An investigation into internet gaming disorder and psychological correlates among medical undergraduates in vocational colleges in China: a cross-sectional appraisal

Background: Internet Gaming Disorder (IGD) is a recognized public health concern, particularly among young adults. Medical students in vocational colleges in China face a unique combination of high academic pressure and potential exposure to problematic gaming behaviors. This study aimed to determine the prevalence of IGD and investigate its relationship with key psychological correlates, including depression, anxiety, and mental well-being, in this specific population. Methods: This cross-sectional survey was conducted from January 2021 to March 2025 in four vocational colleges in Sichuan Province, China. A total of 7,045 medical undergraduates provided valid survey responses, exceeding the calculated minimum sample size of 6,793. Participants completed standardized instruments, including the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), the Patient Health Questionnaire 9 (PHQ-9), the Generalized Anxiety Disorder 7-item (GAD-7), and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Rigorous quality assurance was maintained through standardized participant training and data validation protocols, including a 5% random re-entry check with a conformity threshold of ≥ 95. Data analysis included descriptive statistics, correlation analyses, multiple linear regression, and Structural Equation Modeling (SEM). Results: The study determined the prevalence of IGD (defined as IGDS9-SF ≥ 25) within the cohort. Regression analysis demonstrated that IGD severity was significantly and positively associated with symptoms of depression (PHQ-9: β = 0.310, t = 14.219, p < 0.001) and anxiety (GAD-7: β = 0.215, t = 8.103, p < 0.001). A strong bivariate correlation was observed between GAD-7 and IGDS9-SF (r = 0.388, p < 0.01). Conversely, higher IGD severity was found to be significantly associated with poorer mental well-being (WEMWBS scores). The final SEM further elucidated the direct and indirect complex pathways through which various demographic and psychological factors influence IGD severity. Conclusions: IGD is a prevalent issue among Chinese medical undergraduates in vocational colleges and is significantly linked to adverse mental health outcomes, including increased depression and anxiety symptoms. These findings emphasize the necessity of developing and implementing targeted mental health screening and intervention programs to address problematic gaming behaviors within vocational medical education settings. Clinical trial number: Not applicable.