Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 3:27:e52083.
doi: 10.2196/52083.

The Association Between Internet Addiction and the Risk of Suicide Attempts in Chinese Adolescents Aged 11-17 Years: Prospective Cohort Study

Sihong Li  1 , Xingyue Jin  1 , Lintong Song  1 , Tianqing Fan  1 , Yanmei Shen #  1 , Jiansong Zhou #  1
Affiliations

The Association Between Internet Addiction and the Risk of Suicide Attempts in Chinese Adolescents Aged 11-17 Years: Prospective Cohort Study

Sihong Li et al. J Med Internet Res. .

Abstract

Background: Suicide is a critical public health issue in adolescents worldwide. Internet addiction may play a role in the increased rate of suicide attempts in this population. However, few studies have explored the relationship between pathological internet use and suicide attempts among adolescents.

Objective: This study aimed to conduct a prospective cohort study to examine whether higher severity of pathological internet use was associated with an increased risk of suicide attempts among Chinese adolescents.

Methods: A total of 782 adolescents were recruited from a middle school from November 2020 to December 2020 and followed up for 6 months. An online self-reported questionnaire was used to collect the participants' demographic data and assess their mental health. The Depression, Anxiety, and Stress Scale-21 items (DASS-21) was used to evaluate depression, anxiety, and stress. The Chen Internet Addiction Scale-Revised (CIAS-R) was used to assess the symptoms and severity of pathological internet use. χ2 test and ANOVA were used for intergroup comparison, and logistic regression analysis was used to examine the relationship between the severity of pathological internet use and suicide attempts. We also used a restricted cubic splines model to investigate the pattern of the association.

Results: The participants had an average age of 12.59 (SD 0.64) years, with the majority being of Han ethnicity (743/782, 95.01%) and more than half being male (426/782, 54.48%). Most participants had no previous history of depression (541/782, 69.18%), anxiety (415/782, 53.07%), or stress (618/782, 79.03%). The rate of newly reported suicide attempts was 4.6% (36/782). A significant positive association was observed between internet addiction and suicide attempts (odds ratio 3.88, 95% CI 1.70-8.82), which remained significant after adjusting for age, sex, ethnicity, anxiety, depression, and stress (odds ratio 2.65, 95% CI 1.07-6.55). In addition, this association exhibited a linear pattern in the restricted cubic spline regression model.

Conclusions: This study suggested that internet addiction, rather than internet overuse, was associated with a higher likelihood of suicide attempts, which highlighted the importance of addressing internet addiction symptoms among Chinese adolescents for suicide prevention.

Keywords: adolescents; cohort study; internet addiction; pathological internet use; risk factors; suicide attempts.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Cubic model of the association between the CIAS score and the risk of suicide attempts after adjusting for age, sex, ethnicity, anxiety, depression, and stress. CIAS: Chen Internet Addiction Scale; OR: odds ratio.
See this image and copyright information in PMC

References

    1. Abio A, Owusu PN, Posti JP, Bärnighausen T, Shaikh MA, Shankar V, Lowery Wilson M. Cross-national examination of adolescent suicidal behavior: a pooled and multi-level analysis of 193,484 students from 53 LMIC countries. Soc Psychiatry Psychiatr Epidemiol. 2022;57(8):1603–1613. doi: 10.1007/s00127-022-02287-x. https://europepmc.org/abstract/MED/35445842 10.1007/s00127-022-02287-x - DOI - PMC - PubMed
    1. Clayton MG, Pollak OH, Owens SA, Miller AB, Prinstein MJ. Advances in research on adolescent suicide and a high priority agenda for future research. J Res Adolesc. 2021;31(4):1068–1096. doi: 10.1111/jora.12614. - DOI - PubMed
    1. World Health Organization Suicide in the world: global health estimates. 2019. [2024-12-05]. https://iris.who.int/bitstream/handle/10665/326948/WHO-MSD-MER-19.3-eng.... .
    1. Office of the Surgeon General (US) National Action Alliance for Suicide Prevention (US) 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action: A Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention. Washington (DC): US Department of Health & Human Services; 2012. p. 184. - PubMed
    1. Wang CW, Chan CLW, Yip PSF. Suicide rates in China from 2002 to 2011: an update. Soc Psychiatry Psychiatr Epidemiol. 2014;49(6):929–941. doi: 10.1007/s00127-013-0789-5. - DOI - PubMed

LinkOut - more resources