Social media addiction in five major mental disorders: a cross-sectional comparative study

Social media addiction (SMA) is an increasingly prevalent and significant public health concern. While the relationship between SMA and mental health symptoms, such as anxiety and depression, is well established in the general population, the prevalence, severity, and associations of SMA with mental health symptoms among individuals with mental disorders have not been sufficiently investigated. This study aimed to evaluate the prevalence and severity of SMA, as well as its associations with anxiety and depression symptoms, in diagnostic groups including anxiety disorders (AD), depressive disorders (DD), bipolar disorder (BD), schizophrenia spectrum disorders (SSD), and obsessive-compulsive disorder (OCD).

A total of 707 patients and 162 healthy controls participated in this cross-sectional comparative study conducted in Türkiye. Participants were assessed using the Sociodemographic Data Form, the Bergen Social Media Addiction Scale (BSMAS), and the Hospital Anxiety and Depression Scale. For the BSMAS, the liberal approach defined the cutoff as obtaining a score of three or more on at least four of the six items, while the conservative approach required a score of three or more on all six items. Group comparisons, correlation analyses, and logistic regression analyses were employed for the statistical analyses.

According to the liberal BSMAS criterion, the prevalence of SMA was highest in the OCD group (44.6%, 95% CI = 35.3% - 54.3%) and lowest in the SSD group (20.8%, 95% CI = 14.5% - 28.9%). Compared to the control group, the OCD group was associated with a higher risk of SMA under both the liberal (OR = 2.45, 95% CI = 1.39-4.31) and conservative (OR = 3.68, 95% CI = 1.58-8.59) criteria. BSMAS scores were significantly higher in the OCD, AD, and DD groups than in the controls. Significant positive correlations were observed between SMA severity and anxiety and depression levels in the AD, DD, and BD groups. In contrast, these associations were not significant in the OCD and SSD groups. Logistic regression analysis showed that when applying the conservative criterion, AD, BD, SSD, and OCD diagnoses could be independent risk factors for SMA.

The findings suggest that major mental disorders may be risk factors for SMA. While co-occurring anxiety and depression symptoms play an important role in this relationship, they only partially explain the association, suggesting that additional mechanisms independent of these symptoms may also be influential, especially in OCD and BD. It is recommended that social media use habits be routinely evaluated in individuals with mental disorders and that comprehensive intervention strategies be developed.

Not applicable.