Journal of Mental Health Issues and Behavior (JMHIB) ISSN 2799-1261 · Vol. 4, No. 02 (2024) · pp. 39-49
Research Paper

Patterns of smartphone addiction and associated factors: effects on mental health and academic performance in medical students

Dr. Rufaida Mubaraka1*, Dr. Mahmuda Ansari2, Dr. Kanij Ftaema Mukta3, Dr. A.S.M. Shahariar Ahmed4, Dr. Muhammad Imamuzzaman5
  1. 1 M.B.B.S\MPH (RCH)\ Assistant Professor\ Ashiyan Medical College, Dhaka, Bangladesh.
  2. 2 M.B.B.S \ MPH (CM)\ Assistant Professor\ Popular Medical College, Dhaka, Bangladesh.
  3. 3 M.B.B.S \ Resident, Department of Dermato-venerology, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
  4. 4 M.B.B.S \FIPM(India)\ RMC Hospital and Diagnostic Complex LTD, Dhaka, Bangladesh.
  5. 5 M.B.B.S. (DU), MPH (Community Medicine), MPH (Epidemiology), CCD (BIRDEM), Department of Orthopaedics and Traumatology, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
  6. * Corresponding author: Dr. Rufaida Mubaraka, mumammadimamuzzamanreaz@gmail.com
Received12 July 2024
Revised17 September 2024
Accepted25 September 2024
Published9 November 2024
DOIhttps://doi.org/10.55529/jmhib.45.11.21
LicenceCC BY 4.0
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Abstract

Background: Smartphones are now central to daily life, but their overuse increasingly recognized as a form of behavioral addiction has been linked to declines in mental health, physical wellbeing, and academic performance among young people, including medical students. Objective: To assess patterns of smartphone use and addiction among medical students and examine associated effects on mental health (depression, anxiety, stress) and academic performance. Methods: A descriptive cross-sectional study was conducted among 298 randomly selected medical students at a medical college in Dhaka, Bangladesh. Data were collected via face-to-face interviews using a pretested, validated interview schedule. Verbal informed consent was obtained from all participants, with full confidentiality and voluntary withdrawal rights assured. Data were analyzed in SPSS version 25.0 using descriptive statistics and the chi-square test. Results: Most participants (54.4%) were aged 18–22 years, 58.4% were female, and 89.6% were single. Nearly half (43.3%) self-identified as non-addicts of smartphone use, while 28.8% identified as addicts. Most students (53.4%) had no depression and 46.6% reported normal anxiety levels. A majority (63.4%) were at risk of social media addiction, and 46.6% used smartphones predominantly at night. Physical complaints included eye strain (54.4%), weight gain (46%), and back pain (36.2%). A statistically significant association (p<0.005) was found between social media addiction risk and perceived effect on exam performance. Conclusion: Medical students frequently use smartphones, particularly at night, and while most did not show elevated depression or anxiety, a substantial proportion were at risk of social media addiction and reported physical and academic consequences of smartphone overuse. Targeted awareness and moderation strategies are warranted.

Keywords: Medica Student, Smartphone, Depression, Stress, Anxiety.

1. INTRODUCTION

Smartphones have become part of our daily lives because of their diversified use. It contains numerous functions like gaming, social media apps, shopping apps, digital media apps, digital cameras, banking apps etc. However uncontrolled use of it is referred to as smartphone dependence. It significantly negatively affects individuals' daily and academic careers [1]. With the increasing number of smartphone users, there is also an increased number of problems related to smartphone overuse. Till now addiction from overuse of the internet was not listed as a psychiatric disorder. However, after numerous discussions with various stakeholders, some authorities recognized internet addiction as one of the types of addiction related to individual behaviours [2]. This problematic use of smartphones may affect medical students' professionalism. Individuals can't imagine even a day without the use of a smartphone. For some people, smartphone use is indispensable. In the healthcare delivery system, now smartphones are one of the most important tools. It is used for treatment guidelines, drugs drug-related information, and visualization of medical data like wound photographs or radiological images [3].

Numerous studies revealed that most young individuals including medical students use smartphones only for entertainment purposes despite it serving numerous other useful purposes [4]. Because of smartphone overuse, there may be economic problems and, in some cases, an increasing number of conflicts with parents as a consequence of overuse of smartphones. For many surveys, it was observed that smartphone use also had effects on campus life and interpersonal relations with their classmates [5]. Because of pathological smartphone use, individuals may suffer from loneliness, uncomfortably, restlessness or even feelings of incompleteness [6]. Several studies conducted on medical students found that smartphone addiction is significantly associated with sleeping behaviour problems. Depending on assessment instruments, smartphone addiction among various groups of people ranges from 0% to 38%. It is also evident that smartphone use is associated with the academic performance of students, and the daytime activities of medical professionals while also having a significant effect on their sleep duration or quality [7]. It is strongly associated with anxiety, depression, aggressiveness or delinquency. Despite mental health issues, it also causes numerous physical problems like neck pain, back pain, wrist pain, blurred vision of users and many other physical discomforts. However, beyond physical and mental health issues, it also has social impacts like problems in social interactions, problems in academic achievement and problems in social relationships [8].

2. RELATED WORK

Adolescents were more susceptible to developing smartphone addiction than younger people. Many other recent studies found that smartphone use was related to age, gender and health condition of the users. Young students' smartphone ownership rate is 8% higher than all other age groups [9]. A recent study conducted on medical students found that 44.7% of students had an addiction to smartphone use and 51.3% were suffering from poor quality of sleep. They also found a statistically significant association between smartphone use and poor sleep quality [7]. Nowadays, it is an important component of teaching and also gives access to their textbook and other internet-based learning tools. Smartphones can also benefit them by assessing their current educational standard through interactive quizzes [3]. Most internet users use smartphones through wireless connection and own a smartphone [10]. Smartphone overuse may result from the uncontrolled use of smartphones. Sometimes it causes negligence in other important activities. Some individuals may continue to use smartphones despite knowing their potential harm [11]. Considering the huge negative effect of smartphone use, researchers conducted a study to find out the risks related to smartphone use among young people [6]. Regarding using of digital devices, around 97% of individuals own smartphones, 2.9% play games, 19.4% used to watch TV and 12.4% reported using a PC [12]. A recent study found that 89.7% of medical students use the Internet for coursework, 88.7% to search for relevant information and 85.7% use Internet to watch movies or news [13]. A survey conducted by, found that around 21% of smartphone users reported having difficulties in their educational institutes or work place. It was also found that 45.8% had feelings of anxiety when they were not holding their smartphone, 27.1% opined to spending too much time with their smartphone but 22.6% tried to reduce their smartphone use time and failed more than once. That is why numerous scales were developed to measure the addiction to smartphone use level [8].

3. METHODOLOGY

This descriptive cross-sectional study was conducted at a selected medical college in Dhaka, Bangladesh, enrolled across various academic years. 298 students participated in the study and were selected through a simple random sampling method to minimize selection bias and enhance the findings' generalizability. The study was conducted to capture a snapshot of the relevant variables at a single time. Data collection was carried out using a structured face-to-face interview method. The principal investigator conducted the interviews using a pretested and validated interview schedule to ensure reliability and accuracy. The pretesting phase involved a pilot study with a small subset of students to identify any potential issues with the questionnaire and to refine the tool. This step ensured that the instrument was clear, unambiguous, and suitable for capturing the necessary information. Each interview was conducted in a private and comfortable setting to ensure participant privacy and encourage honest responses. The average duration of each interview was around 10 minutes. Before initiating the data collection process, the purpose and details of the study were clearly explained to each participant. Verbal informed consent was obtained from all participants. The study assured participants of full confidentiality and data were anonymized during analysis and reporting. Participants were also informed of their right to withdraw from the study at any point without providing a reason. It was emphasized that participation was voluntary, and there were no physical, social, or psychological risks associated with the study. Once the interviews were completed, the principal investigator carefully reviewed the completed questionnaires to ensure data accuracy, completeness, and consistency. Any discrepancies were promptly addressed by contacting the participant, where feasible, to clarify or correct any missing responses. Following the data collection, the data were entered into a database and analyzed using SPSS version 25.0. Descriptive statistics, including frequency distributions, percentages, means, and standard deviations, were used to summarize the data, providing a clear overview of the study population and their responses. In addition to descriptive analysis, inferential statistics were applied using the Chi-Square test to explore relationships between categorical variables. The results of the analyses were presented in the form of tables and diagrams to enhance clarity and facilitate the interpretation of findings.

4. RESULTS AND DISCUSSION

The age range of medical students was between 18 to 29 years old; most 162(54.4%) were from 18 to 22 years old with a mean age of 20.9±2.8 years. Around three-fifths 174(58.4%) were female and near two-fifths 124(41.6%) were male. A significant number 267(89.6%) of respondents were single and 31(10.4%) were married. Nearly all 287(96.3%) respondents had adjunct families while only 11(3.7%) had broken families. A significant number 93(31.2%) of medical students were in the first year, around one-fourths 71(23.8%) were in the second year, 54(18.1%) in the third year, 47(15.8%) were in the fourth year and 33(11.1%) were in the fifth year. More than four-fifths 258(86.6%) were hosteller and 40(13.4%) were day scholar. Nearly half 129(43.3%) opined themselves as non-addicts, 86(28.8%) revealed themselves as addicts to smartphones and 83(27.8%) were not sure about it. Regarding professional satisfaction, 187(62.7%) were delighted with their profession, 72(24.2%) had moderate satisfaction and 39(13.1%) had low satisfaction with their profession. The majority of 159(53.4%) medical students had no depression, 68(22.8%) had mild, 43(14.4%) had moderate and 28(9.4%) had severe depression.

Table 1. Respondents by Level of Depression
Table 1

Almost half 139(46.6%) had normal level of anxiety, 51(17.1%) had mild level, 62(20.8%) had moderate anxiety, 27(9.1%) had severe and only 19(6.4%) had extremely severe level of anxiety. Most of the respondents 217(72.8%) had one smartphone and the rest, which is more than one-fourths 81(27.2%) owned more than one smartphone. A significant number of 114(38.2%) respondents use smartphones for less than 2 hours, 79(26.5%) used it for 2 to 3 hours, 48(16.1%) used it for 3 to 4 hours and 57(19.2%) use the smartphone for more than 4 hours. Among the respondents, the majority 139(46.6%) use smartphones at night, 126(42.3%) use them in the evening, 27(9.1%) in the afternoon and 6(2%) use smartphones in the morning. All of them had access to both mobile data and wireless internet. Cent of cent medical students used smartphones for using social media, more than four-fifths 258(86.6%) used smartphones for academic purposes, 163(54.7%) used them for gaming and 67(22.9%) used them for other different purposes. Of students, nearly half 132(44.3%) had sleep more than 7 hours, around one-thirds 88(29.5%) had sleep duration around <7 to ≥6 hours, around one-fifths 58(19.5%) had sleep duration <6 to ≥5 hours and 20(6.7%) sleep for less than 5 hours. Regarding BMI, more than one-tenth 31(10.4%) were underweight, nearly half 141(47.3%) had normal weight, more than one-fourths 78(26.2%) were pre-obese and only 48(16.1%) were obese.

Figure 1
Figure 1. Respondents by BMI of the Students

More than one-thirds112(37.6%) smoke cigarettes and 186(62.4%) does not. A significant 224(75.2%) opined that their exam performance would be better if they didn’t use smartphones and 74(24.8%) revealed that smartphone use does not affect them. Among medical students, 218(73.5%) respondents had no parental rules due to smartphone use, 66(22.4%) had rules and 14(4.1%) didn’t want to answer the question. Majority of them 228(76.5%) check smartphone frequently while 70(23.5%) were not. Around one-thirds108(36.2%) opined to have high study stress, 156(52.3%) had a general level and 34(11.5%) had a low level of stress. Most of them 159(53.4%) had good relations with their classmates, 118(39.6%) had general and 21(7%) had poor relationships with their classmates. A significant number 189(63.4%) were at risk of social media addiction while 109(36.6%) were normal. The majority of 174(58.4%) students never awakened at night to use smartphones, 88(29.5%) use it occasionally, 24(8.1%) of few times and 12(4%) do it almost every day. More than half 162(54.4%) had eye strain, 138(46%) had weight gain and 108(36.2%) had back pain. There is also a statistically significant (p<0.005) association between the risk of social media addiction and the effect of social media use on their exam performance.

Table 2. Association between the Effect of Smartphone use on Exam and Risk of Social Media Addiction
Table 2

4.1 Discussion

Current study respondents were between 18 to 29 years while the majority 162(54.4%) of them were between 18 to 22 years with a mean age of 20.9±2.8 years. This is supported by the findings of Alkhateeb A and team, where the respondents were between 17 to 27 years with a mean age of 21.5±2.68 years [14]. A significant number 174(58.4%) were female and 124(41.6%) were male. This is more or less similar to the findings of Xin C and associates where 62.48% were female and 37.52% were male [15]. More than four-fifths 267(89.6%) of respondents were single and only 31(10.4%) were married. This is substantiated by findings of the study conducted by Salehi M and team, where 87% of medical students were single and 13% of them were married [16]. Almost cent 287(96.3%) had adjunct family while 11(3.7%) had broken family. This is vindicated by the findings of Chomon RJ found that 90.3% had adjunct families and 9.7% had broken families [17]. Around one-thirds 93(31.2%) were in the first year, approximately one-fourths 71(23.8%) were in second year, 54(18.1%) in third year, 47(15.8%) were in fourth year and 33(11.1%) were in fifth year. The findings of corroborate this study's conclusions where they found that 26.93% of their respondents were in the first year, 32.08% were in the second year, 20.40% were in the third year, 10.30% were in the fourth year and 10.30% were in the fifth year [18]. A significant number 258(86.6%) were hosteller and 40(13.4%) were day scholar. This is vindicated by the findings of where 94.70% were hostellers and 5.30% were day scholars [19]. Of the respondents, 129(43.3%) reported themselves as non-addict of smartphone use, 86(28.8%) opined themselves as addicts and 83(27.8%) were not sure about it. This is similar to the findings of Kwon M and their team who found that 57.8% reported themselves as non-addict of smartphone use, 24.8% were addicts and 17.4% didn’t know about it [20]. Regarding satisfaction with their profession, 187(62.7%) were highly satisfied with their profession, 72(24.2%) had moderate satisfaction and 39(13.1%) had low satisfaction with their profession. This is close to the study findings of where 45.1% were highly satisfied, 50.3% were mediumly satisfied and 4.7% had a low level of satisfaction with their profession [21]. More than half 159(53.4%) had no depression, 68(22.8%) had mild depression, 43(14.4%) had moderate and 28(9.4%) had severe depression. This is substantiated by findings of the study conducted by Chomon RJ where 41.35% had no depression or had minimal depressive symptoms, 16.03% had mild depression, 24.05% had moderate depression and 18.56% had severe depression [17]. The majority 139(46.6%) had normal level of anxiety, 51(17.1%) had mild anxiety, 62(20.8%) had moderate anxiety, 27(9.1%) had severe and only 19(6.4%) had extremely severe level of anxiety. This is more or less similar to the findings of where 38.5% had normal, 11.3% had mild, 19.3% had moderate, 13.8% had severe and 17.1% had extremely severe levels of anxiety [22]. Of medical students, 81(27.2%) owned more than one smartphone and 217(72.8%) had one smartphone. This is dissimilar to the findings of Said where they found that 88.4% of medical students had ≤1 smartphone and 11.6% had ≥2 smartphones. This difference might be attributed to variations in the study area and sample size [22].

Around two-fifths114(38.2%) of medical students use smartphone for <2 hours, 79(26.5%) used it for 2 to 3 hours, 48(16.1%) used it for 3 to 4 hours and 57(19.2%) use smartphone for more than 4 hours. This is more or less in line with the study finding of Machado J and team found that 32.6% used it for <2 hours, 21.1% for 2 to 3 hours, 18.5% for 3 to 4 hours and 27.8% used a smartphone for more than 4 hours [23]. Among the respondents, majority 139(46.6%) use smartphone at night, 126(42.3%) used it on evening, 27(9.1%) in afternoon and 6(2%) used smartphone at morning. This is close to the study findings of Machado J and associates found that around three-fifths 57.4% use smartphones at night, 39.3% in the evening, 3% in the afternoon and only 0.4% mostly use smartphones at night [23]. Cent per cent of medical students had access to both mobile data and wireless internet. This is not substantiated by the findings of the study conducted by where 63.8% had wireless internet, 5.5% had cable internet and 30.7% had access to mobile data. This difference might be attributed to variations in the study area and sample size [24]. Of the respondents, cent of cent medical students used smartphones for using social media, 258(86.6%) used smartphones for academic purposes, 163(54.7%) used them for gaming and 67(22.9%) used them for other different purposes. This is substantiated by findings of the study conducted by Al-Shahrani MS, where they found that 91.5% used smartphones for social media, 65.4% for academic purposes, 18.6% for athletics and 14.4% for other purposes [25]. Regarding the duration of sleep 132(44.3%) had sleep >7 hours, 88(29.5%) had sleep duration around <7 to ≥6 hours, 58(19.5%) had sleep duration <6 to ≥5 hours and 20(6.7%) sleep for less than 5 hours. This is more or less similar to the findings of Karim MR and team found that 49% had sleep duration of more than 7 hours, 29.3% for <7 and ≥6 hours, 14.2% for <6 and ≥5 hours and 7.5% for less than 5 hours [26].

Regarding BMI, 31(10.4%) were underweight, 141(47.3%) had normal weight, 78(26.2%) were pre-obese and 48(16.1%) were obese. This is corroborated by the findings of where 36.6% were underweight, 54.1% had normal weight, 7.8% were pre-obese and 1.5% were obese [27]. Of 298 respondents, more than one-thirds112(37.6%) smoke cigarettes and 186(62.4%) does not. This is similar to the findings of who found that 27.1% were smokers and 72.9% were not [28]. Around three-fourths 224(75.2%) opined that their exam performance would be better if they didn’t use smartphones, while 74(24.8%) revealed that smartphone use does not affect their exam performance. This is vindicated by the findings of Reddy S and team, where they found that 60% of respondents' exam performance would be affected by smartphone use [29]. Of the respondents, 218(73.5%) respondents had no parental rules due to smartphone use, 66(22.4%) had parental rules and 14(4.1%) didn’t want to answer. This is close to the study findings of where 79.5% had no parental rules, 17.5% had it and 3% didn’t want to disclose it [30]. Around three-fourths 228(76.5%) check smartphone frequently while 70(23.5%) were not. This is more or less similar to the findings of who found that 58.7% of medical students have the habit of checking their phones frequently [31]. Of the respondents, around one-thirds108(36.2%) of respondents opined to have high study stress, 156(52.3%) had a general level of stress and 34(11.5%) had a low level of stress. This is corroborated by the findings of where 29.9% had a high level of study stress, 47.4% had a general level and 22.7% had a low level of stress [32]. More than half 159(53.4%) had good relations with their classmates, 118(39.6%) had general and 21(7%) had poor relationships with their classmates. This is vindicated by the findings of who found that 48.5% had good, 48.7% had general and 2.8% had poor relationships with their classmates [33]. Around two-thirds 189(63.4%) were at risk of social media addiction while 109(36.6%) were normal. This is substantiated by findings of the study conducted by where they found that 76.95% of medical students had a risk of social media addiction and 23.05% were not [34]. Around three-fifths 174(58.4%) never awakened at night to usage smartphone, 88(29.5%) usage it occasionally, 24(8.1%) of few times and 12(4%) do it almost every day. The findings of Machado J corroborate this and the team found that 51.9% never use smartphones, 35.9% occasionally, 8.9% for few times a week and 3.3% do it almost every day [23]. Of the respondents, most 162(54.4%) had eye strain, 138(46%) had weight gain and 108(36.2%) had back pain. This is more or less in line with the findings of the study conducted by Daniyal M and associates found that among cell phone users around 33.5% suffered from eye strain but 39.5% had it for sometimes and 27.0% were not suffering from it. About 36.0% had weight gain among the users and 33% had weight gain for sometimes while 30.3% did not affect their weight. Of the respondents, 27% had back pain, 56% had it for sometimes while 17% had no problem in their back [35].

5. CONCLUSION

Medical students are young and most of them are single females. They have adjunct families but hostellers. Students are not addicted to smartphones and are satisfied with their profession with no depression. Most of them had normal levels of anxiety and owned one smartphone. Most of them use social media for significant duration at night with wireless internet. Students have normal weight and don’t smoke cigarettes. Their exam performance is affected by smartphone use but don’t have parental rules and are used to checking smartphones frequently. Medical students have general levels of stress and have good relations with their classmates while they are at risk of social media addiction. A significant don’t use smartphones at night but still have problems like eye strain, weight gain and back pain.

Acknowledgments

The authors have no specific acknowledgments to make for this research.

Funding Information

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author Contributions Statement

Name of AuthorCMSoVaFoIRDOEViSuPFu
Dr. Rufaida Mubaraka✓✓✓✓✓✓✓✓✓✓
Dr. Mahmuda Ansari✓✓✓✓✓✓✓✓✓✓✓✓
Dr. Kanij Ftaema Mukta✓✓✓✓✓✓✓✓✓✓✓
Dr. A.S.M. Shahariar Ahmed✓✓✓✓✓✓✓✓✓✓
Dr. Muhammad Imamuzzaman✓✓✓✓✓✓✓✓✓✓✓✓

C: Conceptualization; M: Methodology; So: Software; Va: Validation; Fo: Formal analysis; I: Investigation; R: Resources; D: Data curation; O: Writing – original draft; E: Writing – review & editing; Vi: Visualization; Su: Supervision; P: Project administration; Fu: Funding acquisition.

Conflict of Interest Statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Informed Consent

All participants were informed about the purpose of the study, and their voluntary consent was obtained prior to data collection.

Ethical Approval

Not Applicable.

Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. [1] T. Panova and X. Carbonell, 'Is smartphone addiction really an addiction?', J. Behav. Addict., vol. 7, no. 2, pp. 1-8, June 2018. doi.org/10.1556/2006.7.2018.49
  2. [2] M. Tateno et al., 'Internet addiction, smartphone addiction, and hikikomori trait in Japanese young adult: Social isolation and social network', Front. Psychiatry, vol. 10, p. 455, July 2019. doi.org/10.3389/fpsyt.2019.00455
  3. [3] L. M. Ramjan et al., 'The negative impact of smartphone usage on nursing students: An integrative literature review', Nurse Educ. Today, vol. 102, no. 104909, p. 104909, July 2021. doi.org/10.1016/j.nedt.2021.104909
  4. [4] M. Şata, İ. Çelik, Z. Ertürk, and T. Ue, 'The study of adapting smartphone addiction scale (SAS) for turkish high school students', Journal of Measurement and Evaluation in Education and Psychology, vol. 7, no. 1, pp. 156-169, 2016.
  5. [5] H. S. Choi, H. K. Lee, and J. C. Ha, 'The influence of smartphone addiction on mental health, campus life and personal relations-Focusing on K university students', Journal of the Korean Data and Information Science Society, vol. 23, no. 5, pp. 1005-1015, 2012. doi.org/10.7465/jkdi.2012.23.5.1005
  6. [6] D. F. Jacobs, 'A general theory of addictions: A new theoretical model', Journal of gambling behavior, vol. 2, pp. 15-31, Mar. 1986. doi.org/10.1007/BF01019931
  7. [7] V. A. Kumar, V. Chandrasekaran, and H. Brahadeeswari, 'Prevalence of smartphone addiction and its effects on sleep quality: A cross-sectional study among medical students', Ind Psychiatry J, vol. 28, pp. 82-85, 2019. doi.org/10.4103/ipj.ipj_56_19
  8. [8] S. W. Choi et al., 'Comparison of risk and protective factors associated with smartphone addiction and Internet addiction', J Behav Addict, vol. 4, pp. 308-314, 2015. doi.org/10.1556/2006.4.2015.043
  9. [9] Y. P. Hong, Y. O. Yeom, and M. H. Lim, 'Relationships between smartphone addiction and smartphone usage types, depression, ADHD, stress, interpersonal problems, and parenting attitude with middle school students', J. Korean Med. Sci., vol. 36, no. 19, p. e129, May 2021. doi.org/10.3346/jkms.2021.36.e129
  10. [10] No MS, Heo HN, Choi YJ, Lee HS. Survey on the internet usage. Ministry of Science and ICT and Korea Internet & Security Agency. 2017.
  11. [11] S. Y. Sohn, P. Rees, B. Wildridge, N. J. Kalk, and B. Carter, 'Prevalence of problematic smartphone usage and associated mental health outcomes amongst children and young people: a systematic review, meta-analysis and GRADE of the evidence', BMC Psychiatry, vol. 19, no. 1, p. 356, Nov. 2019. doi.org/10.1186/s12888-019-2350-x
  12. [12] F. Al-Mamun et al., 'Prevalence and factors associated with digital addiction among students taking university entrance tests: a GIS-based study', BMC Psychiatry, vol. 24, no. 1, p. 322, Apr. 2024. doi.org/10.1186/s12888-024-05737-9
  13. [13] H. Abbas, N. Rasheed, U. A. Mani, and M. Kumar, 'Internet addiction among MBBS students at a New Delhi medical college: Prevalence and determinants of a silent pandemic', J. Family Med. Prim. Care, vol. 13, no. 2, pp. 730-735, Feb. 2024. doi.org/10.4103/jfmpc.jfmpc_1242_23
  14. [14] A. Alkhateeb, R. Alboali, W. Alharbi, and O. Saleh, 'Smartphone addiction and its complications related to health and daily activities among university students in Saudi Arabia: A multicenter study', vol. 9, pp. 3220-3224, July 2020. doi.org/10.4103/jfmpc.jfmpc_1224_19
  15. [15] C. Xin, N. Ding, N. Jiang, H. Li, and D. Wen, 'Exploring the connection between parental bonding and smartphone addiction in Chinese medical students. Bmc Psychiatry', vol. 22, Nov. 2022. doi.org/10.1186/s12888-022-04355-7
  16. [16] M. Salehi, Z. Abbaspour, A. Molana, and N. Shahini, 'Impulsivity, inhibition, and internet addiction in medical students of North of Iran. Frontiers in psychiatry', vol. 13, Jan. 2023. doi.org/10.3389/fpsyt.2022.1002625
  17. [17] R. J. Chomon, 'Depression and suicidal ideation among medical students in a private medical college of Bangladesh. A cross sectional web based survey', PloS one, vol. 17, Apr. 2022. doi.org/10.1371/journal.pone.0265367
  18. [18] A. A. Alageel et al., 'Smartphone addiction and associated factors among postgraduate students in an Arabic sample: a cross-sectional study', BMC psychiatry, vol. 21, no. 1, June 2021. doi.org/10.1186/s12888-021-03285-0
  19. [19] S. Awasthi, A. Kaur, H. K. Solanki, G. Pamei, and M. Bhatt, Smartphone use and the quality of life of medical students in the Kumaun Region, vol. 9. Uttarakhand, 2020, pp. 4252-4258. doi.org/10.4103/jfmpc.jfmpc_805_20
  20. [20] M. Kwon, D. J. Kim, H. Cho, and S. Yang, 'The smartphone addiction scale: development and validation of a short version for adolescents. PloS one', vol. 8, Dec. 2013. doi.org/10.1037/t71126-000
  21. [21] H. Liu, Z. Zhou, E. Zhu, L. Huang, and M. Zhang, 'Smartphone addiction and its associated factors among freshmen medical students in China: a cross-sectional study', BMC psychiatry, vol. 22, May 2022. doi.org/10.1186/s12888-022-03957-5
  22. [22] A. H. Said, F. N. Mohd, M. Z. Yusof, N. A. Win, A. N. Mazlan, and A. S. Shaharudin, 'Prevalence of smartphone addiction and its associated factors among pre-clinical medical and dental students in a public university in Malaysia. Malaysian Family Physician: the Official Journal of the Academy of Family Physicians of Malaysia', vol. 17, Nov. 2022. doi.org/10.51866/oa.75
  23. [23] J. Machado, R. R. Pai, and R. R. Kotian, 'The pattern of smartphone usage, smartphone addiction, and associated subjective health problems associated with smartphone use among undergraduate nursing students', vol. 12, Feb. 2023. doi.org/10.4103/jehp.jehp_981_22
  24. [24] A. Amano et al., 'Internet addiction and associated factors among undergraduate students of Jimma University; Jimma, South West Ethiopia, institutional based cross-sectional study', BMC psychiatry, vol. 23, Oct. 2023. doi.org/10.1186/s12888-023-05197-7
  25. [25] A.-S. Ms, 'Smartphone addiction among medical students in Bisha, Saudi Arabia', Journal of Family Medicine and Primary Care, vol. 9, pp. 5916-5920, Dec. 2020. doi.org/10.4103/jfmpc.jfmpc_1205_20
  26. [26] M. R. Karim, H. U. Ahmed, and S. Akhter, 'Behavioral and psychosocial predictors of depression in Bangladeshi medical students: a cross-sectional study', F1000Research, vol. 11, 2022. doi.org/10.12688/f1000research.122927.1
  27. [27] S. Vaghasiya, N. Rajpopat, B. Parmar, K. A. Tailor, H. V. Patel, and J. Varma, 'Pattern of smartphone use, prevalence and correlates of problematic use of smartphone and social media among school going adolescents', Industrial Psychiatry Journal, vol. 32, no. 2, pp. 410-416, July 2023. doi.org/10.4103/ipj.ipj_53_23
  28. [28] F. Fekih-Romdhane, E. Lamloum, A. A. Loch, W. Cherif, M. Cheour, and S. Hallit, 'The relationship between internet gaming disorder and psychotic experiences: cyberbullying and insomnia severity as mediators', BMC psychiatry, vol. 23, Nov. 2023. doi.org/10.1186/s12888-023-05363-x
  29. [29] S. Reddy and C. Parmar, 'Attitude, Perception of 1st MBBS Students about Medical Teaching and Influence of Smart Mobile Phone. Applied sciences', vol. 16, pp. 71-77, 2017.
  30. [30] T. Lederer-Hutsteiner, K. W. Müller, M. Penker, E. Stolz, E. R. Greimel, and W. Freidl, 'The mediating effect of after-midnight use of digital media devices on the association of internet-related addictive behavior and insomnia in adolescents. Frontiers in Public Health', vol. 12, July 2024. doi.org/10.3389/fpubh.2024.1422157
  31. [31] Q. Zeerak, M. Imran, K. Azeez, T. H. Lokanathan, and I. M. Ismail, 'The Effects of Smartphone Addiction on Academic Performance Among Undergraduate Medical Students in Karnataka, India: A Multi-centric Study', Cureus, vol. 16, no. 6, June 2024. doi.org/10.7759/cureus.62796
  32. [32] M. Zhang et al., 'Prevalence of smartphone addiction and its relation with psychological distress and internet gaming disorder among medical college students', Frontiers in Public Health, vol. 12, June 2024. doi.org/10.3389/fpubh.2024.1362121
  33. [33] W. Dong, H. Tang, S. Wu, G. Lu, Y. Shang, and C. Chen, 'The effect of social anxiety on teenagers' internet addiction: the mediating role of loneliness and coping styles. BMC psychiatry', vol. 24, May 2024. doi.org/10.1186/s12888-024-05854-5
  34. [34] J. Sserunkuuma et al., 'Problematic use of the internet, smartphones, and social media among medical students and relationship with depression: An exploratory study. Plos one', vol. 18, May 2023. doi.org/10.1371/journal.pone.0286424
  35. [35] M. Daniyal, S. F. Javaid, A. Hassan, and M. A. Khan, 'The relationship between cellphone usage on the physical and mental wellbeing of university students: A cross-sectional study. International journal of environmental research and public health', vol. 19, July 2022. doi.org/10.3390/ijerph19159352

How to cite: Dr. Rufaida Mubaraka, Dr. Mahmuda Ansari, Dr. Kanij Ftaema Mukta, Dr. A.S.M. Shahariar Ahmed, Dr. Muhammad Imamuzzaman (2024). Patterns of smartphone addiction and associated factors: effects on mental health and academic performance in medical students. Journal of Mental Health Issues and Behavior, 4(02), 39-49. https://doi.org/10.55529/jmhib.45.11.21

Copyright © 2024 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0). Published by HM Publishers.