The Impact of Internet Addiction on Adolescent Mental Health and Academic Function: A Systematic Review of Randomized Controlled Trial and Primary Studies

Abstract

Background: Internet addiction (IA) has emerged as a significant global public health concern, particularly among adolescents whose neurological and psychological developmental trajectories render them uniquely vulnerable to compulsive digital engagement. Existing literature documents bidirectional relationships between IA and a spectrum of psychiatric disorders.

Methods: The study strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Eligible study designs included RCTs, cohort studies, case-control studies, cross-sectional studies, observational, prospective, and retrospective designs. Risk of bias was assessed using the Newcastle-Ottawa Scale. PRISMA 2020 guidelines were followed.

Results: A total of 21 primary studies comprising 67,628 participants from 14 countries were included, with 12 outcome domains analyzed. IA prevalence ranged from 2.68% to 80.7% depending on diagnostic criteria. IA was significantly associated with depressive symptoms (OR range: 1.5–2.0), anxiety (OR range: 1.80–2.96), stress (OR: 12.0), degraded sleep quality, impaired academic performance, diminished self-esteem, social isolation, ADHD symptom severity, reduced quality of life, increased aggression, and elevated NSSI/suicidal ideation risk. Physical activity was identified as a significant mediating protective factor.

Discussion: The evidence consistently demonstrates that IA exerts broad-spectrum negative effects on adolescent mental health and academic function. Neurobiologically, compulsive internet use disrupts dopaminergic reward circuitry, frontal executive control networks, and sleep-wake regulatory systems. Psychosocially, IA perpetuates maladaptive coping patterns, social skill deficits, and academic disengagement.

Conclusion: Internet addiction demonstrates robust, multi-domain negative effects on adolescent mental health and academic function. Cross-national and cross-cultural consistency reinforces the generalizability of findings. Multidisciplinary intervention strategies targeting both individual and systemic risk factors are urgently warranted.