Human communication, the internet, medicine and its addictions

Communication amongst human beings is vital for the development and support of the human race. It is impressive how we have gone from smoke signals, carrier pigeons, ‘‘foot’’ or ‘‘horse’’ messengers, to land and air mail, fax, and telephones. However, nothing is as interesting and as incredible as communication through the internet and its derivations, like ‘‘social networks’’ and the use of the smartphone. This device allows the user to be connected with practically everybody, it even allows audio and video recording and to make commercial transactions. The question is, how does this impact health, science and medicine? The answer is not that simple, and we approach this topic in this issue of Medicina Universitaria. Nowadays the number of places where the internet is considered necessary is growing. There are more and more cities implementing public internet access in zones like parks or squares. This reflects that the need for information and to ‘‘be connected’’ is now a cultural imperative. Nevertheless, up to what point can we consider internet access and social networking a part of the normal development of the individual, and when this can be considered to be an addiction? It is worth noting that in the year 2011 the United Nations (UN) declared access to the internet to be a human right. However, there are some countries with restrictions for internet use, such as China, North Korea, Iran and Egypt. Moreover, there is the risk of being spied upon and having private information stolen and used for criminal purposes, like identity thief. The UN confirmed that access to the web should be maintained, being especially valuable during ‘‘key political moments’’ like elections, times of social unrest and historic political anniversaries. Social networks have become more and more sought after by adolescents and young adults, who find a way of ‘‘socializing’’ and keeping in touch with others in order to update their personal situation in social and professional situations. Up to what point is the relationship between doctor and patient, established through social networks, considered to be prudent? Patients can experience the vulnerability of their personal information, due to the fact that a doctor may publish the patient’s medical or personal information, even when this occurs without giving out any personal information. We must find and maintain that line which divides professional activities from personal relationships. We must understand that patients trust in their right to privacy implied in the doctor-patient relationship. Internet addiction disorder (IAD) is recognized as a disease. First described in 1996 by Young, it has, however, become a bigger issue in recent years, given the large amount of people presenting said pathology. In a German report in 2013, where 71 patients with this disorder were studied, a high incidence of depression, obsessivecompulsive symptoms and interpersonal sensitivity was documented (Wölfing et al., 2013). Scales have been developed in order to assess internet addiction, like the one described by Young, which, in 20 items, allows us to assess the severity of addiction. The highest score is between 80 and 100 points, an indication that the use of the internet is causing serious problems in the life of the patient, making these subjects, including doctors, into patients who suffer from a type of addiction whose consequences are still unknown in detail. Therefore, in this issue of ‘‘Medicina Universitaria’’, we present two interesting studies on the topic.