Association between internet addiction and suicide and self-injury behavior in Chinese adolescents: A meta-analysis

Abstract Background: Internet addiction (IA) has become a significant social issue, with studies indicating a correlation between adolescent suicide, self-injury, and IA. However, the nature of this correlation among Chinese teenagers remains unclear. This research aimed to clarify the relationships between IA and suicidal and self-injury behaviors among Chinese adolescents through a meta-analysis of observational studies. Methods: We searched seven electronic databases from inception to January 16, 2023. Study quality was assessed by the AHRQ and the NOS. We extracted the effect values (OR) of IA and suicide, and self-injury behaviors using STATA (version 16) software for data synthesis. Results: Out of 836 initial studies, 26 cross-sectional (n = 376742) and two prospective (n = 1831) studies were selected to examine the association between IA and suicide and self-injury behaviors in Chinese adolescents. IA was significantly linked to increased odds of suicidal ideation (OR = 1.81, 95% CI: 1.46-2.24), suicide planning (OR = 1.85, 95% CI: 1.36-2.52), suicide attempt (OR = 1.78, 95% CI: 1.34-2.36), and non-suicidal self-injury (OR = 1.91, 95% CI: 1.58-2.31). Subgroup analysis suggested that regional differences, age, and publication year may regulate the association between IA and non-suicidal self-injury behavior. The study found that western China had the highest risk of non-suicidal self-injury, and middle school students were more vulnerable than college students. Moreover, teenagers with IA were found to be at a higher risk of non-suicidal self-injury over time. Additionally, age was identified as a significant moderator of the association between IA and suicidal ideation, with a lower likelihood of suicidal ideation in middle school students compared to college students. Conclusion: This meta-analysis provides evidence of a positive association between IA and suicidal and self-injury behaviors among Chinese adolescents. It emphasizes the need for public health interventions that target IA and related mental health issues in this population.