A multi-school study in England, to assess problematic smartphone usage and anxiety and depression

Department of Biostatistics and Health informatics, Institute of Psychiatry,Psychology and Neuroscience, King’s College London, London, UK2 Population Policy Practice, UniversityCollege London, Great Ormond Street Institute of Child Health, London,  UK3Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience,King’s College London, London, UK4Psychology Department, Institute ofPsychiatry, Psychology and Neuroscience,King’s College London, London, UK5 South London and Maudsley NHSFoundation Trust, London, UK

Abstract

Aim: To assess the association between problematic smartphone usage and anxietyand depression in adolescents.Methods: A cross-sectional study in five schools in the UK were included. The primaryoutcome was moderate anxiety (GAD-7 ≥10) symptoms and secondary outcomeswere moderate depression symptoms (PHQ-9 ≥10) and insomnia. Problematic smart-phone usage was assessed using screentime and the Smartphone Addiction Scale.A multi-level logistic regression was fitted and adjusted Odds Ratio (aOR) with 95%confidence intervals (95% CI) reported. A mediation analysis was conducted.Results: Of the five included schools, 657 adolescents aged 16–18 years were en-rolled. The median age was 17.5 years (17–18 [IQR]) and 508 (77.3%) were female. Ofthese 188 (28.6%) exhibited moderate anxiety and 226 (34.4%) moderate depressionsymptoms. Almost two thirds (421, 64.1%) have tried to cut down their smartphoneuse and 81 (12.5%) wanted help to reduce use. Problematic smartphone use was asso-ciated with increased anxiety (aOR = 2.03, 95% CI 1.28–3.23); depression (aOR = 2.96,95% CI 1.80–4.86); and insomnia (aOR = 1.64, 95% CI 1.08–2.50). Screentime was notassociated with anxiety (β = 0.99, 95% CI 0.91–1.08); or depression (β = 0.98, 95% CI0.89–1.07). Problematic smartphone use had a significant direct, indirect and total ef-fect on both anxiety and depression.

Conclusion: Problematic smartphone usage was associated with anxiety and depression, independent of screentime. Interventions are needed to reduce problematic use.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.17317