Association of Problematic Internet Use With Psychotic Experiences and Depression in Adolescents: A Cohort Study

Abstract Background and Hypothesis Problematic internet use (PIU) is prevalent among adolescents. Past research suggested cross-sectional associations between PIU and psychotic experiences, but little information is available on the longitudinal association. We hypothesized that PIU in adolescence may be longitudinally associated with psychotic experiences, adjusting for confounders. Study Design We analyzed a random sample of adolescents in the Tokyo Teen Cohort to examine how PIU at ages 10 (2012–2015), 12 (2014–2017), and 16 (2019–2021) was associated with mental health issues at age 16. PIU was evaluated by the modified Compulsive Internet Use Scale, psychotic experiences by the Adolescent Psychotic-like Symptom Screener, and depression by the Short Mood and Feelings Questionnaire. We also examined the mediating role of social withdrawal. Study Results We analyzed 3171 adolescents; 151 reported psychotic experiences and 327 reported depression at age 16. Compared with the lowest tertile PIU group, the highest tertile PIU group at age 12 showed an increased adjusted risk of psychotic experiences (RD 3.3%, 95% CI 2.9%–3.7%; RR 1.65, 95% CI 1.55–1.73) and depression (RD 5.9%, 95% CI 5.5%–6.3%; RR 1.61, 95% CI 1.55–1.68) at age 16. PIU at age 16 showed analogous results, while PIU at age 10 suggested a smaller impact. Social withdrawal mediated 9.4%–29.0% of the association between PIU and psychotic experiences. Conclusions PIU is longitudinally associated with psychotic experiences and depression in adolescents. Further longitudinal and intervention studies are warranted to provide robust public health implications and foster a safer digital future.