Internet Use Disorder: Treatment

Even though Internet Use Disorder has been extensively discussed in the media, there have been only a few double-blind, controlled trials on the treatment of Internet Use Disorder. Most of the previous treatment studies either used inconsistent criteria to define Internet Use Disorder or lacked an adequate methodological quality in assessing the therapeutic outcome, or both.

As far as is known, psychotherapy, especially Cognitive Behavioral Therapy (CBT), and self-help programs seem to be effective.

Based on the experience of the treatment of other addicitive or obsessive-compulsive disorders, psychoeducation and family counseling might be helpful.

So far, there are no sufficient data on the pharmacotherapy of Internet Use Disorder. The use of antidepressants, mood stabilizers, anxiolytics, and of Naltrexone has been proposed.

Psychotherapy

Psychotherapy is the proclaimed “sine qua non” in treating Internet Use Disorder. In complete disregard of the high prevalence rates and the impact of Internet Use Disorder on the persons affected, only a handful of studies have been conducted on the causes and treatment options of this disorder.

Psychoeducation

In accordance to the findings on other disorders of obsssive-compulsive- or addictive nature, psychoeducation seems to be an important tool in the treatment of Internet Use Disorder. Clinical studies on this subject have yet to be published.

Cognitive Behavioral Therapy (CBT)

As mentionend above, only few studies on the treatment of Internet Use Disorder have been published. Young reports on positive effects of Cognitive Behavioral Therapy (CBT) in the treatment of patients with Internet Use Disorder (cf. Young 2007).

Du et al. reported on the therapeutic effectiveness of school-based group cognitive behavioral therapy (CBT) for Internet addiction in adolescents. In a randomized, controlled trial including 56 patients, aged 12-17 years, group cognitive behavioral therapy for Internet addiction in adolescent students proved to be effective, particularly in improving emotional state and regulation ability, behavioral and self-management style (cf. Du 2010).

The Johannes Gutenberg University of Mainz (Germany) is conducting a multi-center, randomized, single blind trial to determine the efficacy of a manualized Short-term Treatment of Internet and Computer game Addiction (STICA) (cf. Jäger 2012).

There are several more clinical studies on CBT for Internet Use Disorder from China (cf. Bai 2007, Cao 2007, Fang-ru 2005, Lanjun 2009, Li 2009, Rong 2006, Zhu 2009), who have not been published in English yet.

Acceptance and Commitment Therapy (ACT)

Twohig and Crosby treated 6 male adults, who reported symptoms of problematic Internet pornography viewing, in eight 1.5-hour sessions of Acceptance and Commitment Therapy (ACT). The treatment resulted in an 85% reduction in viewing at posttreatment with results being maintained at 3-month follow-up (83% reduction) (cf. Twohig 2010).

Familiy Counseling and Teacher Education

There are some reports, that familiy counseling and teacher education could be helpful in treating and preventing Internet Use Disorder (vgl. Du 2010, Orzack 2006).

Pharmacotherapy

Few studies on the pharmacotherapy of Internet Use Disorder have been published, and most of these studies do not meet criteria of a a double-blind, placebo-controlled design.

Escitalopram

Dell'Osso et al. treated a small group of patients with Internet Use Disorder (19 adults, 14 completers) with escitalopram, starting with an initial dose of 10 mg/day and an increase to 20 mg/day. The open-label treatment with escitalopram was associated with an improvement of Internet Use Disorder symptoms (cf. Dell’Osso 2008).

Bupropion

Han et al. treated 11 patients who met criteria for Internet video game addiction (IAG) with bupropion SR (bupropion sustained release). After 6 weeks of bupropion-treatment the subjects showed a decrease in craving for Internet video game play, total game play time, and cue-induced brain activity in dorsolateral prefrontal cortex (cf. Han 2010).

Methylphenidate

Han et al. treated 62 children with attention-deficit/hyperactivity disorder (ADHD) who showed some symptoms of Internet Use Disorder with methylphenidate. After 8 weeks of treatment, the Young's Internet Addiction Scale - Korean version (YIAS-K) scores and Internet usage times were significantly reduced (cf. Han 2009).

Naltrexon

In a case report Bostwick et al. describe the treatment of a patient who sufffered from compulsive Internet use for sexual gratification with naltrexone (cf. Bostwick 2008).

Multimodal Treatment

As with other mental health disorders, eg. depressive disorders or anxiety disorders, multimodal treatment appears to be the most promising way to treat Internet Use Disorder. As mentionend above, further studies are needed.