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

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