Associations of Electronic Device Addiction with Anxiety and Depression in Adults: Findings from Hong Kong Jockey Club FAMILY Project

Abstract

Background and Objectives: Excessive use of electronic device (e-device) such as smartphone, tablet and computer is associated with psychopathology in adolescents but less is known in adults. A shorter time to first e-device use after getting up in the morning is indicative of e-device addiction. We examined the associations of time to first e-device use upon waking with risks of anxiety and depressive disorders in a representative sample of general adults in Hong Kong. Methods: A random sample of 2941 e-device users aged 18+ years (mean 46.2, 39.3% men) participated in a population-based telephone interview under the Hong Kong Family and Health Information Trend Survey (FHInTS) in 2016. Exposure measure was time to first e-devices use upon waking (categorized into > 60 mins/ 31-60 mins/ 6-30 mins/ ≤ 5 mins). Outcome measures were anxiety and depression, each defined by a score of 3+ on a scale of 0-6, assessed by the Patient Health Questionnaire-4 (PHQ-4). Data were weighted by the age, gender and education level distributions of the Hong Kong general population. Poisson regression with robust variance estimator was used to yield the prevalence ratios (PR) of anxiety and depression in relation to time to first e-device use upon waking, adjusting for age, gender, education level and household income. Results: The weighted prevalence (95% CI) of time to first e-device use upon waking were 36.3% (34.8-37.8%) for > 60 mins, 14.2% (13.1-15.3%) for 31-60 mins, 22.4% (21.1-23.7%) for 6-30 mins and 27.2% (25.8-28.6%) for ≤ 5 mins. Anxiety, depression, and both conditions were reported by 11.3% (10.2-12.5%), 7.6 (6.8-8.6%) and 4.9 (4.2-5.7%) of the respondents respectively. Participants who used e-device ≤ 5 mins upon waking (vs > 60mins) were more likely to be have anxiety (PR = 1.59, 95% CI 1.17-2.18), depression (1.92, 1.26- 2.92) and both conditions (2.15, 1.27-3.63). All P for trend < 0.05. Conclusions: A shorter time to first e-device use upon waking is associated with higher risk of anxiety and depression in Hong Kong adults. Given the widespread and rapid surge in e-device use worldwide, excessive e-device use may constitute an important public health issue which warrants further research.