title: Poor sleep quality and suicide attempt among adults with internet addiction: A nationwide community sample of Korea.
abstract: OBJECTIVE
  Internet addiction (IA) is defined as a psychological dependence on the internet, regardless of the type of activities once logged on, and previous studies have focused on adolescents and young adults. The aim of this study was to investigate the association between suicide attempts and sleep among community-dwelling adults with IA.
  
  
  METHODS
  The Young's Internet Addiction Test (IAT), the Korean version of the Composite International Diagnostic Interview (K-CIDI) and a suicide questionnaire were used in this cross-sectional multistage, cluster sampling population-based study. A total of 3212 adults aged 18-64 years were interviewed face-to-face, and they had been randomly selected through a one-person-per-household method.
  
  
  RESULTS
  Of the 3212 adults, 204 were assessed as having IA (6.35%). Adults with IA were younger, and more frequently male, unmarried, and unemployed, and had poorer sleep quality than adults without IA (32.8% vs. 19.8%), whereas there was no significant difference in the absolute duration of sleep between the two groups. Adults with IA showed more frequent difficulty initiating and maintaining sleep, non-restorative sleep, daytime functional impairment, and duration of sleep more than 10 hours on weekdays than adults without IA. IA with poor sleep quality was significantly associated with lifetime suicide attempts (AOR = 3.34, 95% CI 1.38-8.05) after adjusting for demographic covariates. Adults with IA who had more sleep problems showed more severe IA, especially those who experienced a previous suicidal attempt. Among mental disorders, IA with poor sleep quality was significantly associated with anxiety disorder and overall psychiatric disorders.
  
  
  CONCLUSIONS
  Among adults with IA, poor sleep quality was found to be associated with more severe IA and lifetime suicide attempt.
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kiwon
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea.
authors.forename: Haewoo
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jin Pyo
authors.initials: JP
authors.lastname: Hong
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Maeng Je
authors.initials: MJ
authors.lastname: Cho
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: Mischoulon
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Department of Health Sciences & Technology, Samsung Biomedical Research Institute (SAIHST), Sungkyunkwan University, Seoul, Korea.
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.|Department of Health Sciences & Technology, Samsung Biomedical Research Institute (SAIHST), Sungkyunkwan University, Seoul, Korea.
authors.forename: Hong Jin
authors.identifier: http://orcid.org/0000-0002-6126-542X
authors.initials: HJ
authors.lastname: Jeon
mesh_terms: D000293:Adolescent; D000328:Adult; D016739:Behavior, Addictive / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D056910:Republic of Korea; D013406:Suicide, Attempted; D055815:Young Adult