The 2-Year Course of Internet Addiction Among a Japanese Adolescent Psychiatric Clinic Sample with Autism Spectrum Disorder and/or Attention-Deficit Hyperactivity Disorder

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


Internet addiction (IA) has been reported as prevalent in adolescents with autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD). However, the course of IA in this population has not been elucidated. The authors performed a 2-year follow-up study including 89 out of 132 adolescents with ASD and/or ADHD in a psychiatric clinical setting who participated in the original cross-sectional study assessing IA prevalence. Within this sample of participants from both the original and the follow-up study, results showed a 2-year IA remission and incidence rate of 60% and 5%, respectively. Our findings imply that the course of IA in psychiatric populations with ASD and/or ADHD might be similar to reports from previous studies with general adolescent populations.


Autism spectrum disorder Attention-deficit hyperactivity disorder Internet addiction Prognosis Health-related quality of life 



The authors would like to thank M. Miki, R. Ohta, and K. Kitagawa for coordinating and managing data during the baseline and follow-up studies. We would also like to thank the outpatient clinic staff in Okayama Psychiatric Medical Center for their assistance in data collection during the baseline and follow-up studies. Finally, we thank J. Miyata, M. Ogura, Y. Sato, and the staff of the child and adolescent psychiatry department in Okayama Psychiatric Medical Center for providing helpful suggestions regarding the follow-up study.

Authors Contributions

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


This study has not received grants from any funding agency.

Compliance with Ethical Standards

Conflict of interest

KM, KO, SI, and ST have no conflict of interest to declare. RS has received professional fees from Igaku-shoin Co. Ltd., Kagaku-hyoronsha Co. Ltd., Medical Review Co. Ltd., and Otsuka Pharmaceutical Co. Ltd., outside the submitted work. TH has received professional fees for speaking at the symposia of Otsuka Pharmaceutical Co., Ltd.. MF has received professional fees from Mochida Pharmaceutical Co. Ltd., Eli Lilly Japan K.K., Sumitomo Dainippon Pharma Co. Ltd., Sentan Igaku-sha Ltd., Igaku-Shoin Ltd., and Iyaku (Medicine and Drug) Journal Co. Ltd. outside the submitted work. MI declares that he has received grants from Novartis. He has received lecture fees from Meiji, Mochida, Takeda, Novartis, Yoshitomi, Pfizer, Eisai, Otsuka, and MSD and personal fees from Technomics. Institution of MI received grant or research support from Eisai, Astellas, Dainippon-Sumitomo, Pfizer, Daiichi-Sankyo, Takeda, and MSD outside the submitted work. The institution to which MF belongs has received grants and 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 Helsinki Declaration of 1964 and its later amendments or comparable ethical standards. Informed consent was obtained from all participants included in the study.

Informed Consent

Informed consent was obtained from all participants included in the study.

Supplementary material

10803_2019_4169_MOESM1_ESM.docx (32 kb)
Supplementary material 1 (DOCX 32 kb)


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 ® ). American Psychiatric Pub.Google Scholar
  2. Chang, F.-C., Chiu, C.-H., Lee, C.-M., Chen, P.-H., & Miao, N.-F. (2014). Predictors of the initiation and persistence of Internet addiction among adolescents in Taiwan. Addictive Behaviors, 39(10), 1434–1440.CrossRefGoogle Scholar
  3. Chen, Y.-L., Chen, S.-H., & Gau, S. S.-F. (2015). ADHD and autistic traits, family function, parenting style, and social adjustment for Internet addiction among children and adolescents in Taiwan: A longitudinal study. Research in Developmental Disabilities, 39, 20–31.CrossRefGoogle Scholar
  4. 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.CrossRefGoogle Scholar
  5. Ko, C.-H., Liu, T.-L., Wang, P.-W., Chen, C.-S., Yen, C.-F., & Yen, J.-Y. (2014). The exacerbation of depression, hostility, and social anxiety in the course of internet addiction among adolescents: A prospective study. Comprehensive Psychiatry, 55(6), 1377–1384.CrossRefGoogle Scholar
  6. Konst, M. J., Matson, J. L., Goldin, R., & Rieske, R. (2014). How does ASD symptomology correlate with ADHD presentations? Research in Developmental Disabilities, 35(9), 2252–2259.CrossRefGoogle Scholar
  7. Kuss, D. J., Griffiths, M. D., Karila, L., & Billieux, J. (2014). Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20(25), 4026–4052.CrossRefGoogle Scholar
  8. Laconi, S., Rodgers, R. F., & Chabrol, H. (2014). The measurement of Internet addiction: A critical review of existing scales and their psychometric properties. Computers in Human Behavior, 41, 190–202.CrossRefGoogle Scholar
  9. Lau, J. T., Wu, A. M., Gross, D. L., Cheng, K., & Lau, M. M. (2017). Is Internet addiction transitory or persistent? Incidence and prospective predictors of remission of Internet addiction among Chinese secondary school students. Addictive Behaviors, 74, 55–62.CrossRefGoogle Scholar
  10. Mariani, J. J., Mariani, J. J., & Levin, F. R. (2007). Treatment strategies for co-occurring ADHD and substance use disorders. American Journal on Addictions, 16(sup1), 45–56.CrossRefGoogle Scholar
  11. Nezu, S., Iwasaka, H., Saeki, K., Obayashi, K., Ishizuka, R., Goma, H., et al. (2016). Reliability and validity of Japanese versions of KIDSCREEN-27 and KIDSCREEN-10 questionnaires. Environmental Health and Preventive Medicine, 21(3), 154.CrossRefGoogle Scholar
  12. Ravens-Sieberer, U., Auquier, P., Erhart, M., Gosch, A., Rajmil, L., Bruil, J., et al. (2007). The KIDSCREEN-27 quality of life measure for children and adolescents: Psychometric results from a cross-cultural survey in 13 European countries. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 16(8), 1347–1356. Scholar
  13. R Core Team. (2014). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.
  14. Romano, M., Truzoli, R., Osborne, L. A., & Reed, P. (2014). The relationship between autism quotient, anxiety, and internet addiction. Research in Autism Spectrum Disorders, 8(11), 1521–1526.CrossRefGoogle Scholar
  15. So, R., Makino, K., Fujiwara, M., Hirota, T., Ohcho, K., Ikeda, S., et al. (2017). 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. Journal of Autism and Developmental Disorders, 47(7), 2217–2224.CrossRefGoogle Scholar
  16. Strittmatter, E., Parzer, P., Brunner, R., Fischer, G., Durkee, T., Carli, V., et al. (2016). A 2-year longitudinal study of prospective predictors of pathological Internet use in adolescents. European Child and Adolescent Psychiatry, 25(7), 725–734.CrossRefGoogle Scholar
  17. Tateno, M., Tateno, Y., Kamikobe, C., Monden, R., Sakaoka, O., Kanazawa, J., et al. (2018). Internet addiction and attention-deficit/hyperactivity disorder traits among female college students in Japan. Journal of the Korean Academy of Child and Adolescent Psychiatry, 29(3), 144–148.CrossRefGoogle Scholar
  18. Tran, B. X., Hinh, N. D., Nguyen, L. H., Le, B. N., Nong, V. M., Thuc, V. T. M., et al. (2017). A study on the influence of internet addiction and online interpersonal influences on health-related quality of life in young Vietnamese. BMC Public Health, 17(1), 138.CrossRefGoogle Scholar
  19. Wang, L., Luo, J., Bai, Y., Kong, J., Luo, J., Gao, W., et al. (2013). Internet addiction of adolescents in China: Prevalence, predictors, and association with well-being. Addiction Research & Theory, 21(1), 62–69.CrossRefGoogle Scholar
  20. Young, K. S. (1998). 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

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychiatryOkayama Psychiatric Medical CenterOkayamaJapan
  2. 2.Department of PsychiatrySaitama Prefectural Psychiatric HospitalSaitamaJapan
  3. 3.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA
  4. 4.Department of NeuropsychiatryOkayama University HospitalOkayamaJapan
  5. 5.Okayama Child Counseling CenterOkayamaJapan
  6. 6.Okayama Center for Developmental DisordersOkayamaJapan
  7. 7.Department of Psychiatry, Shimane University School of MedicineShimaneJapan

Personalised recommendations