Clinical manifestations and treatment of Internet Addiction Disorder

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Internet addiction (Internet addiction) or network (Internet dependence, Internet on dependency) or 300 (pathological internet use network u


Internet addiction (Internet addiction) or network (Internet dependence, Internet on dependency) or 300 (pathological internet use network using rational) is the excessive use of the network against social norms, improper behavior to cause damage or even detrimental to others. Internet addiction disorder (IAD) is a kind of habit and impulse control disorder (or behavior control disorder). Internet addiction is often not certain of the reason, uncontrolled spending a lot of time and effort on the Internet continued to chat, games, browsing, making data, which affects the quality of life, reduce learning or working efficiency, social function is damaged, harmful to health; take it as a formal definition of the disease into the diagnosis system to that is the first by Evan Gelberg (Ivan Goldberg, M.D) theory of morbid made in 1997 and formally recognized the value of study. It can be said that it is an over reliance on the network, and there are a variety of behavioral abnormalities, pathological personality, sympathetic nervous system dysfunction. The typical symptoms of mood changes, loss of interest, or other biological clock disorders, sleep disorders, loss of appetite and weight loss, lack of energy, psychomotor retardation and agitation, decreased self-evaluation and capacity reduction, slow thinking, Dutch act ideas and behavior, reduced social activity, heavy smoking, alcohol and drug dependence etc..

In the past statistics, 295 million of Internet users worldwide, there are 11 million 400 thousand people with different levels of Internet addiction syndrome, accounting for the total number of 6-9%. The number of reported Chinese addiction has more than 16 million people, further investigation also found that the network addicts more concentrated in the 12-18 years old students and no fixed occupation (networm), a housewife also more involved, male and female ratio is about 2:1, these people have plenty of time with computer, which is susceptible to. The "report" health Chinese Internet practitioners officially announced the survey shows that 71% of people consider themselves to be dependent on the network; 52% of Internet practitioners if 1 ~ 2 days does not use a computer or the Internet will feel at ease feeling. "China youth internet addiction data report" shows that in young Internet users, Internet addicts accounted for about 1/10, almost all Internet addicts have clicked on the Yellow pages.

Etiology and pathology

Genetic factors can be observed in clinical practice, different individual experience of the network, sensitivity, tolerance, dependence and withdrawal reactions are not exactly the same, in the same environment only small part of people network addiction. Some long time use of the network, they are necessary in the social, entertainment places excessive use, while others use in the short term even after first use soon developed into addiction, there is a significant difference between their behavior.

Bad personality traits may also be the causes of network dependence, such as life alone, behavior does not conform to social norms, poor thinking, self-control ability, anxiety, tension, etc..

Although the neurobiological mechanism of physiological and biochemical factors is not yet clear, however, the limbic system has been studied by many scholars. The mesolimbic dopamine system to reward dependent addiction. This system mainly in the ventral tegmental area, nucleus accumbens and amygdala. The dopamine system may occur in a series of adaptations, such as quantity, activity, intracellular signal molecule mediated activity, mediated signaling pathways and gene expression changes; from molecular genetics, addiction and neurotransmitter systems and related gene structure and gene expression differences are related.

An obvious feature of learning and memory of addiction said addiction is persistent, even after the withdrawal addiction for a long time, and when the original display related clues, will still have a strong desire for addiction, there is still a high risk of recurrence. A molecular basis of addiction similar to learning and memory; so the addiction is considered a pathological study of memory.

The psychological factors of psychological development factors: childhood experiences and unreasonable education, can affect the psychological development is not mature enough, school education and family education for children of the unrealistic hopes, will make the child long in the "failure" moderate, because of poor grades, the teacher always despised and marginalized students, forcing it to the virtual world to seek "hope". Psychological defense: loneliness, poor flexibility, coupled with the guidance and habits of life events lead to Internet addiction.

The social environment factors of different social environment of different people, after entering in twenty-first Century, most of the students and children are accompanied by computer to grow up, learn computer, computer and Internet is indispensable in the life of their learning tools and experience, even in the elderly is also associated with them. But it is this indispensable, but so many people suffer from network dependence.

Many children because of too much pressure, the parents of the rude way of education, do not feel the love of their parents. Therefore, they will go online, through chat, play games and other ways to release the pressure. From another point of view, if there is no network, these children may lie on the ground to play beads, winning gambling pictures, and even fights, obsessed with martial arts novel drugs to do illegal things, is the network to give them psychological cushion. In the network has been the lack of things in real life, it will not go gambling, drug abuse, do illegal things.

Some people because of spiritual emptiness, some people because of emotional frustration, some people because of marital crisis, all aspects are not the same as the natural causes of network addiction; the results of the unfair distribution of the birth of a folk many irrational emotions,

The performance of these emotions will be expressed through the network, the majority of people in the persecution of hallucinations and violent language enhancement will only become more emotional and extreme, and inextricably bogged down in.

The network system and the lack of moral restraint, and easy to breed irrational news and rumors, because of the lack of rational participation channels, excessive dependence on the Internet is in the Internet to arouse a strong emotion, the network has become a "runaway machine".

Chinese understanding of human nature, not only restricted by the Yin Yang and the five elements, but also affected by the weather, geography and people themselves. According to the characteristics of the ability of the people divided into: Ming, listen to people, different people Cong Zhi, Jing Hui people, people, people, bitter bitter soft hand, Gan eight people hand. The emotion is divided into: Gu Gu, who has been in private, less love, good love, pity, and any ambition six people. Different people is not the same as the network according to the independent and dependent on, but in my opinion, bitter or sweet hand less love, good love, great pity Zhong is prone to network dependence, no matter what kind of people if we rely on the network, in Chinese medicine, the Internet addiction disease in the heart. Chinese medicine believes that the heart of the monarch, the gods out of yan. The heart not only produces the motive of the Internet, but also gets pleasure through the internet. The original pleasure is a positive, is a normal emotional reaction. However, Internet addiction in long-term online to get pleasure in the course of time, psychological increasingly hungry, more and more hope to get more pleasure. "Seven extreme", "things", Chinese medicine believe that strength is limited, but the desire is infinite, the infinite desire to exhaust the limited strength, be afraid; a healthy pleasure to become a double-edged sword, in turn, harm to people's health. The pursuit of the infinite, the infinite pleasure to meet deeply hurt the hearts of the main gods, long-term network dependent hyperexcitability, gas consumption disability allowance, gasification adverse, endogenous phlegm to trance, resulting in disordered thinking, unresponsive and other symptoms.

[clinical manifestations]

Excessive use of network: frequency and time of individual Internet use are beyond the normal limits, the use of network is not for the purpose of learning and work or is not conducive to their learning and work, the network life occupied most of his spare time, resulting in personal life and network students lose their balance between work, to study and work in time inattention, fatigue, sleepiness, in the blues and efficiency decline, serious absenteeism, absenteeism, and has a certain influence on the daily life and interpersonal communication. Excessive use of the Internet is often criticized by others, and even conflict with family and friends for the sake of this. Although the individual has an understanding of the harm, but still continue to use. It should be noted that excessive use should not be accompanied by withdrawal symptoms, or should be considered for Internet addiction.

Internet addiction disorder: Internet addiction disorder has characteristic clinical manifestations, often accompanied by physical and mental symptoms. According to the main purpose and content of the network, Internet addiction can be divided into the following 5 categories: network game addiction and cyber porn addiction, cyber relationship addiction, Internet addiction and network information transaction addiction, which network game addiction.

Clinical features: Patients with the use of the Internet there is a great desire, whether in learning, work or daily life are often in the mind in a network related situation, and look forward to the next Internet; patients can feel intense pleasure and satisfaction in the use of the network, and keep the feelings of pleasure and satisfaction while increasing Internet time and involvement with the Internet, the use of network time, patients gradually lose self-control, stop in the network more time can be made by the first few days of the Internet once daily to the development of the Internet for several hours, the ultimate need for several days in the network; when suddenly to reduce or stop the Internet, the patient will appear irritability, irritability, inattention, sleep disorders, serious or even impulsive, attack and destructive behavior; Some patients will choose the same network as the media, such as television, handheld games, etc., to alleviate the withdrawal response. There has been exacerbated by the withdrawal of craving for patients on the network, patients are often in order to avoid withdrawal reactions happen again and more addicted to the Internet, to leave, resulting in Internet has gradually become a fixed mode of behavior, and even daily behavior are limited in the network, so as to reduce or abandon the former interest, entertainment and other important activities with their family or friends on the Internet to hide the real time and the degree of harm to indulge in the network, network consciousness gradually weakened in the heart, to ignore any advice from family and friends, for access to the Internet and extend the Internet time and by all means, including lying, truancy, absenteeism steal money, family etc.. In the eyes of the family, the patient becomes indifferent, ruthless, lost their sense of responsibility for themselves and others. The patient does not consider many adverse impact of the network to its own, with emotion seems to have been around the network, the Internet and the Internet have completely different experience, and indulging in network, and even.

Types of Internet Addiction

1, network game addiction: more common in young people, this group of people often lack of family or school care in learning they may be a loser, they don't care at home parents and relatives, not to school seriously, often by satire and hit the teacher and the students, even to the society but also to adapt to the the social reality of the losers, so they go to the "virtual world" to this game is to seek happiness and shortcut, they indulge in the game users hold together to form a clique, the "virtual world", from the reality of society, family and school is not popular.

2, Internet porn addiction in adolescents and adults are mostly elderly less, adolescent sexual consciousness just germination, first awakening interest in the opposite sex, become a "high-risk group virtual sex addiction". Some young people may have a chance to experience the virtual sex on the Internet, this kind of stimulation and experience for young people is too strong, they are easy to fall into which can not extricate themselves. For adults, easy intervention and intuitive network, making pornographic content everywhere, some people with curiosity and prone to impulsive or "disorder of sexual preference" of people all day long on these sites to linger, to meet the needs of those unable to meet the needs of daily life. Some experts pointed out that every week to spend more than 11 hours to roam the porn site, there are people suspected of Internet pornography addiction. The Internet addiction disorder is characterized by the involvement of online activities that interfere with your work, study, entertainment, and your relationship with others.

3, network addiction: These are often not good interpersonal factors, the relative isolation, low self-esteem environment, people will ignore the network addiction interpersonal relationship exists, the interpersonal relationship atrophy and the role of perversion, emotion and self concept change, internet interpersonal relationship involved and network dependence behavior, "love" is the typical, the so-called "the two lonely hearts together" or "computer v.says", while the decline in social function, after withdrawal withdrawal.

4, network addiction: all information in the online search is a kind of human behavior, no computer can't work, what clothes to buy, what to buy mobile phone, what medicine to eat, do answer...... And so on, do not check on the Internet will not work; one day if you do not receive the e-mail on the internet. There is a class of people, like is dedicated to computer hacking system, peep or steal others' information, or the illegal production of "computer virus" network system in order to destroy the self appreciation, not knowing but not controlled.

5, the trade of the network addiction: often refers to a group of Internet business and shopping crowd, some failure, they engaged in trade of the network became obsessed with the network but also includes some investors, inextricably bogged down in; on and other commercial sites, there are enterprise employees participating in business, these people are often accompanied by there are many psychological and physical discomfort, such as insomnia, mental appetite, physical symptoms such as back pain, unable to complete the normal work and study, and affect the daily life and social function.

Comorbidity of Internet Addiction

Internet addicts with other mental disorders are common, with other mental disorders that were sick, some people think that the comorbidity of about 2/3. Therefore, it is necessary to think about the existence of CO morbidities in diagnosis. There is no definitive statistics on the prevalence of Internet addiction disorder, but according to the existing knowledge, it can be divided into the following categories.

Anxiety disorder

Nervous, always on tenterhooks, muscle tension, anorexia, gastrointestinal dysfunction, malnutrition, fatigue, sleep rhythm disorder, palpitation and chest tightness and autonomic dysfunction. For a long time staring at the computer screen, focus, blink less, can cause visual fatigue, eye dryness, pain, blurred vision, decreased visual acuity, even screen syncope phenomenon (amaurosis fugax, may be accompanied by nausea and vomiting). The long-term operation of computer can lead to carpal joint syndrome (mouse), migraine, shoulder and neck pain and cervical vertebra disease. The game of failure and death scenes will also have a great impact on the patient, causing fear, fear of emotional experience, and often even worried that there are ominous, etc..

Two, mood disorders

Marked by persistent high or low mood, accompanied by changes in thinking and behavior, and sometimes psychotic symptoms, such as hallucinations, delusions, etc.. Due to over indulge in the network (especially online games), resulting in impaired patients reality testing function, not totally separate from the network of "virtual scene stimulation" and "high status", can appear self-confidence expansion, self evaluation had higher emotion reaction; part of the patients with severe, almost completely isolated and reality, there may be a short disintegration of reality. At the same time, excessive Internet use is often affected by family and friends of opposition and criticism, the individual has serious discomfort and unable to integrate into the sense of real life, appear pessimistic, depressed, no hope for the future, emotional experience, but did not reduce the symptoms of patients with the behavior of the network, the opposite patients tend to to alleviate the negative emotions through the Internet; and the patients in the withdrawal period is also prone to depression.

The mental symptoms usually have the following characteristics: 1. After appearing in Internet addiction, the duration is not long, then get rid of addiction with reduced or disappeared; the network contents of the symptom content in contact with patients is closely related to effects of changes in symptoms of network content and personality characteristics of patients with the symptoms; there will not be reduced in patients with the use of network the behavior, but rather reflects the network dependence has reached a serious level.

Three, stress related disorders

The real environment has a strengthening effect on the dependent behavior, when the network dependent patients to face the reality of life pressure or mild stress, there will be more dependent on the network, Internet behavior, the severity of psychiatric symptoms are frequent. Influence of the real environment and network environment of the individual have been perplexing, some patients are deeply influenced by the network environment, the virtual environment will cause the same as the real environment of trauma patients, such as acute stress reaction, with fear and psychomotor excitement, blind behavior or emotional dull, vague consciousness. Sometimes the painful experience of the network can not help but recall.

Four, oppositional defiant and conduct disorder

The network game unique challenges and reality gives people unlimited imagination, but also brought a lot of violence and unreal, so that many young people blurred the boundaries between reality and the virtual world, forming and curing mode and other bad behavior. In the long time of addiction or out of addiction, often lie, do not obey their parents and teachers, oppositional defiant, violation of school discipline, repeated truancy, fighting, runaway conduct disorder etc.. At the same time, the anonymous and escapism also cured patients with bad social adaption model in personality formation of adolescence may lead to inadequate personality, especially avoidant personality, shows the difficulties and setbacks of others dependent, inferiority, love and need to be recognized, too sensitive to rejection and criticism and can not adapt to the real life, take evasive attitude to social activities and old friends, become withdrawn, suspicious, emotional instability, etc..

Five, hyperactivity disorder, attention deficit hyperactivity disorder (ADHD)

This kind of people first in children, can be extended to adults, children and adolescents with the most, mainly concentrated in the attention, he is active, too much in need quiet occasions, the performance of students in school learning difficulties, poor academic performance, and behavior problems, main performance is impulsive restraint, in the school teachers and students often cause dissatisfaction, cause parents abandon easily at home, these patients have emotional problems, so the network has become their safe havens and comfortably.

Six, schizophrenia

The early patients often have emotional symptoms, such as depression and anxiety, emotional dissonance, hallucinations and delusions of control in continuous internet roaming is often for hours or even days to the network, they may have been thinking of the sense of control, sense of being revealed or forced thinking or pathological symbolic thinking. They strained and strange behavior, then there will be loss or lack of will.

Seven, obsessive-compulsive disorder

Is a kind of neurosis, which is the main clinical phase of obsessive compulsive behavior. Clinical features are originated from the self, patients aware of obsessions, forced intent and compulsive behavior is not necessary, but patients can not control, because patients with intact insight, often the obsessive-compulsive symptoms distress and anxiety. Obsessive compulsive disorder is difficult to form a variety of forms. Forced to browse some web pages, forced online shopping is also one of its manifestations, as well as forced to think about the poor patients will be unable to control a variety of web browsing, trying to find different answers.......

Diagnostic criteria and differential diagnosis


First, Internet Addiction

1, symptoms: long-term, repeated use of the network, the purpose of using the network is not to study and work or not conducive to their own learning and work, with the following symptoms:

(1) the use of the network has a strong desire or impulse.

(2) there was discomfort, irritability, irritability, inattention, sleep disorders such as withdrawal will reduce or stop Internet; the withdrawal by the use of other similar electronic media (such as television, handheld game machine etc.) to relieve.

(3) the following 5 at least in accordance with Article 1: to achieve satisfaction and increased use of network time and input levels; the use of the network at the beginning and end of time and it is difficult to control, after repeated efforts were not successful; the stubborn network regardless of the harmful consequences Q and even know the harm Internet use is still difficult to stop; and reduce or abandon the other interest, entertainment or social activities due to the use of the network; way will use the network as a and7avoidanceoralleviationofunhealthyemotions.

2, the standard of disease: the average daily non work and learning purposes of continuous use of network time to reach or exceed 6 h, and meet the standard of symptoms has reached or exceeded 3 months.

3, the severity of the standard: daily life and social function impairment (such as social, learning or work ability).

4, exclusion criteria exclude excessive use of the network, neurosis, mood disorders, schizophrenia, conduct disorders, schizophrenia, personality disorders and attention deficit hyperactivity disorder, etc..

Two, excessive use of the network

1, symptoms: long-term, repeated use of the network, the physical and mental health have adverse effects, the purpose of using the network is not to study and work or not conducive to their own learning and work. Meet the following 2 items:

(1) excessive use of behavior is often criticized by others and leads to negative consequences;

(2) although individuals are aware of the dangers of excessive Internet use, they continue to use.

2, exclusion criteria: excessive use should not be accompanied by withdrawal symptoms, or should be considered for Internet addiction.

Differential diagnosis (excluding comorbidity)

An anxiety disorder (GAD): lack of clear and specific content of the object, and always on tenterhooks nervous autonomic symptoms, muscle tension, and the movement of the restless, not the experience of the Internet and Internet dependence.

Two, mood disorders: to clear the mood of high or low mainly, the performance of lasting and thinking and behavior changes, but not necessarily linked with the internet.

Three, is a group of stress related disorders caused by psychological and social environment factors of the abnormal psychological reactions, the causes of mental disorders associated with life events and the environment, and social culture and personality characteristics.

Four, oppositional defiant and conduct disorder is a serious violation of the corresponding age children in the period of social norms, and repeated attack and persistent antisocial oppositional defiant behavior, the peak incidence in school-age children.

Five, attention deficit hyperactivity disorder (ADHD): compared with their peers, the performance of a significant concentration of attention difficulties, attention to short duration, as well as hyperactivity or impulse of a group of wayward.

Six, schizophrenia: more onset in young adults, thinking, emotion, behavior and other obstacles, but also mental activity is not coordinated. Usually conscious, intelligent, but hallucinations, delusions and cognitive impairment.

Seven, obsessive compulsive disorder: there are forced thinking or forced behavior, conscious forced and forced to coexist, the two form a strong conflict and feel anxiety and pain, the concept is derived from the self, but also have impaired social function.


Principle of treatment:

1, the first to find a professional psychiatric screening, to see if there is a common disease, and exclude other mental illness.

2, can not discriminate against their behavior, can not be regarded as ideological problems or conduct problems, criticism is not scolding can be corrected, but can not be punished. They are a kind of pathophysiology and pathological psychological phenomenon, do not treat this phenomenon as a general mental illness, so as not to cause psychological trauma.

3, psychological and behavioral therapy combined with drug therapy, drug therapy can create conditions for psychological education. The drug can supplement the body quality and application in drug under the condition of Internet addiction symptoms (especially disease symptoms) can be improved, it is easier to accept behavioral therapy and receive psychological counseling and education.

4, the treatment of Chinese medicine is: adjust Yin and yang. The highest principle of syndrome differentiation and treatment based on "harmony". "Basic questions," said: "the angry sky on where the Yin and Yang, Yang Mi is solid, with both, if no spring and autumn, if the summer without winter, and therefore, is that of st.." Curing the disease is to adjust Yin and Yang, Zang Fu organs, Qi and blood is the concrete embodiment. Treatment of liver and kidney. Although various types of the viscera, Qi and blood, to trace the origin of the liver and kidney injury in many organs will turn the liver and kidney always can not be ignored. The physical and mental treatment. In the traditional Chinese medicine related theory of meaning therapy, take drugs, acupuncture, massage, diet guidance to foster, and with more psychosomatic disease as the objective.

Two, drug treatment: only for those with a common disease.

Three, diet: eating properly nursed back to health, nutritious food with brain nerves.

Four, psychological treatment:

1, the basic quality requirements:

Psychological counseling and psychotherapy is a scientific work, to help people with scientific knowledge and basic skills to help them, so that they understand the real reason for their trouble, correct or abandon maladaptive behavior, to eliminate the symptoms, the physical rehabilitation and psychological maturity.

The professional ethics therapist should have good professional ethics and abide by the relevant laws and regulations.

Abundant theoretical knowledge of psychotherapy (counseling).

Good personality traits.

The dialectical thinking.

2, the commonly used cognitive therapy and behavior therapy.

3, can be used as the other: "Morita therapy", Chinese medicine called "meaning treatment".

To improve quality education acquired the ability to: take care of themselves in life, knowledge learning, action decision-making autonomy, self-discipline, moral evaluation, self introspection, attitude control, emotional self wyatt.......

[method] with prognosis

1, nursing key points: 1 the mental adjustment to establish confidence, active treatment, exercise will strengthen willpower, improve learning interest. The management of doctors, teachers and social education to understand patient care, strengthen the positive education, do simple and crude and discrimination, to avoid damage to the patient's self-esteem or hostility, but not let things drift, prevent attacks, destruction and other dangerous behavior, prevent accidents. Observe the curative effect of close observation of the disease, timely adjustment of treatment, attention to consolidate the effect, not arbitrarily terminated treatment.

2, prognosis: prognosis is good or bad, in addition to the disease itself, but also with the treatment effect and social care, environmental conditions are closely related. If the combination of personality disorder, conduct disorder or mood disorders, and other psychiatric symptoms or mental retardation.

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