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

Abstract

Aim

To assess the association between problematic smartphone usage and anxiety and depression in adolescents.

Methods

A cross-sectional study in five schools in the UK were included. The primary outcome was moderate anxiety (GAD-7 ≥10) symptoms and secondary outcomes were moderate depression symptoms (PHQ-9 ≥10) and insomnia. Problematic smartphone 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 enrolled. The median age was 17.5 years (17–18 [IQR]) and 508 (77.3%) were female. Of these 188 (28.6%) exhibited moderate anxiety and 226 (34.4%) moderate depression symptoms. Almost two thirds (421, 64.1%) have tried to cut down their smartphone use and 81 (12.5%) wanted help to reduce use. Problematic smartphone use was associated 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 not associated with anxiety (β = 0.99, 95% CI 0.91–1.08); or depression (β = 0.98, 95% CI 0.89–1.07). Problematic smartphone use had a significant direct, indirect and total effect on both anxiety and depression.

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