Internet dependence as a predictor of mental health among medical students before and during the COVID-19 pandemic: a longitudinal cohort study in Brazil (2019–2021).
Purpose: This study aims to compare internet dependence (ID) and mental health outcomes among Brazilian medical students before the COVID-19 pandemic (2019) and during peak distancing (2021), and to assess whether baseline ID predicted mental health outcomes at follow-up. Design/methodology/approach...
| Publicado en: | Journal of Mental Health Training, Education & Practice Vol. 21; no. 4; pp. 323 - 338 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Emerald Publishing Limited
2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194637927&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194637927 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17556228 639E jtl: Journal of Mental Health Training, Education & Practice issn: 17556228 maglogo: N pubinfo: dt: 2026 vid: 21 iid: 4 pid: 465 pub: Emerald Publishing Limited artinfo: ui: 194637927 194637927 194637927 194637927 ppf: 323 ppct: 15 formats: tig: atl: Internet dependence as a predictor of mental health among medical students before and during the COVID-19 pandemic: a longitudinal cohort study in Brazil (2019–2021). aug: au: Vitorino, Maria Clara Candido da Silva, Maria Clara Chaves e Santos Soares, Renata de Castro de Melo, Mayara Moreira von Humboldt, Sofia Almeida Vitorino, Luciano Magalhães affil: Department of Medicine, Faculdade de Medicina de Itajubá – Afya, Itajubá, Brazil sug: subj: COVID-19 Pandemic Psychosocial Factors Students, Medical Psychosocial Factors Internet Addiction Mental Health Mental Disorders Risk Factors Risk Assessment Human Male Female Adolescence Adult Brazil Schools, Medical Prospective Studies Depression Anxiety Optimism Pessimism Stress, Psychological Behavior, Addictive Digital Technology Psychological Well-Being Paired T-Tests McNemar's Test One-Way Analysis of Variance Pearson's Correlation Coefficient Spearman's Rank Correlation Coefficient Multivariate Analysis Multiple Linear Regression Confidence Intervals Post Hoc Analysis Data Analysis Software Descriptive Statistics Questionnaires Psychological Tests Adolescent: 13-18 years Adult: 19-44 years Male Female ab: Purpose: This study aims to compare internet dependence (ID) and mental health outcomes among Brazilian medical students before the COVID-19 pandemic (2019) and during peak distancing (2021), and to assess whether baseline ID predicted mental health outcomes at follow-up. Design/methodology/approach: This prospective longitudinal cohort study was conducted at a private medical school in Brazil with two waves (2019, in-person; 2021, online). Instruments included the Internet Addiction Test (IAT), PHQ-9, GAD-7 and the Life Orientation Test-Revised (LOT-R). Paired t-tests and McNemar tests compared within-person changes. Correlations and multivariable linear regression models adjusted for age, sex, family income and mental health service use assessed associations, including change scores (? = T1–T0). Statistical significance was set at p < 0.05. Findings: Ninety-four students completed both waves. Mean PHQ-9 scores increased from 10.56 to 14.80 (? = +4.24; p < 0.001), and mean GAD-7 scores increased from 9.74 to 13.08 (? = +3.34; p < 0.001). Optimism declined from 8.54 to 5.42 (p < 0.001), pessimism increased from 6.97 to 7.73 (p = 0.028) and ID increased from 40.59 to 47.43 on the IAT (p < 0.001). At baseline, ID correlated with higher depressive symptoms (r = 0.282; p = 0.038) and anxiety (r = 0.260; p = 0.042). In adjusted regression models, baseline ID predicted higher anxiety at follow-up (ß = 0.699; p = 0.042), but not depressive symptoms at follow-up (ß = 0.087; p = 0.148). Higher baseline ID also predicted greater increases in PHQ-9 (ß = 0.201; p = 0.022) and GAD-7 (ß = 0.398; p = 0.042) scores from 2019–2021. Originality/value: This study provides longitudinal evidence from a middle-income country tracking ID and mental health among medical students from a pre-pandemic baseline to the period of peak distancing. By examining both negative psychological symptoms and positive psychological markers such as optimism, the findings underscore digital hyperconnectivity as a salient, modifiable correlate of distress in medical training. The results support routine screening and the integration of digital literacy and self-regulation strategies into medical curricula to mitigate risk and promote well-being. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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