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Association of Symptoms of Attention Deficit and Hyperactivity with Problematic Internet Use among University Students in Wuhan, China During the COVID-19 Pandemic

Research output: Contribution to journalArticlepeer-review

Yimiao Zhao, Zhendong Jiang, Suihuai Guo, Ping Wu, Qingdong Lu, Yingying Xu, Lin Liu, Sizhen Su, Le Shi, Jianyu Que, Yan Sun, Yankun Sun, Jiahui Deng, Shiqiu Meng, Wei Yan, Kai Yuan, Siwei Sun, Li Yang, Maosheng Ran, Thomas R. Kosten & 6 more John Strang, Yu Lu, Guofu Huang, Lin Lu, Yanping Bao, Jie Shi

Original languageEnglish
Pages (from-to)220-227
Number of pages8
JournalJournal of Affective Disorders
Published1 May 2021

Bibliographical note

Funding Information: This study is supported by grants from the National Key Research and Development Program of China (no. 2019YFA0706200), the National Natural Science Foundation of China (no. 81761128036, 81821092 and 31900805), Special Research Fund of PKUHSC for Prevention and Control of COVID-19 and the Fundamental Research Funds for the Central Universities (no. BMU2020HKYZX008). Funding Information: John Strang is an NIHR Senior Investigator and is supported by the U.K. National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London, U.K. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Background: COVID-19 is still spreading worldwide and posing a threat to individuals’ physical and mental health including problematic internet use (PIU). A potentially high-risk group for PIU are those with symptoms of attention deficit and hyperactivity (ADHD symptoms), because of restrictions in their physical activity levels and engagement in computer diversions requiring only short attention spans. Methods: We used convenience sampling in a cross-sectional survey of university students from 30 universities in Wuhan, Hubei Province, China. We assessed PIU using the Internet Addiction Test and ADHD symptoms using the WHO Adult ADHD Self-Report Screening Scale. Using logistic regression and linear regression analyses we adjusted for demographic, epidemic-related and psychological covariates in models of the association between ADHD symptoms and PIU. Results: Among 11,254 participants, we found a 28.4% (95% CI, 27.5%-29.2%) prevalence of PIU, relatively higher than before the pandemic. In our final logistic regression model, participants with ADHD symptoms had approximately two times the risk for PIU (OR: 2.31, 95% CI: 1.89-2.83). Similarly, individuals with depression, anxiety, insomnia, PTSD symptoms and feeling stress during the pandemic had a higher risk of PIU, while those exercising regularly during the pandemic had a lower risk. Limitations: The cross-sectional design and reliance on internet based self-reports for ADHD symptoms and PIU assessments, without direct structured interviews for validation, are limitations. Conclusions: The prevalence of PIU was high during COVID-19, and those people with ADHD symptoms and other mental illness symptoms appear to be at higher risk of PIU. Regular exercise may reduce that PIU risk and hence should be recommended during the COVID-19 pandemic.

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