The association between suicidality and Internet addiction and activities in Taiwanese adolescents.
OBJECTIVE
The aims of this cross-sectional study were to examine the associations of suicidal ideation and attempt with Internet addiction and Internet activities in a large representative Taiwanese adolescent population.


METHODS
9510 adolescent students aged 12-18 years were selected using a stratified random sampling strategy in southern Taiwan and completed the questionnaires. The five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia were used to inquire as to the participants' suicidal ideation and attempt in the past one month. The Chen Internet Addiction Scale was used to assess participants' Internet addiction. The kinds of Internet activities that the adolescents participated in were also recorded. The associations of suicidal ideation and attempt with Internet addiction and Internet activities were examined using logistic regression analysis to control for the effects of demographic characteristics, depression, family support and self-esteem.


RESULTS
After controlling for the effects of demographic characteristics, depression, family support and self-esteem, Internet addiction was significantly associated with suicidal ideation and suicidal attempt. Online gaming, MSN, online searching for information, and online studying were associated with an increased risk of suicidal ideation. While online gaming, chatting, watching movies, shopping, and gambling were associated with an increased risk of suicidal attempt, watching online news was associated with a reduced risk of suicidal attempt.


CONCLUSIONS
The results of this study indicated that adolescents with Internet addiction have higher risks of suicidal ideation and attempt than those without. Meanwhile, different kinds of Internet activities have various associations with the risks of suicidal ideation and attempt.
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Master Program and Department of Neurology, School of Medicine, Kaohsiung Medical University, Taiwan.
I-Hsuan
IH
Lin
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Taiwan.
Chih-Hung
CH
Ko
School of Nursing, The State University of New York, University at Buffalo, NY, USA.
Yu-Ping
YP
Chang
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Tai-Ling
TL
Liu
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Peng-Wei
PW
Wang
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Huang-Chi
HC
Lin
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Mei-Feng
MF
Huang
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Yi-Chun
YC
Yeh
Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center and College of Medicine, Chang Gung University, Kaohsiung, Taiwan. Electronic address: wjchou@adm.cgmh.org.tw.
Wen-Jiun
WJ
Chou
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan. Electronic address: chfaye@cc.kmu.edu.tw.
Cheng-Fang
CF
Yen
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D016739:Behavior, Addictive / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D012649:Self Concept; D013334:Students / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology; D011795:Surveys and Questionnaires; D013624:Taiwan