The present study aimed to investigate internet addiction and its effects on the mental health of medical students at Kermanshah University of Medical Sciences. The results of the present study demonstrated that 45.5% of students at Kermanshah University of Medical Sciences were addicted to the internet. This finding was concurrent with the results of studies conducted by Farhadini et al, (44), Sepehrian and Jokar, (45), Fonia et al, (26), and Dargahi and Razavi, (28). According to Douglas et al, internet addiction is a kind of excessive compulsive use of this tool, which, in the event of being deprived of it, the user becomes highly irritable, and his/her reaction manifests itself in the form of bad temper (25). Those who use the internet more than others can replace stronger relationships in real life with lower-quality social relationships, thereby resulting in more loneliness and depression. To further explicate the matter, the internet may serve as a substitute for lives without vitality. Loneliness and isolation may cause people to spend more time on the internet, thereby decreasing the quality of their social relationships.
As forthe demographic characteristics, the results demonstrated that there was a significant difference between male and female students in terms ofinternet addiction. Additonally, 23% of male students wereinternet addicts, which exceeded that of female students by 22.4%.In this study, male students should be given priority in prevention programs for internet addiction. These results were consistent with the results of studies conducted by Alavi et al, (5), Orsal et al, (46) and Fonia et al, (26) whereas inconsistent with the results of studies performed by Atashpour et al, (47) and Shahbazirad and Mirderikvand, (16). In a study done by Ghahremani et al, (6), the internet addiction in boys was higher than that in girls. Similarly, Solhi et al, (32) concluded that 18% of students at Tehran University of Medical Sciences had internet addiction behaviors, and 13% and 5% of men and women were internet addicted, respectively. However, Pirzadeh et al, (2011) reported that 8.3% of students at Payame Noor University of Isfahan had mild internet addiction(48). However, in a study done by Bandani Tarashoki et al, (2017) about the students at Dezful University of Medical Sciences, it was found out that 1.8% of female students had internet addiction behaviors, which was higher than that in male students by 0.9% (49). Male students seem to have more internet addiction than girls. On the other hand, with the growing number of girls entering universities, they have the chance to become more familiar with technologies and have a greater chance of using the internet. In fact, the present research, in line with the findings of previous studies, shows that men are more exposed to internet addiction, not because of biological differences between the two genders, but due to different social and environmental factors to which each gender is exposed. According to the results, it seems that this finding can be an alarm at the increase in this disorder among students, and it is better that proper planning be done in this area in cooperation with university officials.
Based on the results of the present study, the mean score of male students’ mental health was higher than that of female students, and no significant difference was seen between gender and mental health. This finding was inconsistent with the results of a study by Ghodasara et al, (2011) at Vanderbilt University, in which gender served as one of the most important determinants of student’s mental health(50). However, this finding of the present study was consistent with the results ofstudies conducted by Taji and Verdinejad, (51), Sadeghian and Heidarian Pour, (52), Namdar et al, (53) and Imani et al, (54). In studies done by Asadi (55), Rafati et al, (56), Biro et al, (57), Chen et al, (58) and Shahabinejad et al, (59), it was expressed that female students had more mental disorders than male students, which was inconsistent with the results of the present study. It should be noted that the mean score of male students’ mental health was higher than that of female students, possibly due to men’s ability to communicate with others in society and university, the ability to deal with problems and difficulties and the ability to earn money, as well as the women’s excessive emotional dependency on their families and lack of social security in society.
The results of this study revealed that half of the students had poor mental health, and there was a sygnificant difference between the mean scores of depression and internet addiction. These results were consistent with the results of studies done by Nastiezaie (25), Xiuqin et al, (60) and Chung and Wong (61). Kessler et al, (62) concluded that 9.7% of the young aged 18-25 in the USA suffered from depression disorders. The mental health disorders in students cause a sygnificant portion of their mental force to be devoted to such problems, thereby resulting intheir lack of ability and interest to study, disturbing their educational tasks and reducing their motivation, as well as fear, concern, and anxiety.In a study done by Abdollahi (2016) about the nursing students at Tehran University of Medical Sciences, it was shown that 32.1% of students had suspected mental disorders, which was 29.7% in women and 34.3% in men (63). In additon, Rafiei et al, (2012) showed that 67.9% of students at Arak University of Medical Sciences had symptoms of mental deisorders, and only 32.1% of them had normal mental health (64). According to the results of a study conducted by Sherina et al, (2004) about the students of medical universities in Malaysia, it was found that 42.9 percent of students experienced psychological stress (65). Similarly, Masoudi Asl et al, (2013) concluded that 52.4% of students at Tehran University of Medical Sciences were suffering from mental health disorders (66). Likewise, in a study done by Yavarian et al, (2017) about the students at Uromia University of Medical Sciences, it was demonstrated that 45.8% of students had different degrees of mental health disorders.In their study, it was also revealed that10%, 0.5% and 3.2% of students had severe disorders in terms of somatic symptoms, anxiety and insomnia, and depression, respectively. This finding was concurrent with the results of the present study (67). According to the results of studies conducted by Ofili et al, (68), Jadoon et al, (69) and Chen et al, (58), the medical students of Nigeria, Pakistan and China were suffering from depression and psychological stress. It seems that the different prevalence of psychiatric disorders in various studies can be attributed to several factors, including the differences in groups under study.
The results revealed that internet addiction and mental health were negatively related, which was consistent with the results of studies conducted by Shahbazirad and Mirderikvand (16), Fallah (23) and Mousavomoghadam et al, (70). Hosseini et al, (2015) showed that 4.2% of students at Payam Noor University of Charm had severe addiction to the internet. Additonally, a significant relationship was observed between internet addiction and mental health (21). Similarly, in a study performed by Farhadinia et al, (2015), it was demonstrated that internet addiction and mental health significantly correlated among the students of Lorestan University of Medical Sciences (44). Likewise, Marashyan and Asgari (2008) concluded that there was a significant relationship between anxiety and internet addiction.Additionally, students addicted to the internet experience more depression than normal users, thereby leading to their academic failure (71). In a study performed by Shek and Tang (2008) on Chinese adolescents, it was shown that 91% of Chinese adolescents were addicted to the internet, which affected their somatic and mental health and family life and caused depression. Nastiezaie (2009) and Whang et al. (2003) concluded that the mental health of users addicted to the internet was more at risk than normal users, expecially in terms of the subscales of anxiety and depression(25, 72). Vizehfar (2005) expressed that33% of people used the internet to entertain or forget about their problems. Moreover, the results of studies conducted by Nathan et al, (73), Ko rt al, (2) and Alavi et al, (5) revealed that depression and internet addiction correlated. Similarly, Marcantonio et al, (74), Alavi et al, (5) and Shepherd et al, (75) found out that there was a relationship between anxiety and internet addiction. These two findings were consistent with the results of the present study.Depression, as a psychologicaltrauma, seems to lay the groundwork for the internet addicts. Some people resort to the internet to reduce their depression. In this case, the internet may provide a substitute for the joyless lives of depressed people, or they may get depressed as a result of internet addiction. In other words, the internet addicts will experience the negative consequences, such as depression.
In justifying the relationship between depression and internet addiction, it can be expressed that the excessive use of the internet can lead to social isolation and depression throughreducing familial, social and local connection. Therefore, depression may occur as a result of internet addiction, and in this case, the internet addicts experience the resultant negative consequences, such as depression (25).
The results revealed that the five major predictors of vulnerability to internet addiction in university students were as follows: the key reason for using the internet, faculty, depression, the main place for using the internet, and somatic symptoms.
Limitations of the Study
The present study had some limitations. First, the data were collected through a self-reporting method, possibly affecting the accuracy of the results. Second, the subjects’ personal differences may also affect the generalizability of the research findings. Hence, it is suggested that further studies be conducted in this respect to draw comparisons towards reaching a consensus on this matter.