{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T23:29:46Z","timestamp":1786577386536,"version":"build-2736575974"},"reference-count":60,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Internet addiction (IA) has been consistently associated with adverse mental health outcomes, but less is known about whether adolescents with IA seek mental health support, and whether associations between help-seeking and mental health problems differ across pathways.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to describe mental health help-seeking patterns across internet use and IA status, and examine the independent and interactive associations of IA and help-seeking with mental health problems.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Data were drawn from 2 repeated cross-sectional surveys conducted in Shandong Province in 2023 and 2024. A total of 171,970 junior middle school students were included. IA was assessed using a 9-item scale adapted from\n DSM-5<\/jats:italic>\n (\n Diagnostic and Statistical Manual of Mental Disorders<\/jats:italic>\n [Fifth Edition]) Internet Gaming Disorder criteria to assess internet use\u2013related symptoms. Students using the internet for at least 4 hours per day and endorsing at least 4 symptoms were classified as having IA. Help-seeking was categorized as no help-seeking, informal-only help-seeking, and any formal help-seeking. Mental health problems were defined as clinically significant depressive or anxiety symptoms. Pairwise logistic regression compared help-seeking patterns, and Poisson regression with school-clustered CR2 robust SEs estimated adjusted prevalence ratios (PRs).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Overall, 1.4% (2406\/171,970) met the definition of IA; 47.9% (82,402\/171,970), 42.1% (72,461\/171,970), and 9.9% (17,107\/171,970) reported no help-seeking, informal-only help-seeking, and any formal help-seeking, respectively. Among adolescents with IA, 59.9% (1440\/2406) reported no help-seeking, 33.8% (814\/2406) reported informal-only help-seeking, and only 6.3% (152\/2406) reported any formal help-seeking. Compared with nonaddictive internet users, adolescents with IA had lower odds of informal-only versus no help-seeking (OR [odds ratio] 0.690, 95% CI 0.631\u20100.754), any formal versus no help-seeking (OR 0.540, 95% CI 0.455\u20100.640), and any formal versus informal-only help-seeking (OR 0.786, 95% CI 0.659\u20100.937). Compared with nonaddictive internet users, adolescents with IA had a higher prevalence of mental health problems (PR 3.662, 95% CI 3.428\u20103.912). Informal-only (PR 0.581, 95% CI 0.550\u20100.614) and any formal help-seeking (PR 0.461, 95% CI 0.420\u20100.505) were associated with lower prevalence overall. Interaction terms for IA with informal-only help-seeking (PR 1.469, 95% CI 1.336\u20101.616) and any formal help-seeking (PR 2.033, 95% CI 1.696\u20102.437) indicated weaker inverse associations among adolescents with IA. Within the IA group, informal-only help-seeking was associated with lower prevalence (PR 0.848, 95% CI 0.784\u20100.917), whereas any formal help-seeking was not clearly associated with lower prevalence (PR 0.945, 95% CI 0.814\u20101.097). Sensitivity analyses supported these patterns.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Adolescents with IA had a substantially higher prevalence of clinically significant depressive and anxiety symptoms and were less likely to report mental health help-seeking, especially formal help-seeking. These findings highlight a high-burden, low help-seeking subgroup and suggest strengthening school-based mental health services, improving linkage between informal and formal support, reducing stigma, and developing low-threshold digital mental health pathways.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/90014","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T23:23:09Z","timestamp":1786576989000},"page":"e90014-e90014","source":"Crossref","is-referenced-by-count":0,"title":["Internet Addiction, Mental Health Help-Seeking, and Mental Health Problems Among Chinese Adolescents: Repeated Cross-Sectional 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