Association of Internet Addiction Severity with Anxiety, Depression, and Suicidal Ideation among Civil Aircrew Members: A Nationwide Cross-Sectional Survey

Introduction: Internet addiction (IA) is a modern problem. IA in the occupational population needs to be taken seriously. This study aims to investigate the prevalence of IA and explore the relationship between IA and anxiety, depression, and suicidal ideation and among aircrew members. Methods: From December 2022 to March 2023, a cross-sectional survey among all current aircrew members from 10 airlines that agreed to collaborate in China, including pilots, flight attendants, and aviation security officers. IA, anxiety, and depression were assessed using Young’s Internet Addiction Test, Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9, respectively, along with the collection of other possible confounders. Results: This study included a total of 22,617 aircrew members, with a median age (interquartile range) of 30 years (27–34), including 13,712 (60.6%) males and 8,905 (39.4%) females. The increased severity of IA was associated with higher adjusted odds ratios for anxiety (mild: 1.46, 95% confidence interval [CI] [1.26–1.70]; moderate: 3.90, 95% CI [3.34–4.55]; severe: 7.24, 95% CI [5.43–9.67]; P trend <0.001), depression (mild: 1.74, 95% CI [1.54–1.96]; moderate: 3.64, 95% CI [3.18–4.16]; severe: 4.97, 95% CI [3.72–6.65]; P trend <0.001), and suicidal ideation (mild: 1.66, 95% CI [1.30–2.12]; moderate: 2.95, 95% CI [2.29-3.81]; and severe: 4.03, 95% CI [2.74–5.88]; P trend <0.001). Conclusion: IA is prevalent among Chinese aircrew members and associated mental health issues, with a dose–response relationship between IA severity and poor mental health odds. It is important to address IA and its mental link to aircrew for the sake of public safety and flight safety.