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, students aged 13-16 year old from two schools were enrolled regarding their smartphone use, mood and sleep via a semistructured questionnaire at baseline and week 4. The primary outcome was symptoms of anxiety (Generalised Anxiety Disorder Questionnaire, 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 28 March and 3 June 2022. Of those with PSU, 44.4% exhibited symptoms of moderate to severe anxiety compared with 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 to 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.

中文翻译：

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“生活不仅仅是盯着小屏幕”：一项混合方法队列研究，针对英国 13-16 岁学生的智能手机使用问题及其与焦虑、抑郁和睡眠的关系。


背景技术抑郁和焦虑在青少年中很常见，并且在过去十年中有所增加。在此期间，智能手机的使用已变得无处不在。目的 该研究的目的是评估智能手机使用问题 (PSU) 与焦虑之间的关联。方法 采用前瞻性混合方法队列研究设计，在基线和第 4 周通过半结构化问卷调查来自两所学校的 13-16 岁学生的智能手机使用情况、情绪和睡眠情况。主要结果是焦虑症状（广泛性焦虑）障碍问卷，GAD-7）和暴露是 PSU（智能手机成瘾量表短版）。拟合线性回归来评估焦虑的变化。对自由文本回复进行了主题分析。结果 该样本包括 2022 年 3 月 28 日至 6 月 3 日期间登记和随访的 69 名参与者。在患有 PSU 的参与者中，44.4% 表现出中度至重度焦虑症状，而没有 PSU 的参与者中这一比例为 26.4%。焦虑症状的变化与 PSU β=0.18 之间存在线性相关（95% CI 0.04 至 0.32，p=0.013）。发现了几个主题：智能手机对人际关系的积极和消极影响；对学校表现和生产力的负面影响；对情绪的影响参差不齐；希望减少花在智能手机上的时间。结论 随着 PSU 评分随着时间的推移而增加，参与者的焦虑、抑郁和睡眠障碍也会增加。参与者报告了智能手机的积极和消极影响，几乎所有人都采取了减少使用的策略。临床意义 需要为那些寻求支持的人制定和评估干预措施。