Associations of Fear of COVID-19 and Depression with Internet Addiction in Korean Adults: A Cross-sectional Online Study (Preprint)

BACKGROUND Internet use during the COVID-19 pandemic has increased exponentially, resulting in increasing prevalence of Internet addiction. The negative effects of Internet addiction on health including psychological distress have become more prevalent during the pandemic. OBJECTIVE The study aimed to investigate the associations between Internet addiction and psychological distress, including the fear of Coronavirus Disease 2019 (COVID-19) and depression, in Korean adults during the COVID-19 pandemic. METHODS A population-based cross-sectional online survey was conducted from 14th to 18th May 2021. Potential adult survey respondents aged 20 years or older were randomly extracted from one of the largest online survey panels in Korea, matching Korean national demographical proportions (i.e., region, gender, and age). 1,155 participants were recruited. Descriptive and logistic regression analyses were performed to investigate the participants’ characteristics and analyze the adjusted odds ratios (aORs) respectively. RESULTS 11.17%, 15.15% and 37.23% of the Korean adults were at risk of Internet addiction, COVID-19 fear, and depression respectively. Internet addiction was positively associated with COVID-19 fear (aOR=3.25, 95% CI [2.10, 5.04]) and depressive symptoms (aOR=6.40, 95% CI [4.15, 9.86]). Moreover, the participant group with high COVID-19 fear and depression had a 10.22 times higher odds ratio for Internet addiction (aOR=10.22, 95% CI [5.88, 17.77]), compared with the group with low COVID-19 fear and depression. CONCLUSIONS Addictive use of the Internet was significantly associated with psychological distress during COVID-19 pandemic. Development of public health strategies that mitigate addictive Internet use and increase eHealth literacy will be useful to secure the public’s psychological well-being.