet use. Computers in Human Behavior, 31, 351-354.
33. Ohno S (2016). Internet escapism and addiction among Japanese senior high school students. International Journal of Culture and Mental Health, 9(4), 399-406.
34. Ho RC, Zhang MW, Tsang TY, et al (2014). The association between internet addiction and psychiatric co-morbidity: a meta-analysis. BMC Psychiatry, 14:183.
35. Ko CH, Yen JY, Chen CC, Chen SH, Yen CF (2012). The association between Internet addiction and psychiatric disorder: a review of the literature. Eur Psychiatry, 27(1):1-8.
36. Tsai HF, Cheng SH, Yeh TL, et al (2009). The risk factors of Internet addiction--a survey of university freshmen. Psychiatry Res, 167(3):294-299.
37. Chou C, Condron L, Belland JC (2005). A Review of the Research on Internet Addiction. Educ Psychol Rev, 17(4), 363-388.
38. Jeong EJ, Kim DH (2011). Social activities, self-efficacy, game attitudes, and game addiction. Cyberpsychol Behav Soc Netw, 14(4): 213-221.
39. Mythily S, Qiu S, Winslow M (2008). Prevalence and correlates of excessive Internet use among youth in Singapore. Ann Acad Med Singap, 37(1): 9-14.
How to Cite
OTSUKA Y, KANEITA Y, ITANI O, TOKIYA M. Relationship between Internet Addiction and Poor Mental Health among Japanese Adolescents. Iran J Public Health. 49(11):2069-2077.
Original Article(s)