|Year : 2014 | Volume
| Issue : 6 | Page : 709-713
Prevalence and patterns of internet addiction among medical students
Venkata Venu Gopala Raju Srijampana1, Ananda Reddy Endreddy2, Koilada Prabhath2, Bhagawan Rajana2
1 Department of Physiology, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India
2 Department of Psychiatry, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India
|Date of Web Publication||18-Nov-2014|
Ananda Reddy Endreddy
Department of Psychiatry, Katuri Medical College and Hospital, Guntur - 522 019, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Background: There has been an explosive growth in the use of internet not only in India, but also worldwide in the last decade. There were about 42 million active internet users in urban India in 2008 when compared to 5 million in 2000. India now has the world's third-largest national digital population, with approximately, 120 million Internet users in 2011. Aims: The aim was to study prevalence and pattern of internet usage among medical students in Guntur. Materials and Methods: A cross-sectional study was conducted among medical students (n = 211) belonging to two medical colleges, to assess the pattern of internet usage. A semi-structured proforma along with Young's Internet Addiction scale was used. Results: Of 211 medical students, 57.2% were females and 42.8% were males. The users were divided into groups: 64.4% as average users, 11.8% as possible addicts, 0.4% as addicts, and in 23.2% of medical students internet usage was less than average user. Significant usage differences were evident based on the gender of user. Medical students used the internet mostly for social networking (59.7%), downloading media files (18.9%), online gaming (12.3%), and academic purposes (0.1%). About 63% of the medical students were using mobile phones to access the internet. Conclusion: Internet usage for the purpose of social networking (Facebook, WhatsApp, Mails etc.) was very high among the medical students. Availability of high speed internet on mobile phones may be the reason for spending more time on social network websites.
Keywords: Internet addiction, medical students, mobile phones, prevalence
|How to cite this article:|
Raju Srijampana VG, Endreddy AR, Prabhath K, Rajana B. Prevalence and patterns of internet addiction among medical students. Med J DY Patil Univ 2014;7:709-13
|How to cite this URL:|
Raju Srijampana VG, Endreddy AR, Prabhath K, Rajana B. Prevalence and patterns of internet addiction among medical students. Med J DY Patil Univ [serial online] 2014 [cited 2019 Oct 18];7:709-13. Available from: http://www.mjdrdypu.org/text.asp?2014/7/6/709/144851
| Introduction|| |
In the four decades since its inception, the internet has driven dramatic change. It has enabled flow of information, including entertainment, news, financial, and academic material. It has brought people closer together by enabling various forms of interpersonal communication, notably E-mail, instant messaging, video conferencing and social networking. In a very short period, it has become difficult for most of us to imagine a world without instant and continuous access to the internet. 
Internet Addiction Disorder (IAD) ruins lives by causing neurological complications, psychological disturbances, and social problems. Surveys in the United States and Europe have indicated alarming prevalence rates between 1.5% and 8.2%, respectively.  The term "internet addiction" was proposed by Dr. Ivan Goldberg in 1995 for pathological compulsive internet use. 
Young linked excessive internet use most closely to pathological gambling, a disorder of impulse control in Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and adapted the DSM-IV criteria to relate to internet use in the Internet Addiction Test (IAT) developed by her. 
Jerald Block in an editorial in the American Journal of Psychiatry recommends the inclusion of IAD in DSM-V. He opines that conceptually, the diagnosis is a compulsive impulsive spectrum disorder that involves online and/or offline computer usage and consists of at least three subtypes: Excessive gaming, sexual preoccupations, and E-mail/text messaging. 
The Internet's Impact on India
There has been an explosive growth in the use of internet not only in India, but also worldwide in the last decade. There were about 42 million active internet users in urban India in 2008 when compared to 5 million in 2000, as reported by internet and mobile association of India, I-Cube 2008 study.  India now has the world's third-largest national digital population, with approximately 120 million internet users in 2011. The number of internet users in India has grown five-fold since 2005. Mobile Internet usage is growing at the rate of nearly 85% per annum, with nearly 75% of nonvoice usage being devoted to entertainment, where video and music streaming are major growth activities. 
The understanding that the internet use can be a disorder is still in its initial stages in India. There are limited numbers of studies estimating how common the issue of internet addiction is in India.  In a study carried out by Yadav et al.,  among high school students in Ahmadabad India, there was a strong positive correlation between internet addiction and depression, anxiety and stress.
Since 2007 certain educational institutions like IITs, leading Universities have been restricting campus internet usage during night hours because of reports of some suicides being linked to the presumed anti-social behavior that excessive internet promotes. 
Recent reports indicated that some online users were becoming addicted to the Internet in much that same way that others became addicted to drugs or alcohol, which resulted in academic, social, and occupational impairment. 
There is ongoing debate about how best to classify the behavior, which is characterized by spending many hours in nonwork technology related computer/Internet/video game activities.  In a study done in Iran, severe internet addicts used it for nonessential uses like film, music, cartoon, computer games, social sites and chat rooms, but normal users use it for news, events, educational, and universal sites. Furthermore, internet addicts use internet in a drift manner and in private places. 
In India, use of internet is enormous, especially in the young population.  This study was aimed to study the prevalence and patterns of internet addiction among medical students in the city of Guntur.
| Materials and Methods|| |
A cross-sectional survey was carried out in medical students of both sexes, belonging to two medical colleges in the city of Guntur, Andhra Pradesh, South India. The study period was September - November 2013. The study participants were selected by using simple random sampling. Institutional Ethical Committee approval was obtained before starting the study.
- Medical students.
- Both sexes.
- Students aged between 17 and 25 years.
- History of using internet from past 1-year or more.
- Willing to give consent.
- Not willing to give valid consent.
- Not using internet.
The information was collected by using a semi structured proforma that contained details of demographic data, purpose of using the internet (by choosing among the options such as education, online games, social networking or downloading media files), gadget used to access internet (Desktop, Laptop, Mobile phone or Tablet), and the average duration of usage per day. Data were tabulated by using Microsoft office - Excel sheet. The responses obtained were expressed in proportions. The difference in the patterns of internet usage among males and females was analyzed by using Chi-square test.
Measuring internet addiction was a challenge. Goldberg developed the IAD scale by adapting the DSM-IV. Brenner  developed the Internet Related Addictive Behavior Inventory comprising of 32 true and false questions. Young initially developed eight questions Internet Addiction Diagnostic Questionnaire based on DSM-IV. Later, she included 12 new items in addition to the 8 items to formulate an IAT. Young's IAT is the only available test whose psychometric properties have been tested by Widyanto and McMurran. 
The IAT is the first validated instrument to assess internet addiction. The IAT is a 20 item, 6 point Likert scale with scores ranging from 0 to 5 for each item, which measures the severity of self-reported compulsive use of the internet.  Total internet addiction scores were calculated, with possible scores for the sum of 20 items ranging from 0 to 100 (Annexure). The scale showed very good internal consistency, with an alpha coefficient of 0.93 in the similar studies. 
The psychometric properties of the IAT show that it was reliable and valid measure that has been used in further research on internet addiction. The test measures the extent of involvement with the computer and classifies the addictive behavior in terms of severity. The IAT can be utilized among outpatient and inpatient settings and adapted accordingly to fit the needs of the clinical setting. 
| Results|| |
The study questionnaire was administered in two medical colleges and responses were obtained from 211 medical students. Among these 121 (57.2%) were females and 90 (42.8%) were males. Data were collected during routine clinical postings or practical hours. The mean age of the students was 19.9 years. The subjects belonged to different levels of medical course. Using Young's original criteria, the users were divided into groups as average users (64.4%), possible addicts (11.8%) and addicts (0.4%). The internet usage was less than an average user in 23.2% of medical students [Table 1].
Among the medical students, males were using social network websites predominantly when compared to females. This finding was statistically significant (χ2 = 4.24, P < 0.05). Moderate users and the possible addicts used the internet mostly for social networking (59.7%), downloading media files (18.9%), online gaming (12.3%) and academic purposes (0.1%). The purpose of using the internet in addicts was social networking, chatting and downloading media files. Interesting findings were noted with respect to the gadget for accessing internet. About 63% of the medical students were using mobile phones to access the internet [Table 2].
Average duration of daily usage of internet and years of exposure to internet were shown in [Table 3]. Majority of the medical students (82%) were using internet daily around 1-3 h.
| Discussion|| |
A number of studies have been conducted across the world, especially among adolescents with respect to internet addiction. Our study was a preliminary step toward understanding the extent of internet addiction among medical college students.
The rate of Internet surfing for males is higher than that for females. Findings from a study conducted by Pew Internet and American Life Project on college students' use of the Internet revealed that this group heavily uses the Internet when compared to the general population. 
In our study, the prevalence of internet addiction was 0.4%, which was in accordance with studies done by Goel et al.,  and Xie et al.  In contrast to our results, a study done by Ghamari et al.,  among Iranian medical students, shown the overall prevalence of internet addiction was 10.8% and similar findings were observed in the study done by Siomos et al.,  on Greek adolescent students, where the prevalence rate was 8.2%.
The data available from the community, online surveys and clinical samples ,[20-25] suggest that Internet Addiction appears to have a male preponderance, which was observed in our study also.
In our study, moderate users and the possible addicts used the internet mostly for social networking (59.7%), downloading media files (18.9%), and online gaming (12.3%) when compared to academic purpose (0.1%), which was essential for medical students. Similar findings were observed in a study done by Goel et al. 
In our study, susceptibility for internet addiction was nearly same between males and females, which was in contrary to the study done by Xu et al.,  where boys were more susceptible to internet addiction as compared to girls. In our study, lower prevalence of "internet addiction" was observed when compared to Grover et al.,  this might be due to less penetration of internet, in Guntur city when compared to cities like Chandigarh.
In the present study, it is found that, the medical students were using internet mainly for nonessential purposes (social networking, online games) rather than for essential purposes (academic).
| Conclusion|| |
In the last one decade, internet has become an integral part of life, among medical students. Internet usage for the purpose of social networking (Facebook, WhatsApp, Mails etc.) was very high among the medical students. Availability of high speed internet on mobile phones may be the reason for spending more time on social network websites.
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[Table 1], [Table 2], [Table 3]
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