Floros, Georgios D.

Ioannidis, Konstantinos

Apollo (Cambridge)

EDITORIALpublished: 01 April 2021doi: 10.3389/fpubh.2021.676498Frontiers in Public Health | www.frontiersin.org 1 April 2021 | Volume 9 | Article 676498Edited and reviewed by:Wulf Rössler,Charité – UniversitätsmedizinBerlin, Germany*Correspondence:Georgios D. Florosgeorgefloros@gmail.comSpecialty section:This article was submitted toPublic Mental Health,a section of the journalFrontiers in Public HealthReceived: 05 March 2021Accepted: 11 March 2021Published: 01 April 2021Citation:Floros GD and Ioannidis K (2021)Editorial: The Impact of OnlineAddiction on General Health,Well-Being and Associated SocietalCosts. Front. Public Health 9:676498.doi: 10.3389/fpubh.2021.676498Editorial: The Impact of OnlineAddiction on General Health,Well-Being and Associated SocietalCostsGeorgios D. Floros 1* and Konstantinos Ioannidis 21 2nd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, 2Departmentof Psychiatry, University of Cambridge, Cambridge, United KingdomKeywords: online addiction, gaming addiction, problematic internet use, well-being, health impactEditorial on the Research TopicThe Impact of Online Addiction on General Health, Well-Being and Associated Societal CostsAddictive online behaviors have come under increasing research scrutiny in the past twodecades, culminating in the recent inclusion of gaming disorder as a distinct entity in the 11thRevision of the International Classification of Diseases (ICD-11) (1). Beyond gaming, a numberof distinct problematic behaviors have been linked with poor mental health (2, 3), academicunderachievement and vocational struggles (4), and described in distinct geographical areas andacross cultural settings (5–7). The widespread adoption of online applications for communicationand recreation has caused the wider public health discussion and concern (2). While our over-reliance on technology grows, so does the possibility that exposure to online applications can havepervasive health consequences, particularly in a time when societies have specifically restructuredto fight against the COVID-19 pandemic: by embracing the online milieu for work, relationships,and entertainment (8).Although treatment options are available for some time now (9, 10), what has been lessunderstood has been how online addiction and technology overuse may lead to significantconsequences to society, including but not exhaustively, impact on quality of life, productivity andcollateral costs to the health system. In this special issue, the wider impact to the general healthand well-being of the affected individuals was put under examination with the goal of exploring theeffects of online addictive behaviors, including but not limited to, online gaming and social media,to the burden on the individual’s general health and well-being. Of special interest was how thisburden carries over to the macro level in the workplace, the educational system and also the healthsystem, with general productivity loss, missed opportunities at work and education, and increaseduse of the health services. We were pleased to receive a number of high-quality studies reporting onthis burden and helping the exploration of cost-effectiveness of treatment modalities and highlightthe need for investment in health services tailored to population needs.It is important to note that online addiction is not an artificial construct that originated frompsychological research but rather was a concept that sought to include complaints from patientsand their families in order to better understand their source and provide help; in this respect a veryimportant contribution in this Research Topic is the one made by Gjoneska et al. who present aconceptual framework and a template for citizen involvement in research on online addiction; theauthors highlight four ethical aspects for citizen involvement, driven by community case studiesthat were conducted in six European countries.With regards to the impact of online addiction on general health, Mylona et al. examined in aFloros and Ioannidis Editorial: The Impact of Online Addictionliterature review the effects of gaming disorder in eyesight andeye pathology, including eye strain. Prolonged engagement withscreens and digital media can have direct strenuous impact onthe visual system (11, 12), possibly related to the necessity forprolonged near-term adaptation, but also related to mechanicalconsequences of prolonged attention to the screen e.g., dryeye syndrome. Mylona et al. further comment on sequelae ofpoor posture and prolonged physical immobility which arecommonly reported.In an original investigation of problematic usage of theinternet, Lam investigated the effects of parental depressionon adolescent internet addiction using structural equationmodeling. He focused on the by-gender relationships betweenparental mental health (depression and internet addiction) anddemonstrated mediation of adolescent mental stress on therelationship between parental depression and adolescent internetaddiction; those mediating effects were stronger in the samegender parent-adolescent dyads.In another original prospective investigation, Ueno et al.explored the impact on online addiction in a specific worksetting, that of medical residency. Preference for online socialmedia communication was correlated with lower general healthconcurrently and retrospectively as well as with low self-esteemconcurrently. They posit two explanations for the observedassociation, one problematic usage of the internet having animpact on mental health of medical residents and the otherconsidering online usage as a coping strategy against depressionand low self-esteem. In a similar vein, another original cross-sectional investigation looked that the burn out effects that socialmedia overuse can have on vocational settings: Han et al. founda significant positive correlation between social media addictionand job burnout that is either moderated or mediated by socialcomparison depending on whether the milieu is low or highon social comparison, respectively. While social comparisonalone did not correlate with job burnout, social media userswho often compare themselves to peers who are worse off inlife and feel positive emotions were found to be more proneto job burnout. A study by Yu and Luo found that socialmedia addiction in university students was associated withlonger sleeping latency, more sleep disturbance, poorer academicperformance, lower levels of life satisfaction, and higher levels ofdepression with parental reactive restriction and limiting onlinebehaviors showing little effect.Finally, a systematic review and meta-analysis by Dahl andBergmark highlighted the deficits in the assessment and naturalhistory of online addiction and internet gaming disorder; while1-year persistence was demonstrated in about half of the samplesof quantitative synthesis, the field was shown generally lacking ofadequate data to robustly characterize longitudinal outcomes.In conclusion, the studies included in this Research Topicdrew the wider context of online addiction; while the main focusof research inevitably are the psychological correlates that couldculminate up to a psychiatric condition, it is important to keep inmind that this entity is all-encompassing just as the use of digitaltechnologies has an impact on all of our daytime activities.AUTHOR CONTRIBUTIONSAll authors listed have made a substantial, direct and intellectualcontribution to the work, and approved it for publication.REFERENCES1. Jo YS, Bhang SY, Choi JS, Lee HK, Lee SY, Kweon Y-S. Clinical characteristicsof diagnosis for internet gaming disorder: comparison of DSM-5 IGD andICD-11 GD diagnosis. J Clin Med. (2019) 8:945. doi: 10.3390/jcm80709452. Fineberg NA, Demetrovics Z, Stein DJ, Ioannidis K, Potenza MN, GrünblattE, et al. Manifesto for a European research network into problematicusage of the internet. Eur Neuropsychopharmacol. (2018) 28:1232–46.doi: 10.1016/j.euroneuro.2018.08.0043. Ioannidis K, Treder MS, Chamberlain SR, Kiraly F, Redden SA, Stein DJ,et al. Problematic internet use as an age-related multifaceted problem:evidence from a two-site survey. Addict Behav. (2018) 81:157–66.doi: 10.1016/j.addbeh.2018.02.0174. Kuss D, Griffiths M, Karila L, Billieux J. Internet addiction: a systematicreview of epidemiological research for the last decade. Curr PharmDes. (2014)20:4026–52. doi: 10.2174/138161281131999906175. Cao H, Sun Y, Wan Y, Hao J, Tao F. Problematic Internet use in Chineseadolescents and its relation to psychosomatic symptoms and life satisfaction.BMC Public Health. (2011) 11:802. doi: 10.1186/1471-2458-11-8026. Ioannidis K, Chamberlain SR, Treder MS, Kiraly F, Leppink EW, ReddenSA, et al. Problematic internet use (PIU): associations with the impulsive-compulsive spectrum. An application of machine learning in psychiatry. JPsychiatr Res. (2016) 83:94–102. doi: 10.1016/j.jpsychires.2016.08.0107. Laconi S, Kaliszewska-Czeremska K, Gnisci A, Sergi I, Barke A,Jeromin F, et al. Cross-cultural study of Problematic Internet Use innine European countries. Comput Human Behav. (2018) 84:430–40.doi: 10.1016/j.chb.2018.03.0208. Hampshire A, Hellyer P, Soreq E, Trender W, Mehta MA, Ioannidis K,et al. Dimensions and modulators of behavioural and mental-health changesduring the Covid-19 pandemic: an N= 343,017 study. medRxiv. (2020).doi: 10.1101/2020.06.18.201346359. Siomos K, Dafoulis V, Floros G, Karagiannaki-Kastani I, Christianopoulos K.Presentation of a specialized outpatient unit for internet and PC addiction-first year of operations, results, recommendations for the future. EurPsychiatry. (2010) 25:413. doi: 10.1016/S0924-9338(10)70409-010. Floros G, Garyfallos G, Giouzepas J. Student counseling service forproblematic use of the Internet and personal computers. Presentation of thefirst two years of operation. In:WPA Thematic Conference - 4th INA EuropeanCongress - 1st Congress on Psychiatry and Related Sciences. Athens: AthensWorld Psychiatric Association (2012).11. Kim J, Hwang Y, Kang S, Kim M, Kim T-S, Kim J, et al. Association betweenexposure to smartphones and ocular health in adolescents. OphthalmicEpidemiol. (2016) 23:269–76. doi: 10.3109/09286586.2015.113665212. Jaiswal S, Asper L, Long J, Lee A, Harrison K, Golebiowski B. Ocularand visual discomfort associated with smartphones, tablets and computers:what we do and do not know. Clin Exp Optometry. (2019) 102:463–77.doi: 10.1111/cxo.12851Conflict of Interest: The authors declare that the research was conducted in theabsence of any commercial or financial relationships that could be construed as apotential conflict of interest.Copyright © 2021 Floros and Ioannidis. This is an open-access article distributedunder the terms of the Creative Commons Attribution License (CC BY). The use,distribution or reproduction in other forums is permitted, provided the originalauthor(s) and the copyright owner(s) are credited and that the original publicationin this journal is cited, in accordance with accepted academic practice. No use,distribution or reproduction is permitted which does not comply with these terms.Frontiers in Public Health | www.frontiersin.org 2 April 2021 | Volume 9 | Article 676498

Editorial: The Impact of Online Addiction on General Health, Well-Being and Associated Societal Costs

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Editorial: The Impact of Online Addiction on General Health, Well-Being and Associated Societal Costs

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