Internet gaming disorder predicts the incidence, persistence, and worsening of suicidal ideation: A population-based cohort study of 96,158 Chinese adolescents

Mar 13, 2025Journal of affective disorders

Internet gaming disorder linked to new, ongoing, and worsening suicidal thoughts in 96,158 Chinese teenagers

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Abstract

21.4% of adolescents reported suicidal ideation at baseline.

The one-year incidence of suicidal ideation was 13.8%, while the persistence rate was 50.1%.
Among adolescents with mild or moderate suicidal ideation, 1656 experienced worsening over the year.
Gamers with internet gaming disorder (IGD) had a higher risk of developing new suicidal ideation compared to non-gamers.
The adjusted odds ratio for incident suicidal ideation in gamers with IGD was 1.95.
Persistent suicidal ideation was associated with IGD, with an adjusted odds ratio of 1.56.
Worsening suicidal ideation was also linked to IGD, with an adjusted odds ratio of 1.75.

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INTRODUCTION: While cross-sectional studies suggest a strong association between internet gaming disorder (IGD) and suicidal ideation, longitudinal evidence is limited. This two-wave longitudinal study investigated whether IGD predicts the one-year incidence, persistence, and worsening of suicidal ideation.

METHODS: A total of 96,158 Chinese adolescents were assessed in November 2022 and one year later. IGD was measured using the 9-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF), categorizing participants as non-gamers, gamers without IGD, and gamers with IGD. Suicidal ideation and their severity were evaluated using the ninth item of the 9-item Patient Health Questionnaire. Baseline demographics, lifestyle factors, and internalizing and externalizing problems were collected and controlled. Multiple logistic regression models examined associations between IGD and incident, persistent, and worsening suicidal ideation, with subgroup and sensitivity analyses performed.

RESULTS: The prevalence of baseline suicidal ideation was 21.4 %, including 17.5 % mild, 2.5 % moderate, and 1.3 % severe. The one-year incidence and persistence rates of suicidal ideation were 13.8 % and 50.1 %, respectively. Among 19,254 adolescents with mild or moderate suicidal ideation, 1656 reported worsening over the year. Compared to non-gamers, gamers with IGD had a higher risk of incident (adjusted odds ratio [AOR], 1.95; 95 % CI, 1.57-2.42), persistent (AOR, 1.56; 95 % CI, 1.34-1.82), and worsening suicidal ideation (AOR, 1.75; 95 % CI, 1.37-2.23) (all p < 0.001).

CONCLUSIONS: IGD contributes to the development, persistence, and worsening of suicidal ideation among Chinese adolescents. Targeted interventions addressing IGD may reduce suicidal ideation in this population.

LIMITATIONS: Self-reported data potentially introduced bias.

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Internet gaming disorder predicts the incidence, persistence, and worsening of suicidal ideation: A population-based cohort study of 96,158 Chinese adolescents

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