title: The impact of suicidality-related internet use: a prospective large cohort study with young and middle-aged internet users.
abstract: BACKGROUND
  There has been no study that has allowed clear conclusions about the impact of suicide-related or mental health consultation-related internet use.
  
  
  OBJECTIVE
  To investigate the impacts of suicide-related or mental health consultation-related internet use.
  
  
  METHODS
  We conducted prospective observational longitudinal study with data collection at baseline screening (T0), 1 week after T0 (T1) and 7 weeks after T0 (T2). Participants with a stratified random sampling from 744,806 internet users were 20-49 years of age who employed the internet for suicide-related or mental health consultation-related reasons and internet users who did not. The main outcome was suicidal ideation. Secondary outcome measures comprised hopelessness, depression/anxiety, and loneliness.
  
  
  RESULTS
  The internet users who had employed the internet for suicide-related or mental health consultation-related reasons at T0 (n = 2813), compared with those who had not (n = 2682), showed a significant increase in suicidal ideation (β = 0.38, 95%CI: 0.20-0.55) and depression/anxiety (β = 0.37, 95%CI: 0.12-0.61) from T1 to T2. Those who disclosed their own suicidal ideation and browsed for information about suicide methods on the web showed increased suicidal ideation (β = 0.55, 95%CI: 0.23-0.88; β = 0.45, 95% CI: 0.26-0.63, respectively). Although mental health consultation with an anonymous other online did not increase suicidal ideation, increased depression/anxiety was observed (β = 0.34, 95%CI: -0.03-0.71).
  
  
  CONCLUSIONS
  An increased suicidal ideation was observed in the young and middle-aged who employed the internet for suicide-related or mental health consultation-related reasons. Mental health consultation via the internet was not useful, but those who did so showed worsened depression/anxiety.
authors.affiliation: Department of Psychology and Education, Faculty of Human Sciences, Wako University, Machida, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Sueki
authors.affiliation: Department of Epidemiology and Biostatistics, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yonemoto
authors.affiliation: Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Takeshima
authors.affiliation: Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Inagaki
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008132:Loneliness / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012044:Regression Analysis; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
references.citation: J Med Internet Res. 2012 Sep 26;14(5):e122
references.pmid: 23010086
references.citation: J Consult Clin Psychol. 1974 Dec;42(6):861-5
references.pmid: 4436473
references.citation: J Affect Disord. 2012 Dec 10;141(2-3):480-3
references.pmid: 22609195
references.citation: Arch Suicide Res. 2009;13(3):264-76
references.pmid: 19591000
references.citation: Am J Public Health. 2012 May;102 Suppl 2:S195-200
references.pmid: 22401525
references.citation: Behav Res Ther. 1997 Nov;35(11):1039-46
references.pmid: 9431735
references.citation: PLoS One. 2013 Oct 30;8(10):e77555
references.pmid: 24204868
references.citation: J Am Acad Child Adolesc Psychiatry. 2003 Apr;42(4):386-405
references.pmid: 12649626
references.citation: Crisis. 2000;21(4):186-8
references.pmid: 11419530
references.citation: Crisis. 2013 Jan 1;34(5):348-53
references.pmid: 23685338
references.citation: Psychopathology. 2013;46(1):1-13
references.pmid: 22854219
references.citation: Int J Environ Res Public Health. 2012 Jan;9(1):123-38
references.pmid: 22470283
references.citation: J Consult Clin Psychol. 1979 Apr;47(2):343-52
references.pmid: 469082
references.citation: J Clin Psychol. 2001 Jul;57(7):901-14
references.pmid: 11406803
references.citation: Psychiatr Serv. 2009 Jul;60(7):943-9
references.pmid: 19564225
references.citation: Lancet. 2009 Jan 10;373(9658):99-100
references.pmid: 19097637
references.citation: Cyberpsychol Behav. 2008 Feb;11(1):107-13
references.pmid: 18275323
references.citation: BMJ. 2008 Apr 12;336(7648):800-2
references.pmid: 18403541
references.citation: J Clin Psychol. 1996 Nov;52(6):609-15
references.pmid: 8912103
references.citation: Psychiatry. 2007 Spring;70(1):12-8
references.pmid: 17492908
references.citation: Am J Psychiatry. 1999 Nov;156(11):1836-7
references.pmid: 10553759
references.citation: BMJ. 2004 Dec 4;329(7478):1298-9
references.pmid: 15576715
references.citation: Int J Methods Psychiatr Res. 2008;17(3):152-8
references.pmid: 18763695
references.citation: J Med Internet Res. 2009 Jul 23;11(3):e29
references.pmid: 19632979
references.citation: Suicide Life Threat Behav. 2001;32(1 Suppl):68-75
references.pmid: 11924697
references.citation: Death Stud. 2012 Jul;36(6):565-80
references.pmid: 24563935
references.citation: BMJ. 2008 Apr 26;336(7650):905-6
references.pmid: 18436921
references.citation: J Pers Soc Psychol. 1980 Sep;39(3):472-80
references.pmid: 7431205
references.citation: Psychol Med. 2002 Aug;32(6):959-76
references.pmid: 12214795