How often do you miss out on sleep because you're online late at night? How often do you choose to spend more time online than going out with others? How often do you block out disturbing thoughts about your real life with soothing thoughts of the internet? If you answer "always" or "often" to such questions, you may have a problem with internet use.
Problematic internet use has been considered a potential mental health issue since the mid-1990s in the US and Europe, with people exhibiting similar symptoms to other established addictions. Studies have shown that young, introverted men are most at risk, but an increasing number of women are also exhibiting such behaviour.
As the internet becomes more widely available across Asia, problematic use among adolescents - particularly playing online games - is becoming a bigger health issue. The problem is on the rise in Taiwan and on the mainland, according to recent studies. Given the proliferation of mobile technology, it is only expected to get worse.
There has been a lot of debate about whether problematic internet use should be considered a psychiatric disorder or mental illness, similar to other well-established addictive disorders. Doctors in East Asia, including in China and South Korea, are now increasingly using "internet addiction" as a diagnosis.
Studies have shown potential links between psychiatric symptoms, aggressive behaviour, depression and pathological internet use among adolescents. One study on people addicted to the internet, in particular to multiplayer role-playing games, showed that these games induced seizures in some patients. One of my recent studies demonstrated for the first time that young people in China with no mental health problems, but who have a problem with internet use, could develop depression as a result. Subsequent studies of young people elsewhere have confirmed this.
So how can we prevent internet abuse among children and adolescents? A primary prevention strategy must involve parents. Undoubtedly, new technology has brought increased convenience and excitement. However, parents need to be aware of the dangers of technology overuse, and not become "techno junkies" themselves, so they do not set a bad example for their children.
There is no substitute for the presence of parents in the healthy development of children, especially from early childhood to adolescence. An iPad may be a good tool to provide a visual aid in telling stories to a two-year-old, but it should not be used for baby-sitting. Parents need to be more vigilant about their children's internet use, paying attention to patterns of use and what they use the internet for.
Education about online safety needs to go beyond developing an awareness of dangerous content, scamming and identity theft. These elements could be incorporated into primary and secondary schools' general education curriculum.
It is evident that young people who have issues with internet use are most at risk from mental health problems. Thus, screening in schools could help identify at-risk individuals who would benefit from early counselling and treatment.
Lawrence T. Lam is a professor in the Department of Health and Physical Education, Hong Kong Institute of Education