Effects of pornographic content consumption on anxiety and depression: A systematic review and meta-analysis (Preprint)

BACKGROUND The consumption of pornographic content has become increasingly prevalent in today’s digital age. Although pornography use is often viewed as recreational or harmless, emerging evidence suggests that frequent, compulsive or problematic use may worsen mental health. Hence, this study aims to review the existing literature to investigate the effects of pornographic consumption on anxiety and depression, while examining factors affecting consumption. OBJECTIVE This study aims to investigate the effects of pornographic consumption on anxiety and depression. METHODS We systematically searched PubMed, Embase, Cochrane, and PsycINFO for all studies that examined anxiety and depression in pornographic content consumers (PCC). PRISMA reporting guidelines were followed. Random effects meta-analyses were conducted for the primary analysis using correlation coefficients (COR) and standardised mean differences (SMD). A synthesis without meta-analysis approach was further performed to examine factors affecting pornography consumption. RESULTS A total of 19 studies were included. Overall meta-analysis indicated significant positive correlations between pornographic consumption and both anxiety (COR=0.16, 95%CI: 0.08; 0.25) and depression (COR=0.24, 95%CI: 0.15; 0.32). Subgroup analyses found that PCC who were less than 25 years old showed a stronger correlation with anxiety compared to older users (COR=0.22 vs COR=0.16, p=0.0321). Systematically reviewing the studies found that male gender and younger age significantly increased pornographic content consumption. CONCLUSIONS The study found significant positive correlations between pornographic consumption and both anxiety and depression, with an increased effect on younger users. This highlights the need for targeted interventions and public education about these associations and suggests that pornographic use assessments may be relevant in mental health evaluations.