KEY POINTS:
Tense? Angry? Can't get online? Internet addiction is now a serious public health issue that should be officially recognised as a clinical disorder, according to a leading psychiatrist.
Excessive gaming, viewing online pornography, emailing and text messaging have been identified as causes of a compulsive-impulsive disorder by Dr Jerald Block, author of an editorial for the respected American Journal of Psychiatry.
Dr Block argues that the disorder is now so common that it merits inclusion in the Diagnostic and Statistical Manual of Mental Disorders, the profession's primary resource to categorise and diagnose mental illnesses. He says internet addiction has four main components:
* Excessive use, often associated with a loss of sense of time or a neglect of basic drives.
* Withdrawal, including feelings of anger, tension and/or depression when the computer is inaccessible.
* The need for better computers, more software, or more hours of use.
* Negative repercussions, including arguments, lying, poor achievement, social isolation and fatigue.
A primary case study is South Korea, which has the greatest usage of broadband in the world. Dr Block points out that, after 10 people died from blood clots - from remaining seated for long periods - in internet cafes and another was murdered because of an online game, South Korea "considers internet addiction one of its most serious public health issues".
The government estimates around 210,000 South Korean children are affected and in need of treatment, of whom 80 per cent might need drugs targeting the brain and nearly a quarter could need to go to hospital.
Dr Block, a psychiatrist at the Oregon Health and Science University in Portland, writes that the extent of the disorder is more difficult to estimate in America because people tend to surf at home instead of in internet cafes.
But he believes there are similar cases, concluding: "Unfortunately internet addiction is resistant to treatment, entails significant risks and has high relapse rates."
He said he did not believe specific websites, such as or YouTube, were responsible.
"The relationship is with the computer," he said. "First, it becomes a significant other to them. Second, they exhaust emotions that they could experience in the real world on the computer, through any number of mechanisms: emailing, gaming, porn.
"Third, computer use occupies a tremendous amount of time in their life. Then if you try to cut the cord in a very abrupt fashion, they've lost essentially their best friend. That can take the form of depression or rage."
Harry Husted, a single 51-year-old from New York, spends 16 hours a day on the internet. He insists that he is not addicted, but admits that he used to be.
"I used to work with computers for eight hours, then get home and go online for seven hours. I would stay up till two or three in the morning until I got so sleepy I had to go to bed. I wouldn't go out to get the groceries and I couldn't have cared less about friends, TV, anything.
"After a while I realised what was happening and did something about it. Now if I use MySpace it's only to advertise my business."
Internet addiction clinics have sprung up around the world in an attempt to wean people off their need for a fix.
Many people have turned, apparently without irony, to web discussion boards with names such as Internet Addicts Anonymous.
The Centre for Internet Addiction Recovery in Bradford, Pennsylvania, says internet addiction has become a growing legal issue in criminal, divorce and employment cases.
It offers a consultation service to lawyers that includes "assessing the role of electronic anonymity in the development of deviant, deceptive and illegal sexual online activities".
Robert Freedman, editor of the American Journal of Psychiatry, said expressions of the addiction could be diverse.
"In Korea, it seems to be primarily gaming sites. In America, it seems to be Facebook. It's porn, it's games, it's gambling, it's chatting with friends. All these things existed before, but now they're a lot easier."
To beat the addiction, he advised: "A self-help group might be a place to start. Maybe replace an online group with a real one."
* SYMPTOMS
Are you a net junkie? If you answer "yes" to five or more of these questions, you might have an internet addiction.
Do you feel preoccupied with the internet? (Think about your online activity or anticipate your next online session.)
Do you need increasing amounts of time on the net in order to achieve satisfaction?
Have you repeatedly made unsuccessful efforts to control, cut back or stop internet use?
Do you feel restless, moody, depressed or irritable when attempting to cut down or stop internet use?
Do you stay online longer than originally intended?
Have you jeopardised or risked the loss of a significant relationship, job, educational or career opportunity because of the internet?
Have you lied to family members, a therapist or others to conceal the extent of your involvement with the internet?
Do you use it to escape from problems (eg, feelings of helplessness, guilt, anxiety, depression)?
Source: Centre for Internet Addiction Recovery (www.netaddiction.com)
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