Sex differences in the longitudinal association between high risk of internet gaming disorder and subsequent suicidality among adolescents: A cohort study

Jeong, Hyunsuk and Yim, Hyeon Woo and Potenza, Marc N. and Lee, Seung-Yup and Lee, Hae Kook (2026) Sex differences in the longitudinal association between high risk of internet gaming disorder and subsequent suicidality among adolescents: A cohort study. JOURNAL OF BEHAVIORAL ADDICTIONS, 75 (2). pp. 756-765. ISSN 2062-5871

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Abstract

Objectives Internet Gaming Disorder (IGD) has become a growing public health concern among adolescents. Although previous cross-sectional studies have linked problematic gaming with suicidality, longitudinal evidence remains limited. This study examined sex-specific associations between IGD risk and subsequent suicidal behaviors among adolescents who were not suicidal at baseline. Methods Data were derived from the iCURE study, a prospective cohort involving 1,874 students (1,082 boys and 792 girls) aged 9–14 years. Participants with baseline suicidality were excluded. The Internet Game Use-Elicited Symptom Screen was used to identify adolescents at high risk of IGD (HRIGD). Suicidality was assessed at two-year follow-up using items adapted from the SCID-I. Relative risks (RRs) and 95% Confidence Intervals (CIs) were estimated using generalized linear models stratified by sex and adjusted for potential confounders. Results At baseline, 8.0% of boys and 3.4% of girls were classified as HRIGD. At the two-year follow-up, boys in the HRIGD group showed significantly higher incidences of suicidality (17.4% vs. 5.0%), suicidal ideation (16.3% vs. 4.7%), and suicide plans or attempts (5.8% vs. 1.0%) than those at lower risk. In fully adjusted models, HRIGD remained associated with suicidality (RR = 3.05, 95% CI = 1.53–6.07), suicide ideation (RR = 2.99, 95% CI = 1.48–6.05), and suicide plans and/or attempts (RR = 4.03, 95% CI = 1.08–15.07) among boys, but not among girls. Conclusions This longitudinal cohort study among adolescents without baseline suicidality indicates that IGD risk is related to subsequent suicidality in boys. Early identification and sex-specific preventive strategies targeting excessive gaming may help mitigate future suicide risk in adolescents.

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