Sex differences in prevalence, risk factors and clinical correlates of internet addiction among chinese college students

Background: Internet addiction(IA) is now very common. However, few studies have explored the sex differences in risk factors for IA, especially among Chinese college students. This study aimed to investigate the sex differences in prevalence, risk factors and clinical correlates of IA among Chinese college students. Methods: A total of 8098 college students from Hunan province were recruited using a cross-sectional design and a convenience sampling method. Each student filled out the survey online anonymously, which collected their information on their socio-demographics, internet addiction(Revised Chinese internet addiction scale;CIAS-R), ADHD(Wender Utah Rating Scale and World Health Organization (WHO) Adult ADHD Self-Report Scale v 1.1 Symptom Checklist), depression(Self-reporting Depression Scale;SDS), insomnia(Athens Insomnia Scale;AIS), anxiety(Self-Rating Anxiety Scale;SAS) and suicidal behaviors through WeChat. Results: Overall, the prevalence of IA in males and females was 7.21%(259/3592) and 8.17%(368/4506), respectively. Multivariate logistic regression analysis revealed that suicidal ideation[odds ratio (OR),1.557;95% confidence interval (CI),1.083-2.240], suicide attempts(OR,2.081;95%CI:1.271-3.409), ADHD(OR,6.487;95% CI,4.697-8.959) and insomnia(OR,2.596;95%CI,1.910-3.529) were independent risk factors for male IA after controlling for confounding variables. Nationality(OR,1.507;95%CI,1.058-2.145), suicidal ideation (OR,2.012;95%CI,1.532-2.641), depression(OR,1.771;95%CI:1.071-2.930), ADHD(OR,4.497; 95%CI,3.285-6.158) and insomnia (OR,2.356;95%CI,1.813-3.061) were independent risk factors for female IA. Limitation: No causal relationships could be drawn due to the cross-sectional design. Conclusions: This study shows IA is common among both sexes. IA is significantly associated with ADHD, insomnia and suicidal behaviors in both male and female students, indicating the importance of screening IA and addressing ADHD, insomnia and suicidal behaviors to improve the mental health of college students and better prevent suicide in both sexes.