Phubbing and social media addiction in patients with epilepsy: A cross-sectional case-control study

Problematic smartphone use, phubbing behavior, and social media addiction have emerged as important behavioral concerns. Although psychiatric comorbidities are common in epilepsy, data regarding digital behavioral addictions in epilepsy remain limited. This study aimed to evaluate phubbing, smartphone addiction, and social media addiction in adults with epilepsy (AWE) compared with healthy controls and to investigate their associations with psychological and epilepsy-related clinical variables.

This cross-sectional case-control study included 102 AWE and 102 age- and sex-matched healthy controls. Participants completed validated scales assessing phubbing, social media addiction, smartphone addiction, depression, and anxiety. Correlation analyses and bootstrap-based path analyses were performed.

Healthy controls demonstrated significantly higher general phubbing, nomophobia, smartphone addiction, and social media addiction scores than AWE (all p < 0.01). In contrast, AWE had significantly higher depressive symptom scores (p < 0.001). Anxiety symptoms emerged as the strongest predictor of behavioral addiction-related measures in both groups. Hospital Anxiety and Depression Scale - Anxiety subscale (HADS-A) scores significantly predicted general phubbing, smartphone addiction, and social media addiction in both AWE and healthy controls (all p < 0.001). Epilepsy-related clinical variables showed minimal associations with problematic digital behaviors. TikTok use was significantly more prevalent among AWE than healthy controls (23.5% vs. 3.9%, p < 0.001).

AWE did not demonstrate greater problematic smartphone or social media use compared with healthy controls, despite exhibiting higher depressive symptom burden. Anxiety symptoms appeared to represent the principal correlate of problematic digital engagement independent of epilepsy-related clinical characteristics.