الفهرس 
Smartphone AddictionOnly 14 pages are availabe for public view
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Abstract
Smartphones are popular devices capable of processing more information
than other phones; they include many features such as games, access to the Internet and social networks, messaging, videos, multimedia, and navigation, in addition to their use for communication. Access to the Internet is increasingly easy due to improvements in mobile technology and the prevalence of smartphones. (Wilmer, H.H., et al., 2017)
The booming use of smartphones and the fact that these phones encompass many features have raised the issue of smartphone addiction. Smartphone addiction is similar in many aspects to Internet addiction. Yet, there are also some differences, such as the easy portability, real-time Internet access and easy and direct communication features of smartphones. (Wyner, E.J., 2019)
Behaviour addictions, including smartphone addiction, are generally difficult to define because they are related not only to physical, but also to social and psychological factors. The core features of behavioural addiction include the following: sustained engagement in a behaviour despite its negative effects, decreased control over participation in the behaviour, compulsive participation, and appetitive or craving urges that instantly precede engagement in the behaviour. (Zhang KZ, 2014)
based on the definition of Internet addiction, smartphone addiction has been defined as the overuse of smartphones to the extent that it disturbs users’ daily lives. Remarkably, Addiction manifests itself in various forms such as preoccupation, tolerance, lack of control, withdrawal, mood modification, conflict, lies, excessive use and loss of interest. (Soni, R.,2017)
Excess smartphone use can cause physical health-related problems such as blurred vision and pain in the wrists or neck. Moreover, smartphone overuse may lead to some mental or behavioural problems. It may cause maladaptive behavioural difficulties, interfere with school or work, reduce real-life social interaction, and lead to relationship disorders. (Chen et al., 2017)
In a study conducted on smartphone users, it was found that state anxiety, trait anxiety, and depression were higher in the smartphone overuse group than in the normal use group. Poor sleep quality has emerged as a relevant public health problem in technologically advanced societies. In particular, it can be a risk factor for depression, loneliness, anxiety and sleep disturbances. (Xie, W. and Karan, K., 2019)
Depressive and anxiety disorders are two main common disorders that are highly prevalent globally, as over 300 million people are estimated to suffer from depression, which is equivalent to 4.4% of the world’s population. they mainly affecting young adults at their most active years. As per the DSM-5 and ICD-10, people with depression experience an unhappy mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. (Sjoberg, L., 2017)
It is speculated that not only addiction to smartphone usage can affect one’s mental and behavioural status, but also that those with mood disorders are more likely to become addicted to using their smartphones.
Numerous tools have been utilized in literature to assess the same phenomenon, but with different terms such as excessive smart phone usage, smartphone addiction, dependency on smart phones, internet addiction problematic mobile phone usage. (Hussain, et al., 2017)
High levels of smartphone addiction were correlated with low self-esteem, loneliness, depression and shyness. Depression is a general reflection of the psychological wellbeing that is thought to be highly correlated with addiction to smartphone usage. The majority of studies on this issue revealed that there is a relationship between these two variables; however, all these studies were conducted in specific populations. (Yuchang., et al., 2017)
Successful management of the smartphone addiction and if depression and anxiety present can decrease the clinical outcome and severity so this study aimed to Determine the prevalence of smartphone addiction among medical students, Determine the gender differences in the levels of mobile phone addiction and find the relation between severity of smartphone addiction and severity of depression and anxiety.
Methodology
• Cross section study (observational) was used
• The study was carried out at Faculty of Medicine, Ain Shams University.
• Total number of 400 participants was included in the study
• An informed written consent was obtained from all subjects enrolled in the study after explaining in details the aim of the work and assuring the confidentiality of each subject.
• The subjects were assessed using the following measure:
1. A designed sheet including: age, gender, Academic year.
2. The general screening part of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) (First et al., 1994), It was translated and validated to an Arabic version.
3. General Health Questionnaire (GHQ-12).
4. Smartphone Addiction Scale (SAS) – Short Version
a. The Arabic version was used, it was translated and validated
5. Hamilton Depression Rating Scale: Arabic version was used after being translated and validated
6. Taylor Manifest Anxiety Scale: Arabic version was used after being translated and validated.
The main findings in this study were
The mean ± standard deviation of the age of participants was 20.2± 2.6.
The total number of participants was 400 of which 64.8% were considered smartphone addicts, and of the smartphone addict group 34.8% had generalized anxiety disorder and 27.5% had major depressive disorder.
Out of the female participants, 70% of them were on the high-risk group for smartphone addiction while out of the male participants only 59.5% were of high-risk group for smartphone addiction.
there was statistically significant increase High risk for development of smartphone addiction in females. (p value=0.028)
one hundred and forty-six participants (36.5%) had Evidence of distress and Severe psychological distress was detected in 57 participants (14.2%).
there was high statistical significance between high risk of smartphone addiction development (SAS results) and psychological stress (GHQ results) in male and female participants. (p value in both =0.001)
27.5% of high-risk group for smartphone addiction development had major depressive disorder out of them 42.9% had Mild depression, 26.2% had Moderate depression and 29.2% had Severe depression.
34.8% of high-risk group for smartphone addiction development had generalized anxiety disorder and of them 51.9% had Mild anxiety symptoms, 28.8% had Moderate anxiety symptoms and 19.2% had Severe anxiety symptoms.
A positive moderate correlation was found between smartphone addiction and severity of depression and anxiety, high statistical significance was found between severity of smartphone addiction (SAS results) and severity of depression and anxiety (HDRS and TMAS result)
1. The cross-sectional nature of the study renders making an inference of the causal relationships between the variables impossible, and future researchers should adopt a longitudinal research design to examine causality.
2. The study was conducted among students in faculty of medicine Ain Shams University, yet broader range would be recommended.
3. sample size was difficult due to refusal of few students to participate, owing to denying agreement for psychiatric assessment.
4. Moreover, all of the participants were university students with a limited number of the sample, and may not represent the total population. Longitudinal studies and samples with different educational and age backgrounds are needed.
5. The cross-sectional design, which is not the best way to evaluate causal relations, also limited the results.
Conclusion
from the findings of the present study, it can be concluded that:
• The total number of participants was 400 of which 64.8% were considered smartphone addicts, and of the smartphone addict group 34.8% had generalized anxiety disorder and 27.5% had major depressive disorder.
• Out of the female participants, 70% of them were on the high-risk group for smartphone addiction while out of the male participants only 59.5% were of high-risk group for smartphone addiction.
• there was statistically significant increase High risk for development of smartphone addiction in females. (p value=0.028)
• one hundred and forty-six participants (36.5%) had Evidence of distress and Severe psychological distress was detected in 57 participants (14.2%).
• that there was high statistical significance between high risk of smartphone addiction development (SAS results) and psychological stress (GHQ results) in male and female participants. (p value in both =0.001)
• 27.5% of high-risk group for smartphone addiction development had major depressive disorder out of them 42.9% had Mild depression, 26.2% had Moderate depression and 29.2% had Severe depression.
• 34.8% of high-risk group for smartphone addiction development had generalized anxiety disorder and of them 51.9% had Mild anxiety symptoms, 28.8% had Moderate anxiety symptoms and 19.2% had Severe anxiety symptoms.
• A positive moderate correlation was found between smartphone addiction and severity of depression and anxiety, high statistical significance was found between severity of smartphone addiction (SAS results) and severity of depression and anxiety (HDRS and TMAS results)
Recommendation
Based on the forgoing conclusions
Clinical Recommendations:
• Increasing awareness of psychiatrists and all mental health workers about Behavioural addiction types and their impact on mental health.
• Screen routinely for the presence of smartphone addiction or other types of behavioral addiction.
• Awareness to self-monitor the symptoms for smartphone addiction.
• Proper treatment if symptoms of depression or anxiety appear to break the vicious circle and prevent increase severity.
• Spreading the awareness of the reasonable usage of smart phones, especially among students who could be at higher risk of depression.
Research Recommendations:
• Study on both undergraduate and postgraduate students also across different population to compare and give more generalized results and valuable outcomes is recommended.
• Study the impacts of smartphone addiction on the mental health as general not only depression and anxiety.
• The relationship between depression, anxiety and smartphone addiction is an escalating global concern that necessitates future studies to investigate further on this aspect.