Mental Health
The Effects of Problematic Smartphone Use on Adolescent Sleep and Mental Health: An Evaluation of Structural Associations Sheng-Hung Chu* Sheng-Hung Chu Yu-Ting Chin Pei-Wen Wu Pei-Tung Lin Jyun-Hao Guan Chien-Hung Lee
Background: Problematic smartphone use (PSU), which disrupts sleep patterns and reduces face-to-face social interactions, may significantly impact sleep problems and mental health. This study aimed to investigate the effects of PSU on sleep quality and depression in adolescents, as well as to explore their potential structural associations using structural equation modeling.
Methods: We examined 2,138 adolescents aged 14–19 years, randomly selected from 17 senior high schools in three areas with varying socioeconomic statuses in Taiwan. A questionnaire, consisting of 11 symptoms developed from the DSM-5 criteria for substance use disorder, was used to measure PSU. Participants with 0-1, 2-3, 4-5 and ≥6 DSM-5 symptoms were defined as no, mild, moderate, and severe PSU, respectively. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and disturbances, and the Center for Epidemiologic Studies Depression Scale (CES-D) was utilized to evaluate depressive symptoms. Generalized structural equation modeling was employed to analyze the relationships among PSU, sleep quality, and depression.
Results: The prevalence of DSM-5–defined mild, moderate, and severe PSU in adolescents was 12.9%, 17.6%, and 49.2%, respectively. Adolescents with mild, moderate, and severe PSU reported poorer sleep quality, with PSQI scores increased by 0.83, 1.05, and 2.09, respectively (all P<0.05). Adolescents with severe PSU had 3.1 higher CES-D scores for depressive symptoms. After adjusting for covariates, increased PSQI scores were significantly associated with higher CES-D scores (β=1.78, 95% CI: 1.64-1.92). Furthermore, sleep quality, latency, duration, disturbance, and daytime dysfunction mediated the relationship between smartphone usage time and depression scores.
Conclusion: Our findings indicate that PSU is linked to poorer sleep quality and depressive symptoms in adolescents, underscoring the need for targeted interventions to address PSU and improve mental health.