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Health Response to Problematic Usage of the Internet: A Global Survey on Trends, Available Treatments and Key Challenges

Khojasteh Zonoozi, A.; Schofield, J.; Abolghasemi, F. S.; Achab, S.; Bowden-Jones, H.; Demetrovics, Z.; Ebrahimi, M.; Fineberg, N.; Khazaal, Y.; Lee, H. K.; Siste, K.; Stein, D. J.; Wu, A. M. S.; Zare-Bidoky, M.; ISAM-GEN Societies Experts, ; Potenza, M. N.; Baldacchino, A. M.; Ekhtiari, H.

2025-05-21 addiction medicine
10.1101/2025.05.20.25327972 medRxiv
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Background and AimsProblematic usage of the internet (PUI) is a growing concern as technology evolves, with over 5.3 billion individuals, including children, using the internet globally. While specific forms of PUI, such as those involving online gaming and gambling, have been recognized as disorders in major diagnostic manuals, there remains a lack of global data regarding prevalence, treatment and health responses to PUI. This study aimed to examine the magnitude, treatment and health responses to PUI at an international level and identify gaps in knowledge. MethodsWe conducted a global survey within the International Society of Addiction Medicines Global Expert Network (ISAM-GEN), involving addiction societies from 38 countries across Europe (13), Asia/Oceania (12), the Americas (8) and Africa (5). Response to PUI was assessed across various domains, including non-specific PUI and problematic online gaming, problematic online gambling, problematic online pornography, problematic social media use and problematic online buying/shopping. The survey structure included sections on six case scenarios representing different PUI subtypes, each followed by targeted questions, along with an evaluation of the significance of PUI, country-level health responses to PUI and the perceived severity of specific PUI subtypes. ResultsProblematic online gambling (94.8%) and online gaming (86.9%) emerged as the most frequently reported forms of specific PUI, categorized as either frequent or occasional. These were followed by problematic use of social media (84.2%), online pornography (68.3%) and online buying/shopping (52.6%). Psychotherapeutic approaches, such as cognitive behavioral therapy, were identified as the most widely available treatments for PUI, accessible in over 70% of countries surveyed. Despite increasing global attention to PUI, reflected in the establishment of PUI-focused interest groups in 44.7% of the surveyed societies, significant gaps remain. These gaps include the absence of professional certifications, reported by 78.9% of societies, insufficient educational plans for practitioners (68.4%) and a perceived lack of expert training programs (63.2%). Such deficiencies are concerning given that 65.8% of societies emphasized the projected 10-year severity of PUI as either extremely or very important. ConclusionWhile not as rigorous as representative community surveys, this survey and its findings highlight the global importance of PUI and suggests critical gaps in healthcare responses. The disparity between awareness of PUIs significance and the limited resources to address it warrant urgent interventions internationally. Future efforts should focus on enhancing training programs and investing in sustainable solutions to monitor and mitigate the growing burden of PUI worldwide.

Published in Journal of Behavioral Addictions · not in our set (fewer than 10 published preprints to learn from) · training set

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