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Background: The internet has become an indispensable part of daily life, particularly for medical students, providing access to academic resources and medical literature. However, its excessive use has led to the emergence of Internet Addiction (IA), a behavioral disorder with potential adverse effects on physical, psychological, and academic performance. Objectives: To assess the prevalence and spectrum of Internet Addiction among undergraduate medical students and to identify socio-demographic and usage-related determinants influencing addiction levels. Methods: A cross-sectional study was conducted over six months (April–September 2023) at Government Medical College, Anantnag, involving 400 MBBS students. Data were collected using a semi-structured proforma and Young's Internet Addiction Test (IAT). Socio-demographic characteristics and internet usage patterns were recorded. Ethical clearance was obtained from the Institutional Ethics Committee. Results: The mean age of participants was 21±4 years with nearly equal gender distribution. Most participants were hostel residents (88.8%) and from nuclear families (76.3%). The prevalence of Internet Addiction was 87%, with 61% exhibiting moderate addiction, 25% mild, and 1% severe addiction. Significant associations were observed between internet addiction and variables such as age >20 years (OR=2.6, p=0.001), MBBS year (highest in 4th year students, p=0.001), and reported negative impact on academic performance (OR=3.0, p=0.001). No significant association was found with gender, residence, or years of internet use. Conclusions: A high prevalence of Internet Addiction was observed among medical students, predominantly at a moderate level. Age, academic year, and perceived academic impact were significant predictors of IA. These findings underscore the need for awareness and interventions to promote responsible internet usage among medical students to safeguard their academic and mental well-being.
Ever since its inception in late 20th century, the internet hasdramaticallychanged the world. It has enabled flow of information, including entertainment, news, financial, and academic material. Now, in 21st century, internet has become an integral part of human society as the ways of the tools of businesses, communication and popular culture around the world, access to information, access to new events, learning and education especially among youths. It has invaded the daily activities of lifestyle and played a vital role and change the living standard. The use of Internet has escalated to such proportions that other important works are often neglected, and people have become dependent on Internet in everyday life. The Internet and mobile association of India reports that in the year 2017 approximate number of active Internet users in India were 456 million which was further estimated to increase to 478 million by 2018. The use of the internet to achieve a definite goal, for an appropriate amount of time, without psychological or physical discomfort, is termed as healthy internet usage. The capability of various individuals to limit their use of the internet to appropriate times varies. A negative impact on health is observed in several individuals who cannot limit their usage of internet. This excessive internet usage has led to the emergence of the term "Internet Addiction" (IA) or pathological internet usage. The term of internet addiction was first coined by Dr. Ivan Goldberg in 1995 to describe “pathological and compulsive use of internet”. It is a multi-dimensional disorder that is explained as limitless utilization of certain online applications. Internet Addiction leads to different physical, psychological and social disorders and causes a number of functional and structural changes in brain with related various comorbidities. Students are worst affected by the excessive use of internet. The overall prevalence of internet addiction is between 0.3% and 38%. Use of internet by medical students is unavoidable as it has revolutionized the medical practice with the increasing use of telemedicine and evidence based medicine. Students use internet for literature searches and for other relevant medical information, as it’s inexpensive and freely accessible. As per literature, usage of internet for 38 hours per week on average may lead to problems such as lack of sleep and excessive tiredness. Furthermore, this affects their study performance due to poor concentration in class. The global relevance of internet addiction among medical students is rising and its growing negative impact on physical, psycho social and academic performance is worrisome. The literature on internet usage among Indian medical students is limited and there are a few studies in our setup correlating Internet addiction and academic performance. This study aimed to determine the prevalence of Internet addiction among medical students and its correlation with academic performance from a medical college in Kashmir valley.
The present study was conducted at Government Medical College (GMC), Anantnag, over a period of six months, from April 2023 to September 2023. The study population comprised undergraduate MBBS students enrolled at GMC Anantnag. Data were collected using a semi-structured proforma that included socio-demographic variables along with Young’s 20-item Internet Addiction Questionnaire.
Inclusion Criteria:
Exclusion Criteria:
A cross-sectional study design was employed, involving a total of 400 undergraduate medical students. The primary objective was to assess the pattern of internet usage among the participants. Prior to data collection, the study protocol was reviewed and approved by the Institutional Ethics Committee of GMC Anantnag. To maintain confidentiality and ensure voluntary participation, informed consent was obtained from all students. Participants were assured that their personal information would be kept confidential. To preserve anonymity, the questionnaire did not include any questions requiring the disclosure of the student's name. The study was approved by the Institutional Ethics Committee of Government Medical College, Anantnag.
Table1: Socio-demographic characteristics of the particpants
|
Variable
|
Frequency (N=400) |
Percentage (100%) |
|
|
Age Mean (SD) |
<20 ≥20 |
103 296 |
25.8% 74.2% |
|
Gender |
M F
|
201 199 |
50.3% 49.8% |
|
Residence |
Hostler Dayscholar
|
355 45
|
88.8 11.3 |
|
Type of family
|
Nuclear Joint |
305 95 |
76.3 23.8 |
|
MBBS YR |
Istyr 2ndyr 3rdyr 4thyr |
82 39 108 171 |
20.5 9.8 27.0 42.8 |
Table1 shows the socio demographic details of the study participants. A total of 400 MBBS students were included in the study. The mean age of the participants was 21±4yrs.There was almost equal participation of males and females in our study, majority of the participants (89%) were hostlers and 76% belonged to nuclear families. Approximately 43% of the respondents were from 4th year MBBS followed by 27% from 3rd year MBBS. The 2nd and Ist year MBBS students constituted 30% of the respondents.
Table2: Distribution of the participants on the basis of internet usage
|
Variable |
Frequency(N=400) |
Percentage (100%) |
|
|
Use of internet for |
Academic non academic |
377 23 |
94.3 5.8 |
|
Effect of internet on academic performance |
Yes No |
251 149
|
62.8 37.2 |
|
Availability of internet
|
Yes No |
398 2 |
94.3 5.8 |
|
Yrs of internet use
|
<5 ≥5 |
341 59 |
85.3 14.8 |
|
Hrs spent on internet per day |
≤2 3-4 ≥5 |
70 232 98
|
17.5 58.0 24.5 |
In our study, the majority (94.3%) of respondents stated to use internet for academic purposes.63% had effect of internet on their academic performance,94% had the availability of internet and 15% had used internet for more than 5 years. Most of the participants (83%) used internet for more than 2 hours per day (Table2)
Table3: Association of internet addiction with various socio demographic and internet usage profiles
|
Variable |
No Addiction N (%) |
Addiction N (%) |
OR (95%, CI) P-Value |
|
Age group ≤20 >20 |
26.2% 11.4% |
75.8% 88.6% |
2.6(1.446-4.698)0.001 |
|
Gender Male Female |
16.9% 13.6% |
83.1% 86.4% |
1.03(0.58-1.82)0.9 |
|
Residence Hostlier Day scholar |
14.6% 20.0% |
85.4% 80.0% |
0.84(0.35-2.09) 0.71
|
|
Type of family Nuclear Joint |
16.4% 11.6% |
83.6% 88.4% |
2.34(1.02-5.3) 0.41
|
|
MBBS YEAR 1styr 2ndyr 3rdyr 4thyr |
40.0% 18.2% 18.2% 23.6% |
17.4% 8.4% 8.4% 45.8% |
0.001
|
|
Effect on academic Performance Yes No |
17.9% 6.7% |
82.1% 93.3% |
3.0(1.48-6.22) 0.001
|
|
Yrs of internet use <5 ≥5 |
14.4% 10.2% |
85.6% 89.8% |
1.48(0.60-3.63) 0.53 |
|
Hrs spent on internet <5 5 or more |
52.7% 40.9% |
47.3% 59.1% |
1.61(0.91-2.85) 0.09
|
Table 3 shows the association of internet addiction with various socio demographic and internet usage profiles. The variables that were significantly associated with internet addiction include Age, Year of MBBS and Effect of internet use on academic purpose. The participants above 20years were more likely to have internet addiction than those who were 20 years or less (OR=2.6; CI=1.446-4.698, P=0.001). 4th year MBBS students were found likely to have IA than Istyr MBBS students (p value =0.001). The participants who were addicted to internet were more likely to have effect on their academic performanceOR=3.0; CI=1.48-6.22P= 0.001.
Internet addiction disorder (IAD) can otherwise be referred to as problematic internet use or pathological internet use. Young people are at particular risk of developing internet addiction. Case studies have shown that students whose academic performance was not better used to spend more time online. These students experience health consequences from loss of sleep as they stay online for checking social network status updates etc.
In our study, a total of 400 MBBS students were included. The prevalence of IA in the present study was found to be 87%. These findings are quite similar to the findings of a study conducted by Ade D et al. In our study, 61% had moderate IA followed by mild IA which was present in 25%. Only 1% of the students had severe degree of IA. A study conducted by Dawadi P et al also reported moderate to severe level of addiction in more than half of the respondents. However, in studies conducted by Ade D et al and Jain S et al, mild addiction was more prevalent than moderate addiction. In another study conducted by Doaa M et al reported that the moderate level of internet addiction 49.5% followed by severe addiction 1.9% were present among the students. A study conducted in Kashmir by Bhat and Kawa revealed the proportion of respondents suffering from mild, moderate and severe degrees of IA to be 41.53%,28.74% and 30% respectively. Goel et al. in his study reported 74.5% population as moderate users, 24.8%as possible addicts and 0.75% as addicts.
There was no significant difference in the prevalence of IA among females and males which is contrary to the study done by Xu et al1. Where boys were more susceptible to IA as compared to girls. However, studies have found that addiction was more prevalent in males than females. In our study, majority of the students had the mean duration of internet use for 5 and more than 5 years. These findings are consistent with the study conducted by Saheli et al. in medical students from Mashed, Iran. In our study, statistical significance was found between the students’ internet usage and effect on their academic performance (p=0.001). These findings are consistent with a study conducted by Akhter N et al (2013) among undergraduate students at Hamdard institute of Medical Sciences and Research New Delhi. Another study conducted by Zainudin A, (2013) among Malaysian University students found statistically significant differences in academic performance.
Limitations:
This study involved only students of Medical college of Anantnag Kashmir and had taken a small sample size. Moreover, the study was cross-sectional, it was not possible to conclude a cause effect relationship between the causative factors and IA among students
Our study concludes that there is a high prevalence of Internet addiction among medical students. Young adults tend to be unaware of how much time they really spend on social networking sites and our study revealed that it has a significant effect on their academic performances. Therefore, we recommend to aware the students about the internet addiction and its consequences on their health and their academic performance
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