Internetabhängigkeit, Suizidalität und selbstverletzendes Verhalten – Ein systematisches Review

Zusammenfassung

Hintergrund Internetabhängigkeit (IA) geht mit einem hohen Maß an komorbiden psychischen Störungen, insbesondere Depressionen, Angststörungen, ADHS und Persönlichkeitsstörungen und einem erheblichen Leidensdruck einher. Im Hinblick auf das hieraus resultierende Gefahrenpotenzial untersucht die vorliegende Arbeit die aktuelle Forschungsliteratur bezüglich Suizidalität und nicht suizidalem selbstverletzendem Verhalten (NSSV) bei IA.

Methoden In einer systematischen Literaturrecherche wurden klinische und nicht-klinische Studien in 14 Datenbanken auf der Titel- Abstract-Ebene nach den häufigsten Schlagworten für IA, NSSV und Suizidalität durchsucht. Die nach Abzug der mehrfach vorhandenen Publikationen verbliebenen 2334 Artikel wurden nach definierten Ein- und Ausschlusskriterien gefiltert. Insgesamt konnten 15 Studien, die IA, NSSV und Suizidalität mittels validierter psychometrischer Instrumente erheben, in das Review eingeschlossen werden.

Ergebnisse Der Zusammenhang zwischen IA und Suizidalität wurde in 10 Studien untersucht, 4 Studien untersuchten den Zusammenhang von IA, Suizidalität und NSSV, eine Studie ausschließlich den Zusammenhang von IA und NSSV. Sämtliche Studien zeigten höhere Prävalenzen für NSSV beziehungsweise Suizidalität der Probanden mit einer IA im Vergleich zu Probanden ohne IA, wobei die Punkt-Prävalenzraten für Suizidalität mit 1,6–18,7% erheblich variierten.

Diskussion Die Ergebnisse der eingeschlossenen Publikationen legen nahe, dass Internetabhängigkeit mit einer erhöhten Rate an nicht-suizidalem selbstverletzendem Verhalten und mit einer erhöhten Suizidalität einhergeht, wobei sich für Suizidgedanken ein deutlicherer Zusammenhang abbildet als für tatsächliche suizidale Handlungen. Um ein besseres Verständnis insbesondere kausaler Zusammenhänge zwischen IA, NSSV und Suizidalität zu entwickeln, bedarf es weiterer, möglichst longitudinaler Studien.

Fazit für die Praxis  Vor dem Hintergrund der aktuellen Studienlage ist es ratsam, bei Internetabhängigen routinemäßig auch eine differenzierte Anamnese bezüglich NSSV sowie suizidalen Gedanken und Impulsen durchzuführen.

Abstract

Background Internet addiction (IA) is associated with a high rate of co-morbid mental disorders, especially depression, anxiety disorders, ADHD and personality disorders and a considerable level of psychological strain. In terms of risk assessment, the present work investigates the current research literature on suicidal behavior and non-suicidal self-injurious behavior (NSSI).

Methods We performed a systematic literature search in 14 databases on title and abstract level for the most common keywords for IA, NSSI and suicidality. After deduction of multiple items, 2334 articles remained. They were filtered per inclusion and exclusion criteria. We identified studies that examined the relationship between IA, NSSI and suicidality, which were assessed by validated psychometric instruments. This allowed a total of 15 studies to be included.

Results The relationship between IA and suicidality was examined in 10 studies, four studies examined the relationship of IA, suicidality, and NSSI, and one study exclusively focused on IA and NSSHB. All studies showed higher prevalence for NSSI and respectively suicidality of the subjects with an IA compared to subjects without IA, with point prevalence varying considerably between 1.6–18.7%.

Discussion The results of the included publications suggest that Internet dependency is associated with an increased rate of non-suicidal self-harming behavior and increased suicidality, with suicidal ideation being more closely related to IA than suicidal actions. In order to develop a better understanding of causal relationships between IA, NSSI and suicidality, further longitudinal studies are required.

Conclusion Against the background of the presented studies NSSHB and suicidality need to be explicitly addressed within the assessment and treatment of IA patients.

Schlüsselwörter

Internetabhängigkeit - Suizidalität - Selbstverletzendes Verhalten - Prävalenz - Komorbidität

Key words

Internet addiction - suicidality - self injury - prevalence - comorbidity

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