‘There’s more to life than staring at a small screen’: A mixed methods cohort study of problematic smartphone use and the relationship to anxiety, depression and sleep in 13–16-year-old students in the UK

Ben Carter, Najma Ahmed, Olivia Cassidy, Oliver Pearson, Maria Georgala, Marilia Calcia Calcia, Clare Mackie, Nicola Kalk

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Depression and anxiety are common in adolescents and have increased over the last decade. During that period smartphone usage has become ubiquitous.
Objectives
The study aim was to assess the association between problematic smartphone usage (PSU) and anxiety.
Methods
Using a prospective mixed-methods cohort study design, 13-16 year olds from two schools were enrolled regarding their smartphone use, mood and sleep via a semi-structured questionnaire at baseline and week-4. The primary outcome was symptoms of anxiety (GAD-7) and exposure was PSU (Smartphone Addiction Scale short-version). A linear regression was fitted to assess the change in anxiety. Thematic analysis of free text responses was conducted.
Findings
The sample included 69 participants that were enrolled and followed up between 28th March to 3rd June 2022. Of those with PSU, 44.4% exhibited symptoms of moderate to severe anxiety, compared to 26.4% of those without PSU. There was a linear association between change in symptoms of anxiety and PSU β=0.18 (95%CI 0.04-0.32;p=0.013). Several themes were found: both positive and negative effects of smartphones on relationships; negative effects on school performance and productivity; mixed effects on mood; a desire to reduce the amount of time spent on smartphones.

Conclusions
Increased anxiety, depression and inability to sleep were seen in participants as their PSU score increased over time. Participants reported both positive and negative effects of smartphones and almost all used strategies to reduce use.

Clinical Implications
Interventions need to be developed and evaluated for those seeking support.
Original languageEnglish
JournalBMJ mental health
Publication statusAccepted/In press - 8 Jun 2024

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