A proposed criterion for clinical diagnosis of internet addiction / 解放军医学杂志

ABSTRACT

Objective To establish a clinical diagnostic criterion(referred as criterion hereinafter) for patients with social dysfunction and abnormal mental behaviors caused by internet addiction,so as to provide guidance in future mechanism study,treatment and prevention for such disorder.Methods A rough draft of symptom parameters was used to evaluate the symptoms among the patients with a chief complaint of wallowing in internet which caused damned influence on study,work and interpersonal communication.The 1st draft of the criteria was drawn up according to the incidence and correlation of the symptoms.408 patients with internet addiction(IA) diagnosed according to the 1st draft were followed up for 12 months after being discharged from hospital,and the diagnostic coincidence and recurrence rate were calculated and analyzed,based on which the 1st draft was then revised and the 2nd draft was established.Clinical tests were performed on 150 patients with the same chief complaints by psychiatrists from many mental hospitals in China.Descriptions in the 2nd draft were not modified based on the test findings and the final draft was formulated.Results The proposed criterion for IA symptom included the following 7 items ① craving for using internet;② withdrawal reactions after internet use reduced or stopped;③ tolerance;④ unable to control the intention of using internet;⑤ regardless of hazardous consequences;⑥ pay no attention to other activities;and ⑦ avoidance or alleviation of unhealthy emotions.Items ① and ② combined with any one of the remains made the final diagnosis of IA.The criterion for illness duration was suggested as greater than or equal to 6 hours of continuous internet use one day in average and 3 months at least after meeting the criteria for IA symptom.It was found by following-up that one year recurrence rate among the discharged patients from hospital was 70.6%,and the diagnostic coincidence was 96.1%.The diagnostic consistency on symptom evaluation between two psychiatric raters was 89.3%-98.0%(Kappa 0.73-0.87,P