Calls from some doctors for China to define Internet Addiction as a mental illness have triggered a furious dispute among the country's 250 million netizens.

Tao Ran, director of the Addiction Treatment Center of Beijing Military Region General Hospital believes Internet addiction is a kind of mental illness, but is quick to add that he is not saying Internet addicts are mad, still less that netizens who spend long periods on the web are all Internet addicts.

Tao has led a team to draw up diagnostic criteria for identifying Internet addicts.

What is Internet addiction?

Tao's criteria emphasize two points: a strong desire and attraction to the Internet, and withdrawal symptoms such as anxiety, rage, attention deficit and sleep disorder if access is denied or restricted.

Five other symptoms are: spending more and more time on Internet; wanting to reduce time spent on the Internet but being unable to; continuing to surf even realizing it is harmful; losing interest in other activities; using the Internet to escape from reality or reduce tension.

Internet addiction can lead to introversion, low self-esteem, social phobia and other psychological problems. Tao has identified five sub-types: addiction to online computer games, pornography sites, contact and dating sites, news and information, and Internet shopping.

The standard for identifying an addict is someone who, for three months or more, spends more than 6 hours a day on the Internet, over and above everyday use for work or study.

The controversy arises because defining these diagnostic criteria has added a new disease to clinical medicine and implies that Internet addicts need medical treatment in mental institution.

"Internet addiction can be cured in about three months; 80 percent of sufferers can rid themselves of this addiction," says Tao.

How the criteria finalized

Tao says his criteria are the result of four years of research covering more than 3,000 cases. Beijing Military Region General Hospital started a program to rid young people of Internet addiction in March, 2005, and the following year established the country's first diagnosis and treatment center for Internet addiction.

About 1,300 of the 3,000 cases were selected for clinical research. "We observed the symptoms of more than 50 percent of the sufferers and studied the frequency of outbreaks," says Tao.

He told China Newsweek that they defined an initial draft of the criteria from their own observations and drawing on overseas research papers. They refined the draft following a survey of 110 strongly addicted patients whose study, work and social interaction was being affected. If a symptom was found in more than 50 percent of cases, it was added to the criteria.

They subsequently observed and treated 408 patients whose symptoms accorded with the draft, and visited them randomly one year after they left hospital to calculate the relapse rate.

Finally, psychiatrists in other major hospitals carried out tests on 150 patients who suffered from the same problems. The description was adjusted on the basis of the results of the test and the final version of the diagnostic criteria was released.

Is Internet addiction mental illness?

If China officially defines Internet addiction as a mental illness it will inform the World Health Organization.

But from the start there have been disputes over the issue. Pediatrician Du Yasong of the Shanghai Counseling Center says it is too early to identify Internet addiction as an illness, let along mental illness. Deputy Director of the Guangdong Institute of Mental Health Xu Mingzhi also casts doubt on the scientific basis of the definition of Internet addiction.

In fact, the concept of Internet addiction was originated by New York psychiatrist Ivan Goldberg in 1995, but he did not regard it as a mental illness. He said people become addicted to the Internet or gambling because such activities help relieve pressure and anxiety. The concept of "addiction" can be enlarged to encompass almost every aspect of social life – people can be addicted to reading, running, or even social interaction but these addictions should not be regarded as illness.

Zhang Jianxin, deputy director of the Institute of Psychology at the Chinese Academy of Sciences, told China Newsweek that such defining diagnostic criteria would be useful because there are around 4 million young people in China who are addicted to the Internet. But we need to be careful about defining it as a mental illness; after all, China has more than 253 million netizens.

(China.org.cn by Fan Junmei, December 2, 2008)