Year: 2026 | Month: August | Volume: 16 | Issue: 8 | Pages: 193-205
DOI: https://doi.org/10.52403/ijhsr.20260820
Internet Addiction and Mental Distress Among Undergraduate Medical Students: A Sequential Explanatory Mixed-Methods Study
Anirban Nandy1, Tridibes Bhattacharya2, Avijit Dey3
1Senior Resident, Department of Community Medicine,
Deben Mahato Government Medical College and Hospital, Purulia, West Bengal, India
2Assistant Professor, Department of Community Medicine,
Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India
3Post Graduate Trainee, Department of Community Medicine,
Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India
Corresponding Author: Anirban Nandy
ABSTRACT
Background: Problematic internet use is increasingly relevant among medical students because of extensive academic and recreational dependence on digital technology. This study assessed moderate/severe internet addiction, mental distress, associated factors, and experiences underlying severe internet addiction.
Methods: A sequential explanatory mixed-methods study was conducted among 200 undergraduate medical students at a teaching hospital in Eastern India. Stratified random sampling selected 50 students from each of four MBBS phases. Internet addiction was assessed using the 20-item Internet Addiction Test (IAT), with scores ≥50 defining moderate/severe addiction. Mental distress was assessed using the SRQ-20, with scores ≥8 indicating distress. Bivariate analyses and separate multivariable logistic regression models were performed. Variables with p<0.20 and epidemiological relevance were considered for multivariable analysis. Sparse cells were assessed, and during- and post-working-hour categories were combined in the internet-addiction model because of complete separation. All 14 students with severe addiction underwent in-depth interviews, followed by thematic analysis and integration using a joint display.
Results: Moderate/severe internet addiction was present in 95/200 (47.5%; 95% CI: 40.7–54.4%), while mental distress was present in 72/200 (36.0%; 95% CI: 29.7–42.9%). IAT and SRQ-20 scores were positively correlated (Spearman’s rho=0.463, p<0.001). Screen time was independently associated with internet addiction (AOR 1.38, 95% CI 1.19–1.54) and mental distress (AOR 1.18, 95% CI 1.06–1.31). Qualitative analysis identified coping escape, entertainment/social validation, and loss of control with late-night use.
Conclusion: Problematic internet use and mental distress were common and significantly correlated among medical students. The findings represent associations and do not establish causality or temporal direction.
Key words: Internet addiction; medical students; mental distress; IAT; SRQ-20; mixed-methods study; screen time.