Compulsive internet use scale performs better than problematic internet use questionnaire at predicting depressive and anxiety symptoms in medical students

Abstract

Background. Medical students and resident doctors often experience severe psychological distress, are particularly vulnerable to poor mental well-being and have higher rates of mental illness as well as psychological distress compared to the general population [1]. Depressive and anxiety disorders may have both immediate and delayed negative outcomes, including decreased academic performance, interpersonal problems and decreased quality of life [2]. Studies also show that problematic internet use (PIU) contributes to anxiety and depression severity [3]. PIU lead an unhealthy lifestyle and more often show symptoms of depression. However, it is unclear which scales measuring PIU are better than others at predicting the presence of significant anxiety and depressive symptoms. Objective. The aim of this study was to evaluate the prognostic value of the Compulsive Internet Use Scale (CIUS), the Problematic Internet Use Questionnaire (PIUQ9) and a single question “whether internet use impairs daily functioning” (IUIDF), to predict depressive and anxiety symptoms in medical students. Methods. Lithuanian medical students participated in two independents online surveys launched between December 2020 and February 2021 (Study 1, N¼518 [mean age 23.6 ± 3.0 years], 21.4% men), and between May 2020 and June 2021 (Study 2, N¼398 [mean age 23.0 ± 3.4 years], 16.3% men). The participants completed the CIUS [4] and answered question “Impairment to engage in daily activities and social life due to excessive internet use (NO/YES)” (IUIDF, Study 1), PIUQ9 (Study 2) [5], the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Assessment (GAD-7) (both studies) [2]. Block-wise linear regression analyses were performed to estimate the prognostic value of CIUS, PIUQ9 and IUIDF on PHQ-9 and GAD-7 when controlling for gender, age and time of internet use. Results. IUIDF led to increase in the linear regression model coefficient of determination R-square by 0.175 (p<0.001); R-square of the final model was 0.182, adjusted R-square was 0.176 (p<0.001), standardized coefficient beta equaled 0.420 (p<0.001), when predicting PHQ9 (Study 1). The predictive influence of IUIDF was higher if compared to the effect of PIUQ9 (increase in R-square 0.110 (p<0.001), R-square 0.128, adjusted R-square 0.120 (p<0.001), beta¼0.350 (p<0.001), Study 2). CIUS also showed a larger influence in predicting PHQ9 (increase in the coefficient of determination R-square 0.247 (p<0.001), R-square of the final model 0.254 (p<0.001), adjusted R-square 0.249 (p<0.001), beta¼0.497 (p<0.001)) if compared to PIUQ9 (Study 2) and IUIDF (Study 1). Conclusions. The CIUS performs better than PIUQ9 or single question on function impairment due to PIU in predicting depressive and anxiety symptoms in medical students regardless of age, gender and time of internet use. However, in short medical surveys one question item on functioning difficulties due to PIU could be recommended using as it predicts anxiety and depression symptoms relatively well.