Background
Smartphones have become essential components of daily life, and research into the harmful effects of problematic smartphone use (PSU) on mental health is expanding globally. Although several recent studies have addressed the relationship between PSU and mental health in the Middle East and North Africa (MENA) region, this issue has yet to be synthesized and critically evaluated.
Methods
To find quantitative observational studies on the relationship between PSU and mental health in the MENA region, we developed a search strategy based on a search equation and adapted it for four databases. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the selection process. This review included approximately 33 cross-sectional studies and one cohort study out of the 6423 studies identified. The only available language was English. All identified studies published until October 8th, 2021, were considered. A modified Newcastle-Ottawa scale was used to assess the quality of the included studies, as we were interested in three mental health outcomes: depression, anxiety, and stress.
Results
The studies enrolled 21696 people and had low to moderate methodological quality. The prevalence of PSU ranges from 4.3 percent to 97.8 percent. The time factor (average duration of use per day, frequency of use, consultation during the night), type of application used on the smartphone, and socio-demographic characteristics were the determinants of PSU (age, gender, marital status). Depression, anxiety, and stress were all strongly correlated with PSU, with a stronger relationship between PSU and depression (0.164 ≤ r ≤ 0.996) than between PSU and anxiety (0.12 ≤ r ≤ 0.562) or stress (0.14 ≤ r ≤ 0.508).
Conclusions
PSU is a real public health issue because it is linked to mental illnesses and social dysfunctions that are a wearisome burden on society. As a result, more epidemiological studies, particularly longitudinal ones that respect the quality of evidence, are needed in all MENA countries to better plan, and implement preventive measures to avoid devastating complications for individuals and societies.
Systematic review registration:
an a priori protocol is registered on PROSPERO under the number CRD42022266732.