Internet Linked to Health in Adolescents

Internet Linked to Health in Adolescents - MedPage Today

Teenagers who are heavy users of the Internet -- spending more than two hours a day online -- appear to have an increased risk of depression as well as some somatic complaints, Swiss researchers reported. On the other hand, they found a similar association with an apparent increased risk of depression among teens who didn't use the Net at all, according to Pierre-André Michaud, MD, of the Institute of Social and Preventive Medicine in Lausanne, Switzerland, and colleagues. The finding suggests that regular Internet use is now "normative behavior without major health consequence" but that physicians should be alert for extremely high or low levels of use, Michaud and colleagues argued online in Pediatrics. Using the Internet is now a commonplace activity among young people, the researchers noted, raising health concerns that have primarily focused on heavy users. To examine the issue, Michaud and colleagues turned to the 2002 Swiss Multicenter Adolescent Survey on Health, a nationally-representative survey of teens ages 16 to 20 years in either high school or vocational school. More than 7,200 participants -- 3,906 boys and 3,305 girls -- were divided into four categories according to the intensity of their Internet use. Heavy Internet users were defined at those who were online two or more hours a day, regular Internet users were online several days a week for less than two hours a day, and occasional users logged in no more than an hour a week. The fourth category was Internet nonusers -- teens who reported no Internet use at all in the month before the survey. For multivariate analyses, the regular users were regarded as the reference group. Michaud and colleagues also asked about participants' perceived health, depression, overweight, and somatic complaints like headaches, back pain, and insufficient sleep. The researchers found there were more heavy Internet users among the boys -- 7.3% versus 2.2% among girls -- but a similar proportion of nonusers, at 16.4% among both sexes. Most boys and girls were either regular or occasional users -- 44.9% and 31.4%, respectively, for boys and 41.5% and 39.8%, respectively, for girls. Multivariate analysis showed a U-shaped relationship between Internet use and some health issues, the researchers reported. Specifically: Male heavy users and nonusers both were significantly more likely to report depression, with relative risk ratios of 1.36 and 1.31, respectively. Girls at all levels of use reported significantly more depression than regular users, but the heavy users had the highest relative risk ratio, at 1.86. Nonusers and occasional users had relative risk ratios of 1.46 and 1.24, respectively. Male heavy users were 78% more likely to report being overweight than regular users. The relative risk ratio was 1.78, with a 95% confidence interval from 1.07 to 2.95. Male nonusers were significantly more likely to report frequent back pain, with a relative risk ratio of 1.87. Female heavy users were significantly more likely to report insufficient sleep, with a relative risk ratio of 1.91. Michaud and colleagues cited some limitations to their study, noting that young people not attending school were not assessed, which may limit that applicability of the study results. The authors also cautioned that the data were collected in 2002 -- before the explosion of multimedia technologies that have made Internet access easier. The study also did not look at the effects of specific activities online, they reported. Its generalizability was also limited by the data being collected only among adolescents in Switzerland. The study had support from the Swiss Federal Office of Public Health, Université Laval, the Centre Hospitalier Universitaire de Québec and its foundation, and the Royal College of Physicians and Surgeons of Canada. The authors said they had no relevant financial relationships to disclose.

Primary source: Pediatrics