The Impact of Suicidality-Related Internet Use: A Prospective Large Cohort Study with Young and Middle-Aged Internet Users

Background: There has been no study that has allowed clear conclusions about the impact of suicide-related or mental health consultation-related internet use. Aim: To investigate the impacts of suicide-related or mental health consultation-related internet use. Methods: We conducted prospective observational longitudinal study with data collection at baseline screening (T0), 1 week after T0 (T1) and 7 weeks after T0 (T2). Participants with a stratified random sampling from 744,806 internet users were 20-49 years of age who employed the internet for suicide-related or mental health consultation-related reasons and internet users who did not. The main outcome was suicidal ideation. Secondary outcome measures comprised hopelessness, depression/anxiety, and loneliness. Results: The internet users who had employed the internet for suicide-related or mental health consultation-related reasons at T0 (n = 2813), compared with those who had not (n = 2682), showed a significant increase in suicidal ideation (beta = 0.38, 95% CI: 0.20-0.55) and depression/anxiety (beta = 0.37, 95% CI: 0.12-0.61) from T1 to T2. Those who disclosed their own suicidal ideation and browsed for information about suicide methods on the web showed increased suicidal ideation (beta = 0.55, 95% CI: 0.23-0.88; beta = 0.45, 95% CI: 0.26-0.63, respectively). Although mental health consultation with an anonymous other online did not increase suicidal ideation, increased depression/anxiety was observed (beta = 0.34, 95% CI: 20.03-0.71). Conclusions: An increased suicidal ideation was observed in the young and middle-aged who employed the internet for suicide-related or mental health consultation-related reasons. Mental health consultation via the internet was not useful, but those who did so showed worsened depression/anxiety.