Journal of Autism and Developmental Disorders

, Volume 47, Issue 7, pp 2217–2224 | Cite as

The Prevalence of Internet Addiction Among a Japanese Adolescent Psychiatric Clinic Sample With Autism Spectrum Disorder and/or Attention-Deficit Hyperactivity Disorder: A Cross-Sectional Study

  • Ryuhei SoEmail author
  • Kazunori Makino
  • Masaki Fujiwara
  • Tomoya Hirota
  • Kozo Ohcho
  • Shin Ikeda
  • Shouko Tsubouchi
  • Masatoshi Inagaki
Original Paper


Extant literature suggests that autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are risk factors for internet addiction (IA). The present cross-sectional study explored the prevalence of IA among 132 adolescents with ASD and/or ADHD in a Japanese psychiatric clinic using Young’s Internet Addiction Test. The prevalence of IA among adolescents with ASD alone, with ADHD alone and with comorbid ASD and ADHD were 10.8, 12.5, and 20.0%, respectively. Our results emphasize the clinical importance of screening and intervention for IA when mental health professionals see adolescents with ASD and/or ADHD in psychiatric services.


Autism spectrum disorder Attention-deficit hyperactivity disorder Internet addiction Behavioral addiction 



The authors would like to thank E. Miki, R. Ohta, and K. Kitagawa for coordination and data management with the present study. We also thank J. Arakane, and the outpatient clinic staff in Okayama Psychiatric Medical Center, for assistance in data collection with the study.

Author’s Contributions

RS conceived of the study, participated in its design and coordination, performed the statistical analysis, interpretation of the data and drafted the manuscript; KM conceived of the study, participated in the design, coordination and data collection, interpretation of the data and helped to draft the manuscript; MF participated in the design, interpretation of the data and helped to draft the manuscript; TH participated in interpretation of the data and helped to draft the manuscript; KO, SK and ST participated in data collection and interpretation of the data and helped to draft the manuscript; MI participated in the design and coordination, interpretation of the data and coordination and drafted the manuscript; All authors read and approved the final manuscript.


This study received no specific grant from any funding agency.

Compliance with Ethical Standards

Conflict of interest

All authors have no conflict of interest to declare. TH has received honorarium for speaking at symposia from Otsuka Pharmaceutical Co., Ltd.. MI has received lecture fees from Pfizer Japan Inc.; Mochida Pharmaceutical Co., Ltd.; Shionogi & Co., Ltd.; Sumitomo Dainippon Pharma Co., Ltd.; Daiichi Sankyo Co., Ltd.; Meiji Seika Pharma Co., Ltd.; and Takeda Pharmaceutical Co., Ltd., outside the submitted work. He has received royalties from Nippon Hyoron Sha Co., Ltd.; Nanzando Co., Ltd.; Seiwa Shoten Co., Ltd.; Igaku-shoin Ltd.; and Technomics, Inc., outside the submitted work. He has received grant or research support from the Japanese Ministry of Health, Labour and Welfare and the Japanese Ministry of Education, Science, and Technology. The institution to which MF and MI belong has received grant or research support from Eisai Co., Ltd.; Mochida Pharmaceutical Co., Ltd.; Astellas Pharma Inc.; Otsuka Pharmaceutical Co., Ltd.; GlaxoSmithKline K. K.; Shionogi & Co.; Sumitomo Dainippon Pharma Co., Ltd.; Jansen Pharmaceutical K. K.; Pfizer Japan Inc.; MSD K. K.; Yoshitomiyakuhin Corporation; Daiichi Sankyo Co. Ltd.; Meiji Seika Pharma Co., Ltd.; Tsumura & Co.; AbbVie; Ono Pharmaceutical Co., Ltd.; and Eli Lilly Japan K. K.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


  1. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR fourth edition (text revision). Washington DC: American Psychiatric Association.CrossRefGoogle Scholar
  2. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5 ® ). Washington DC: American Psychiatric Pub.CrossRefGoogle Scholar
  3. Bernardi, S., & Pallanti, S. (2009). Internet addiction: A descriptive clinical study focusing on comorbidities and dissociative symptoms. Comprehensive Psychiatry, 50(6), 510–516. doi: 10.1016/j.comppsych.2008.11.011.CrossRefPubMedGoogle Scholar
  4. Carli, V., Durkee, T., Wasserman, D., Hadlaczky, G., Despalins, R., Kramarz, E., et al. (2013). The association between pathological internet use and comorbid psychopathology: A systematic review. Psychopathology, 46(1), 1–13. doi: 10.1159/000337971.CrossRefPubMedGoogle Scholar
  5. Eguchi, S., Koike, S., Suga, M., Takizawa, R., & Kasai, K. (2015). Psychological symptom and social functioning subscales of the modified Global Assessment of Functioning scale: Reliability and validity of the Japanese version. Psychiatry and Clinical Neurosciences, 69(2), 126–127.CrossRefPubMedGoogle Scholar
  6. Finkenauer, C., Pollmann, M. M., Begeer, S., & Kerkhof, P. (2012). Brief report: Examining the link between autistic traits and compulsive Internet use in a non-clinical sample. Journal of Autism and Developmental Disorders, 42(10), 2252–2256. doi: 10.1007/s10803-012-1465-4.CrossRefPubMedGoogle Scholar
  7. Ha, J. H., Yoo, H. J., Cho, I. H., Chin, B., Shin, D., & Kim, J. H. (2006). Psychiatric comorbidity assessed in Korean children and adolescents who screen positive for Internet addiction. The Journal of Clinical Psychiatry, 67(5), 821–826.CrossRefPubMedGoogle Scholar
  8. Institute for Information and Communications Policy (2013). Heisei 25 survey on Internet usage environment among youth (in Japanese). Accessed 16 December 2016.
  9. Jensen, C. M., & Steinhausen, H. C. (2015). Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. ADHD Attention Deficit and Hyperactivity Disorders, 7(1), 27–38, doi: 10.1007/s12402-014-0142-1.CrossRefPubMedGoogle Scholar
  10. Joelsson, P., Chudal, R., Gyllenberg, D., Kesti, A. K., Hinkka-Yli-Salomaki, S., Virtanen, J. P., et al. (2016). Demographic characteristics and psychiatric comorbidity of children and adolescents diagnosed with ADHD in specialized healthcare. Child Psychiatry and Human Development, 47(4), 574–582. doi: 10.1007/s10578-015-0591-6.CrossRefPubMedGoogle Scholar
  11. Johansson, A., & Götestam, K. G. (2004). Internet addiction: Characteristics of a questionnaire and prevalence in Norwegian youth (12–18 years). Scandinavian Journal of Psychology, 45(3), 223–229.CrossRefPubMedGoogle Scholar
  12. Kaess, M., Durkee, T., Brunner, R., Carli, V., Parzer, P., Wasserman, C., et al. (2014). Pathological internet use among European adolescents: Psychopathology and self-destructive behaviours. European Child & Adolescent Psychiatry, 23(11), 1093–1102.CrossRefGoogle Scholar
  13. Kawabe, K., Horiuchi, F., Ochi, M., Oka, Y., & Ueno, S. (2016). Internet addiction: Prevalence and relation with mental states in adolescents. Psychiatry and Clinical Neurosciences, 70(9), 405–412. doi: 10.1111/pcn.12402.CrossRefPubMedGoogle Scholar
  14. Kim, B. S., Chang, S. M., Park, J. E., Seong, S. J., Won, S. H., & Cho, M. J. (2016). Prevalence, correlates, psychiatric comorbidities, and suicidality in a community population with problematic Internet use. Psychiatry Research, 244, 249–256. doi: 10.1016/j.psychres.2016.07.009.CrossRefPubMedGoogle Scholar
  15. Lam, L. T. (2014). Risk factors of internet addiction and the health effect of internet addiction on adolescents: A systematic review of longitudinal and prospective studies. Current Psychiatry Reports, 16(11), 508. doi: 10.1007/s11920-014-0508-2.CrossRefPubMedGoogle Scholar
  16. Lam, L. T., & Peng, Z. W. (2010). Effect of pathological use of the internet on adolescent mental health: A prospective study. Archives of Pediatrics and Adolescent Medicine, 164(10), 901–906. doi: 10.1001/archpediatrics.2010.159.CrossRefPubMedGoogle Scholar
  17. MacMullin, J. A., Lunsky, Y., & Weiss, J. A. (2016). Plugged in: Electronics use in youth and young adults with autism spectrum disorder. Autism: The International Journal of Research and Practice, 20(1), 45–54. doi: 10.1177/1362361314566047.CrossRefGoogle Scholar
  18. Mak, K. K., Lai, C. M., Watanabe, H., Kim, D. I., Bahar, N., Ramos, M., et al. (2014). Epidemiology of internet behaviors and addiction among adolescents in six Asian countries. Cyberpsychology, Behavior, and Social Networking, 17(11), 720–728, doi: 10.1089/cyber.2014.0139.CrossRefGoogle Scholar
  19. Mazurek, M. O., Shattuck, P. T., Wagner, M., & Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(8), 1757–1767. doi: 10.1007/s10803-011-1413-8.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Mazurek, M. O., & Wenstrup, C. (2013). Television, video game and social media use among children with ASD and typically developing siblings. Journal of Autism and Developmental Disorders, 43(6), 1258–1271. doi: 10.1007/s10803-012-1659-9.CrossRefPubMedGoogle Scholar
  21. Ngai, S. S. (2007). Exploring the validity of the internet addiction test for students in grades 5–9 in Hong Kong. International Journal of Adolescence and Youth, 13(3), 221–237. doi: 10.1080/02673843.2007.9747976.CrossRefGoogle Scholar
  22. Osada, H. (2013). Internet addiction in Japanese college students: Is Japanese version of internet addiction test (JIAT) useful as a screening tool. Bulletin of Senshu University School of Human Sciences, 3(1), 71–80.Google Scholar
  23. Park, M.-H., Park, E.-J., Choi, J., Chai, S., Lee, J.-H., Lee, C., et al. (2011). Preliminary study of internet addiction and cognitive function in adolescents based on IQ tests. Psychiatry Research, 190(2), 275–281.CrossRefPubMedGoogle Scholar
  24. R Development Core Team (2014). R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing. 2013. ISBN 3-900051-07-0.Google Scholar
  25. Romano, M., Osborne, L. A., Truzoli, R., & Reed, P. (2013). Differential psychological impact of internet exposure on internet addicts. PLoS ONE, 8(2), e55162. doi: 10.1371/journal.pone.0055162.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Shane-Simpson, C., Brooks, P. J., Obeid, R., Denton, E.-g., & Gillespie-Lynch, K. (2016). Associations between compulsive internet use and the autism spectrum. Research in Autism Spectrum Disorders, 23, 152–165. doi: 10.1016/j.rasd.2015.12.005.CrossRefGoogle Scholar
  27. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929. doi: 10.1097/CHI.0b013e318179964f.CrossRefPubMedGoogle Scholar
  28. van den Eijnden, R. J., Spijkerman, R., Vermulst, A. A., van Rooij, T. J., & Engels, R. C. (2010). Compulsive internet use among adolescents: Bidirectional parent-child relationships. Journal of Abnormal Child Psychology, 38(1), 77–89. doi: 10.1007/s10802-009-9347-8.CrossRefPubMedGoogle Scholar
  29. van Emmerik-van Oortmerssen, K., van de Glind, G., van den Brink, W., Smit, F., Crunelle, C. L., Swets, M., et al. (2012). Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug and Alcohol Dependence, 122(1–2), 11–19. doi: 10.1016/j.drugalcdep.2011.12.007.CrossRefPubMedGoogle Scholar
  30. Winkler, A., Dorsing, B., Rief, W., Shen, Y., & Glombiewski, J. A. (2013). Treatment of internet addiction: A meta-analysis. Clinical Psychology Review, 33(2), 317–329. doi: 10.1016/j.cpr.2012.12.005.CrossRefPubMedGoogle Scholar
  31. Young, K. S. (1998a). Caught in the net: How to recognize the signs of internet addiction–and a winning strategy for recovery. New York: John Wiley & Sons.Google Scholar
  32. Young, K. S. (1998b). Internet addiction: The emergence of a new clinical disorder. CyberPsychology & Behavior, 1(3), 237–244.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of PsychiatryOkayama Psychiatric Medical CenterOkayamaJapan
  2. 2.Department of NeuropsychiatryOkayama University HospitalOkayamaJapan
  3. 3.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA
  4. 4.Okayama Child Counseling CenterOkayamaJapan
  5. 5.Okayama Center for Developmental DisordersOkayamaJapan

Personalised recommendations