Evidence mapPaperPMID 39695507Full record

ArticleBMC psychiatry2024

Associations between internet addiction and suicidal ideation in depressed adolescents: the mediating effect of insomnia as well as sex differences.

Lewei Liu, Yinghan Tian, Haojie Fan, Jiawei Wang, Changhao Chen, Zhiwei Liu, Feng Geng, Daming Mo, Xiangfen Luo, Xiangwang Wen and 4 more

Abstract read
In one paragraph

Article in BMC psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Suicidal risk among adolescent psychiatric inpatients: the role of insomnia, depression, and social-personal factors.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Lewei LiuDepartment of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China.
Yinghan TianDepartment of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China.
Haojie FanDepartment of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China.
Jiawei WangDepartment of Psychiatry, Bozhou People's Hospital, Bozhou, 236800, Anhui, China.
Changhao ChenDepartment of Psychiatry, Suzhou Second People's Hospital, Suzhou, 234099, Anhui, China.
Zhiwei LiuDepartment of Psychiatry, Fuyang Third People's Hospital, Fuyang, 236044, Anhui, China.
Feng GengDepartment of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230000, Anhui Province, China.
Daming MoDepartment of Psychiatry, Hefei Fourth People's Hospital, Hefei, 230000, Anhui Province, China.
Xiangfen LuoDepartment of Psychiatry, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, 233040, Anhui, China.
Xiangwang WenDepartment of Psychiatry, Ma'anshan Fourth People's Hospital, Ma'anshan, 243031, Anhui, China.
Xin ZhaoDepartment of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China.
Mingru HaoDepartment of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China.
Lei XiaDepartment of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China. xialei@ahmu.edu.cn.
Huanzhong LiuDepartment of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China. huanzhongliu@ahmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsomnia may mediate the association between internet addiction (IA) and suicidal ideation (SI). However, such association has not been thoroughly investigated in adolescents with major depressive disorder (MDD). Thus, our study aimed to explore whether insomnia significantly affects the association between IA and SI in adolescents with MDD, as well as any sex differences.

methodsFrom January 2021 to September 2023, this cross-sectional study included 502 adolescents with MDD and 123 healthy controls (HCs). The Clinical Global Impression-Severity (CGI-S), the Internet Addiction Test (IAT), the Insomnia Severity Index Scale (ISI) and the Positive and Negative Suicidal Ideation Scale (PANSI) were used to assess subjects' severity of depression, IA, insomnia and SI. And we employed the PROCESS macro program to examine the mediating role of insomnia between IA and SI.

resultsCompared to HCs, adolescents with MDD had significantly higher levels of SI and their prevalence of IA and insomnia were 50.0% and 35.7%. In patients, PANSI scores correlated negatively with age and age of onset, and positively with disease duration as well as the scores of the CGI-S, IAT, and ISI (all p < 0.01). Moreover, above-mentioned correlations were more significant in girls. Mediation analyses showed that insomnia mediated the effect of IA on SI, and the total, direct, and indirect effects were 0.197 (95% CI: 0.132-0.262), 0.157 (95% CI: 0.096-0.218) and 0.040 (95% CI: 0.014-0.068), respectively. In female patients, the total, direct, and indirect effects were 0.224 (95% CI: 0.151-0.296), 0.191 (95% CI: 0.124-0.257) and 0.033 (95% CI: 0.002-0.068), respectively. In male patients, insomnia acted as a fully mediated effect between IA and SI, with an effect value of 0.045 (95% CI: 0.008-0.093).

conclusionDepressed adolescents have higher suicide risk, and SI is significantly associated with IA and insomnia, especially in girls. Moreover, insomnia may mediate the association between IA and SI. However, given the small sample size of this study and the limitations of assessment tools used, the results need to be viewed with caution. Regardless, clinical interventions should be strengthened for IA and insomnia in adolescents with MDD to reduce suicide risk.

Indexed as

Internet Addiction DisorderMajor Depressive DisorderSleep Initiation and Maintenance DisordersSuicidal IdeationAdolescentCase-Control StudiesCross-Sectional StudiesFemaleHumansMaleSeverity of Illness IndexSex FactorsAdolescentsInsomniaInternet addictionMajor depressive disorderSuicidal ideation

Identifiers

PMID39695507
PMCPMC11656905

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.