Mental Health Center, School of Public Health, Southern Medical University, Guangzhou 510515, China.
Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China.
Addict Behav. 2024 May;152:107969. doi: 10.1016/j.addbeh.2024.107969. Epub 2024 Jan 24.
Problematic smartphone use (PSU) has been suggested to present with depressive symptoms and suicidal ideation (SI) as well as sleep disturbance, lack of social support, and emotional isolation. The aim of this systematic review and meta-analysis was to evaluate the association between PSU with depressive symptoms and SI in university students, and to determine the potential influence of the coronavirus disease 2019 (COVID-19) outbreak.
Observational studies pertinent to our research were identified through comprehensive searches of the PubMed, Embase, Cochrane Library, and Web of Science databases. To account for potential heterogeneity, the random-effects models were employed to aggregate the findings.
Eighteen datasets from 17 case-control studies, including 24,019 university students, were included. Among them, 8,775 (36.5 %) had PSU. A higher prevalence of depressive symptoms (odds ratio [OR]: 2.40, 95 % confidence interval [CI]: 2.19 to 2.63, p < 0.001; prediction interval: 1.95 to 2.96) was observed in university students with higher scores for PSU measures. A subgroup analysis showed a stronger association between PSU and depressive symptoms after the COVID-19 outbreak as compared to that before the outbreak (OR: 2.76 versus 2.16, p for subgroup difference = 0.002), which explained the heterogeneity. The association between PSU and depressive symptoms in university students was similar to those reported in studies from China and other countries, and in studies with different quality scores. Finally, a meta-analysis of three studies suggested that PSU was also associated with the prevalence of SI (OR: 2.18, 95 % CI: 1.77 to 2.68, p < 0.001; I = 0 %).
In university students, PSU may be a risk factor for depressive symptoms and SI, and the association between PSU and depressive symptoms became stronger after the COVID-19 outbreak.
有研究表明，智能手机使用问题（PSU）与抑郁症状和自杀意念（SI）以及睡眠障碍、社会支持不足和情感孤立有关。本系统评价和荟萃分析的目的是评估大学生中 PSU 与抑郁症状和 SI 的相关性，并确定 2019 年冠状病毒病（COVID-19）大流行的潜在影响。
通过全面检索 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库，确定了与我们的研究相关的观察性研究。为了考虑潜在的异质性，采用随机效应模型对研究结果进行汇总。
纳入了 17 项病例对照研究的 18 组数据集，共纳入 24019 名大学生。其中，8775 人（36.5%）有 PSU。PSU 得分较高的大学生抑郁症状的发生率更高（优势比 [OR]：2.40，95%置信区间 [CI]：2.19 至 2.63，p<0.001；预测区间：1.95 至 2.96）。亚组分析显示，与 COVID-19 爆发前相比，COVID-19 爆发后 PSU 与抑郁症状之间的相关性更强（OR：2.76 与 2.16，p 亚组差异=0.002），这解释了异质性。PSU 与大学生抑郁症状之间的关联与来自中国和其他国家的研究以及不同质量评分研究报告的结果相似。最后，三项研究的荟萃分析表明，PSU 也与 SI 的患病率相关（OR：2.18，95%CI：1.77 至 2.68，p<0.001；I=0%）。
在大学生中，PSU 可能是抑郁症状和 SI 的危险因素，并且 COVID-19 爆发后 PSU 与抑郁症状之间的关联变得更强。
