Internet addiction: a descriptive clinical study focusing on comorbidities and dissociative symptoms (2009)

Compr Psychiatry. 2009 Nov-Dec;50(6):510-6. doi: 10.1016/j.comppsych.2008.11.011. Epub 2009 Jan 20.

Bernardi S1, Pallanti S.



Internet addiction (IAD) is an emerging cause of morbidity and has been recently considered to merit inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Given the paucity of knowledge about IAD, we conducted a descriptive clinical analysis of patients focusing on clinical, demographic features, and comorbidities. The detachment has been suggested as a reason for the attractiveness of the Internet; thus, we assessed dissociative symptoms and their association with IAD disability.


A cohort of 50 adult outpatients were screened using the Internet Addiction Scale. Exclusion criterion was using the Internet for only one purpose such as gaming or gambling.


Nine women and 6 men constituted the sample of Internet addicts; each of them had a score of 70 or higher on the Internet Addiction Scale.


Comorbidities and subthreshold symptoms were screened carefully. Dissociative symptoms were analyzed with the Dissociative Experience Scale, and disability was assessed using the Sheehan Disability Scale.


Hours/week spent on the Internet were 42.21 +/- 3.09. Clinical diagnoses included 14% attention deficit and hyperactivity disorder, 7% hypomania, 15% generalized anxiety disorder, 15% social anxiety disorder; 7% dysthymia, 7% obsessive compulsive personality disorder, 14% borderline personality disorder, and 7% avoidant personality disorder. One patient met criteria for binge eating disorder. Severity measures of IAD were associated with higher perception of family disability (r = 0.814; P <or= .001) and with higher Yale-Brown Obsessive Compulsive Severity score (r = 0.771; P <or= .001). Scores for the Dissociative Experience Scale were higher than expected (23.20 +/- 1.83) and were related to higher obsessive compulsive scores (r = 0.618; P <or= .001), hours per week on the Internet (r = 0.749; P <or= .001), and perception of family disability (r = 0.677; P <or= .001).


From a phenomenological point of view, IAD in our sample population seems to be more compulsory than rewarding or mood driven. Dissociative symptoms are related to severity and impact of IAD.