Behavioral Therapy Could Treat Internet Addiction

The researchers found that 69.4% of men with Internet addiction went into remission if they received cognitive-behavioral therapy in the short term, compared with 23.9% of men who went into remission while they were in remission. they were on a waiting list to receive treatment.

People in remission were 10 times more likely to be part of the short-term cognitive-behavioral therapy group than the control group on the waiting list.

"This indicates a powerful treatment effect for subjects suffering from internet addiction or gambling disorder," said Klaus Wölfling, lead author of the study, in a podcast for JAMA Psychiatry. Wölfling is a researcher in the department of psychosomatic medicine and psychotherapy at the University Medical Center of Johannes Gutenberg University in Germany.

According to researchers, Internet addiction is an excessive use of the Internet that negatively affects the family, social relationships, work and other aspects of life.

Last year, the World Health Organization recognized gambling disorder on the Internet as a mental health problem. The criteria for gambling disorder of the WHO International Clbadification of Diseases include at least 12 months of recurring patterns of gambling, loss of control and continued behavior, even after causing negative consequences and distress in from other aspects of life.

For this study, researchers used a broader definition of Internet addiction, to include gambling-dependent patients, social networks, badgraphy, online browsing or use. General Internet. The prevalence of Internet addiction is estimated at 6% worldwide.

15 weeks of therapy

The study looked at 143 men between the ages of 17 and 55 in four outpatient clinics in Germany and Austria, meeting the Internet Dependence Criteria based on the Internet Dependence and Dependence Survey scores. computer games, a standardized survey used in the field.

It is based on 14 criteria, including the frequency of Internet activities, withdrawal symptoms, concern for the Internet, and loss of interest in other life activities. Internet addiction was defined as a score greater than 13, while remission was defined as a score less than 7.

Short-term cognitive-behavioral therapy consisted of 15 weeks of group and individual sessions. The program was divided into three phases: education on addiction, psychotherapeutic intervention – for example, healthy use of the Internet – and "focus on relapse prevention techniques and the transition to daily life", according to Wölfling .

People who were part of the control group of the waiting list finally received cognitive-behavioral therapy, but after a 15-week delay to allow the realization of the study.

According to Wölfling, the study focused only on men, as they are the predominant patients for Internet addiction in clinics. For behavioral dependence in general, men "account for 90% of patients treated or diagnosed externally," the researchers wrote.

Patients were badessed at the beginning of treatment, during treatment and after treatment, at four months.

Those in the short-term cognitive therapy group also underwent a follow-up evaluation after six months. The researchers examined self-reported behaviors and symptoms of Internet addiction.

At the end of treatment, patients in the treatment group had less severe symptoms of addiction, such as withdrawal, preoccupation and time spent online, as well as improved social, occupational and daily living conditions.

Patients showed lower overall depression rates, with no significant differences between the two groups. The researchers noted that a small number of people became more depressed and had to be transferred to a hospital facility.

This was the first randomized clinical trial conducted in several clinics dealing with the treatment of Internet addiction, but the study had several limitations.

The small size of the sample could have "overestimated" the effect of short-term therapies, the researchers wrote.

In addition, the study was limited to men and, according to the information provided by patients to their own condition. Some patients dropped out of the study and 100 patients completed the study as planned.

According to Wölfling, future randomized controlled trials should better retain patients, include women and last longer.

"Patients could still benefit more if the treatment phase is extended," he said in the JAMA Psychiatry podcast.

"The understanding of the person and their history and the development of the behavior or pathological disorder may be more important for the patient to know his own story and the development of his life."