Uzależnienie od internetu jako poważne wyzwanie diagnostyczne

Dear Editor,

The article by Janiszewski et al. entitled “Inter¬net addiction – diagnostic difficulties and treat¬ment” [1] published in your journal caught our attention and prompted further reflection. The problem of addiction is widely known, but it was not until the 21st century that we faced the new challenge of internet addiction. The paper focuses on discrepancies in diagnostic criteria and clearly presents the problem of internet addiction. While we agree with the conclusions presented by the authors, we would like to propose our own ideas we believe would be worth considering in future work.
Firstly, we would add a longitudinal perspective to the article. Observing patients for at least a number of years would help us gain knowledge about periods of remission, factors increasing the likelihood of relapse and the dynamics of symptoms. Focusing mainly on reviewing data from pharmacological treatment and psychothe¬rapy is extremely important in this case, but supplementing this with longitudinal studies could increase the effectiveness of future therapy. Many articles confirm the value of longitudinal studies in psychiatry. The work by Anstey and Hofer [2] confirms their impact on the identification of predictors of change over time, assessment of treatment outcomes and risk factors among other things.
In addition, we would like to emphasise, and draw attention to, the importance of standardising diagnostic tools [3]. In modern medicine, more and more new scales are being developed e.g. for cate-gorising patients though their validation in a cli¬nical context is rarely discussed [3]. The COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) guidelines clearly state that measurement tools should undergo formal validation – assessment of reliability, vali¬dity and sensitivity to change [3]. In Poland, only an adaptation of the standard IAT (Internet Addiction Test) is available, while the IAT-F (Internet Addiction Test for Families) version has not yet been adapted [4]. As we know, the test takes into account the observations of parents/legal guardians, which can provide us with an objective description of the patient [5]. For example, in the work of Jeong et al. [6], where children underwent self-assessment, we observe a high percentage of false negative results; in this case, by using a different method, researchers could obtain a realistic and reliable picture of the patient.
Social and cultural factors are of great importance in the reality that surrounds us. We observe a growing number of internet users in Poland [7] but there are still few, if any, analyses that would give a clear answer as to what significance this has for the risk of addiction. Research shows that the family and social environment of upbringing is important. All kinds of family circumstances, peer pressure and even educational requirements regarding the use of social media can, of course, either increase or decrease the risk of addiction [8]. There are many comparative analyses that clearly show that social media addiction is associated with different cultural groups. Each has its own distinct predispositions in this area and is certainly different. Collecting and summarising these many factors, even within a single country, could help to understand why symptoms are more common in certain groups [9].
In summary, the article by Janiszewski et al. [1] accurately and valuably addresses the topic of internet addiction. In our opinion, the implementation of longitudinal studies [2], cultural factors [9] and the standardisation of tools [3] can significantly contribute to the exploration of this topic. The ideas presented may help in the creation of new clinical recommendations.

Conflict of interest/Konflikt interesów

None declared./Nie występuje.

Financial support/Finansowanie

None declared./Nie zadeklarowano.

Ethics/Etyka

The work described in this article has been carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) on medical research involving human subjects, Uniform Requirements for manuscripts submitted to biomedical journals and the ethical principles defined in the Farmington Consensus of 1997. Treści przedstawione w pracy są zgodne z zasadami Deklaracji Helsińskiej odnoszącymi się do badań z udziałem ludzi, ujednoliconymi wymaganiami dla czasopism biomedycznych oraz z zasadami etycznymi określonymi w Porozumieniu z Farmington w 1997 roku.

References/Piśmiennictwo