Report on Digital Addictions in the Czech Republic 2023

This is a summary of the report, which has been published in full in Czech only. It can be found on the Czech version of this website under the title Zpráva o digitálních závislostech v České republice 2023.

Summary of the Report on Digital Addictions in the Czech Republic 2023

Definitions and concepts of digital addictions

The overuse of the Internet and digital technologies affects a relatively large proportion of the population and is the cause of a range of health disorders and adverse impacts on individuals and their surroundings.
Digital addiction is usually defined as the compulsive use of digital technology that continues despite its adverse consequences
In general, it refers to the overuse of computers and mobile phones, or Internet overuse, i.e., excessive time spent searching for information, using social media, playing digital games, watching films and TV shows, pornography, or shopping online.
However, consensus on the definition of digital addiction does not yet exist.
Internet addiction and digital-related disorders are not yet defined in official classifications of diseases and disorders (DSM-5 and ICD-10).

Digital addictions policy and regulation

In the Czech Republic, the policy on the overuse of digital technologies is part of an integrated addiction policy.
The National Strategy for the Prevention and Reduction of Harms Related to Addictive Behaviour 2019-2027 is the main strategic policy document defining the focus of policy in the field of addiction. The preparation of the Addiction Policy Action Plan 2023-2025 was initiated during 2022.
Digital games are rated according to the PEGI system, which has five recommended ages - 3, 7, 12, 16 and 18 years. Compliance with these age groups is not supported by legislation.
Gaming disorder is most commonly associated with MMORPG games, which allow several thousand players to play the game at the same time.
Loot boxes, i.e., virtual packets that the player can acquire during the game or purchase with virtual currency, have become a common feature of digital games. In some EU countries, loot boxes are classified as gambling.
Most social networks allow an account to be created from the age of 13, some require the age of 16. Many children set up an account earlier, making intentionally false declarations when registering. It is common to use multiple profiles simultaneously and to create fictive profiles.
Some social networks have been a subject of media attention due to concerns that they collect personal data on users over the long term. Media discussions also target the suitability and harms of the content of the posts for children and adolescents. Inappropriate content is mainly represented by various types of dangerous challenges.
The promotion of goods and services on the Internet takes place not only through advertising, but also through social media marketing and via influencers. Influencers particularly affect children and adolescents who often imitate their lifestyles. Hidden online product advertising by influencers is problematic as it can be used to market products that are not intended for people under the age of 18.

Use of digital technologies among children and young people

The overuse of digital technologies among children and adolescents is not systematically monitored, yet the topic of digital gaming and use of social networks has been explored in several studies. However, these studies use different screening instruments and therefore provide different estimates of the number of adolescents at risk of digital addiction.
According to the HBSC 2022 study, 48% of boys and 16% of girls aged 11-15 played digital games (i.e., games on a computer, tablet, console, etc.) every day.
A total of 13% of boys and 5% of girls were categorised as at-risk gamers according to the IGD scale.
Based on the SMDS scale, 5-7% of boys and 7-13% of girls aged 11-15 were categorized at risk related to social media use.
Among 16-year-olds, a total of 21.9% played digital games on daily basis, significantly more often boys (36.9%) than girls (6.3%), according to the ESPAD 2019 study. 74.2% of students spend their free time on social networks on daily basis.
A total of 12.9% of students (21.7% of boys and 3.8% of girls) fell into the category of at risk of gaming disorders according to a screening scale focusing on the subjective perception of problems related to social networking and digital gaming.
About 34.1% of students (25.2% of boys and 43.4% of girls) fell into the category of being at risk related to the amount of time they spend on social media.
A total of 9.1% of students aged 15-19 (18% of boys and 2% of girls) spend four or more hours a day on gaming, according to the UPOL 2021 study. A total of 22.4% spend 4 or more hours a day on social media.

Use of digital technologies in the adult population

The overuse of digital technologies is neither systematically monitored among adults. However, the topic of digital gaming and the use of social networks has been included in several studies.
78% of the Czech adult population use the Internet daily. 99% of the population use a mobile phone, 78% use the Internet on their mobile phone.
According to Citizen Survey 2022, adults spend an average of 150 minutes online on a typical weekday and 190 minutes a day at weekends. According to various studies, gamers spend 90 minutes playing digital games on a weekday and 120 minutes at weekends, and 100 minutes on a regular working day and 120 minutes at weekends on social media.
Men are more likely than women to spend time online playing digital games and watching pornography, while women are more likely to spend time on social media and shopping.
An estimated 4% of adults (4% of men and 5% of women) are at risk of digital addiction according to the EIU screening scale, with 2% falling into the high-risk category. The largest shares of people at risk of digital addiction are in the 15-24 age group (18%) and 25-34 age group (9%). The proportion of population at risk of digital addiction declines significantly with age.
Extrapolating the survey results to the Czech population aged 15+ years, an estimated 380-445 thousand people are at risk of digital addiction in the Czech Republic. An estimated 210-320 thousand people fall into the low or medium-risk category while an estimated 125-160 thousand people aged 15+ fall into the category of high risk of digital addiction.

Health and social impacts and correlates of overuse of digital technologies

The excessive use of digital technologies is perceived as a serious public health problem, with a range of adverse impacts on individuals and their environment. The health effects of the overuse of the Internet and digital technologies are not systematically monitored in the Czech Republic.
Direct effects of overuse of digital technologies include disruption of daily rhythm, neglect of personal hygiene, eating and/or sleeping, fatigue, headaches, eye pain, back pain or other musculoskeletal pain, and impaired time orientation.
Long-term effects include reduced physical activity, obesity, reduced social contacts outside the online environment and loss of friends, conflicts in personal relationships, neglect of leisure activities, lack of concentration and problems at work or school.
Children and adolescents at risk of digital addiction are 2-6 times more likely than their peers to report neglecting leisure activities, sleeping or eating problems, problems at school (e.g., worsened school performance) and impacts on time spent with friends and family. At the same time, in adolescence, an association exists between the overuse of digital technologies and anxiety disorders, ADHD, depression, suicidal ideation, as well as aggression and substance use.
According to a study among Prague students aged 11-19, the proportion of those who have experienced problems related to online activities has been increasing since 2019, as well as the proportion of students who report problems repeatedly or regularly.
Girls were most likely to report unsuccessful efforts to limit their time spent online, while boys report impact on time spent with family, friends or preparing for school.
In the 2022 Citizen Survey, around a quarter of adults reported problems as a result of their Internet use in the last 12 months - the most common being spending time online even when they don't enjoy it (28%), neglecting to eat or sleep (25% of adults) and feeling uncomfortable when unable to be online (20%).
Clients of addiction services report neglecting sleep and/or hygiene, work or school, and problems with concentration and attention.

Prevention of digital addictions

Addiction prevention targeting children and young people includes the prevention of digital addictions and is part of the broader framework of school-based prevention of risk behaviour. The issue of digital addiction is usually part of the broader concept of safe online behaviour and the prevention of cyberbullying.
In the 2021/2022 academic year, 6% of school-based prevention programmes focused on topics of behavioural addictions, including the overuse of digital technologies.
More than 2,700 cases of risk behaviour related to digital addictions and/or gambling were handled in Czech schools in the 2021/2022 academic year, representing 4% of all recorded cases of risk behaviour. Most often, these cases were dealt with at the upper level of primary schools and at the lower grades of grammar schools.
To provide guidance to educators on the risks associated with the use of digital technologies, the Technology and Prevention online training module offers interventions aimed at children and their parents, with the aim of early detection and reduction of digital addiction problems.
The iprev.cz website has launched a systemic tool titled as the Interactive Platform for Mental Health Support and the Prevention of Risk Behaviour (IPREV), which, among other things, supports the training of professionals in prevention.

Treatment and responses to digital addictions

No specific treatment and counselling services are currently available in the Czech Republic that target primarily clients with problems related to the overuse of digital technologies.
Treatment and other interventions for people overusing digital technologies, or at risk of developing digital addictions, aim to reduce the amount of time spent on digital technologies and to increase control over their use.
Currently nearly 300 addictology programmes of different types are estimated in the Czech Republic. According to the 2020 Census of Addictology Services, there were a total of 109 programmes (37.3%) in the Czech Republic that provided services to clients at risk of digital addiction.
According to the final reports of the programmes supported by the subsidy procedure of the Office of the Government of the Czech Republic, the number of programmes working with clients at risk of excessive use of digital technologies is growing. At the same time, the number of clients in these supported services increased from 83 in 2017 to 354 clients per year in 2022.
Clients at risk of digital addictions are most commonly reported by outpatient services, in many cases these are specialized outpatient programmes for clients at risk of problem gambling, and outpatient addictology programmes for children and adolescents.
Programmes report that digital addictions are increasingly common among children and adolescents aged 10-18, particularly as regards excessive online gaming and excessive use of social media.
Some health care facilities report patients with digital addictions using the dg. F63.8 code (other compulsive and impulsive disorders) to health insurance companies. Patients with dg. F63.8 are most commonly reported by psychiatric and clinical psychology facilities, as well as health facilities providing care in the addiction domain, psychiatric facilities for children and adolescents and health centres providing care in the addictive diseases domain.
Since 2015, 150-210 people with digital addiction are reported annually to health insurance companies (dg. F63.8). In particular, the number of children and adolescents aged 10-19 has increased. While in 2015-2019 the number of children reported was 23-25 per year, in the following period, 34-46 patients in this age group were reported annually. By 2022, the number of patients was 72.
Since 2019, the National Telephone Quitline Hotline on 800 350 000 has offered counselling to people with any addiction problem, including the overuse of digital technologies. In 2022, 86 individuals with a behavioural addiction related problem used the helpline, including 12 with a problem other than gambling.
There are several online counselling services in the Czech Republic that also provide anonymous counselling on digital addictions and link to other services.