Background: The link between problematic social media (SM) use and socio-emotional deficits has limited clinical evidence. This study compares SM addiction risk and empathic abilities between psychiatric outpatients and healthy peers, exploring how SM categories and/or diagnostic category may modulate these relations. Methods: A total of 362 Italian adolescents (11–18 years; 147 cases, 215 controls) completed the Social-Media Disorder Scale (SOMEDIS), Bergen Social-Media Addiction Scale (BSMAS), Interpersonal Reactivity Index (IRI), and Reading the Mind in the Eyes test (RME). Self-reported daily online time and most used social media platforms were recorded. Results: Clinical participants showed higher mean SOMEDIS (M = 18.37) and BSMAS scores (M = 11.71) compared with controls (both p < 0.001). Females reported longer daily SM use (χ2 = 5.4, p = 0.020). Positive associations were observed between SM addiction risk and age. Within the clinical group, adolescents with emotional dysregulation displayed higher problematic use scores; a modest correlation emerged with internalizing symptoms (withdrawn—depression). Regarding empathy, higher SM addiction risk correlated with lower cognitive empathy (IRI Perspective Taking, Fantasy) and higher Personal Distress. Platform type showed small differences: users of “Profiling” platforms reported lower empathy scores compared to “Entertainment” users. Conclusions: Adolescents with psychiatric conditions appear more vulnerable to problematic SM use and reduced empathic abilities. Associations were modest, and platform effects were limited. These findings should be considered exploratory; larger longitudinal studies are needed to clarify causal pathways between SM use, empathy, and adolescent mental health.
Accorinti et al. (Sat,) studied this question.