Naomi Anne Fineberg is Professor of Psychiatry at the University of Hertfordshire, and a Consultant Psychiatrist at Hertfordshire Partnership University NHS Foundation Trust, where she leads the NHS England Highly Specialised Service for Obsessive Compulsive and Related Disorders. She is President-Elect of the British Association for Psychopharmacology, co-chairs the World Psychiatric Association Anxiety and Obsessive-Compulsive Disorders Scientific Section, coordinates the Horizon Europe Network for Problematic Usage of the Internet and is Secretary of the International College of Obsessive-Compulsive Spectrum Disorders. Professor Fineberg has a substantial track record in the investigation of the neurobiology and treatment of obsessive-compulsive disorders and behavioural addiction, including problematic usage of the Internet. She is Editor-in-Chief of Comprehensive Psychiatry.

Abstract

Problematic use of the internet as a global health challenge: New approaches to diagnosis, treatment, and networked research

There is growing concern about problematic usage of the internet (PUI) and its mental health and societal costs, including harmful effects on young people. I will review advances in nosology, biopsychosocial mechanisms, interventions and services for PUI, describe emerging results from a large multinational cohort study of schoolchildren, co-designed with public stakeholders, and discuss evidence-based recommendations for new global health and social policy initiatives for PUI. Emerging evidence suggests PUI derives from an interaction between the person, their cognitive (including impulsive and compulsive executive functioning) and affective status and the environment. This explains in part why young people, whose cognitive-affective functioning is still maturing, are so susceptible and provides a rationale for development of tailored interventions. Evidence from randomised controlled trials and meta-analyses show promise of efficacy for pharmacological and non-pharmacological approaches in PUI, but significant gaps in training and service-provision exist. Research goals include improved understanding of the course and evolution of PUI across different age groups, genders and other vulnerable groups, methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and services, and ethical health and social policy changes that adequately safeguard young people and protect individuals’ digital human rights.