Mobile Phone Use and Stress, Sleep Disturbances, and Symptoms of Depression among Young Adults - A Prospective Cohort Study

Sara Thomée; Annika Härenstam; Mats Hagberg

Disclosures

BMC Public Health. 2011;11 

In This Article

Results

Study Group Characteristics

Fifty-two percent of the men and 34% of the women were single at baseline. A majority of the respondents had completed upper secondary school, 13% of the men and 16% of the women had finished college or university studies, while 5% of the men and 6% of the women only elementary school. Fifty-one percent of the men and 41% of the women reported work as main occupation, while 40% of the men and 48% of the women studied, and 8% of the men and 12% women were categorized as other. Forty-three percent of the men and 56% of the women reported high social support, 41% of the men and 32% of the women reported medium social support, and 16% of the men and 13% of the women reported low social support.

A little more than half of the participants were categorized as having low mobile phone use (five or fewer calls and five or fewer SMS messages per day) and 22% of the men and 24% of the women as having high use (eleven or more calls or SMS messages per day) (Table 1). A massive majority reported that they were expected to be available on a daily basis and one out of four around the clock. Only a few percent found accessibility via mobile phones very stressful, while about half of the participants did not find it stressful at all. Most participants were never, or only on rare occasions, woken up by the mobile phone, and only a few reported being woken by the mobile phone on a weekly basis. Thirteen percent of the men and 22% of the women indicated that they themselves, or someone close to them, thought that they used the mobile phone too much, and 6 and 14%, respectively, had tried, but failed, to cut down on mobile phone use (Table 1).

The women reported stress almost twice as often as the men (29% compared to 16%) at baseline. Twenty-three percent of the men and 34% of the women indicated sleep disturbances. Of the men, 27% reported one and 24% two symptoms of depression, and of the women, 30% reported one and 34% two symptoms of depression. Among participants who were symptom-free at baseline (in outcome variable concerned), the prevalence at 1-year follow-up was as follows for the men and women, respectively; current stress: 10% and 19%, sleep disturbances: 15% and 20%, symptoms of depression (one item): 24% and 28%, and symptoms of depression (two items): 12% and 18%.

Drop-out Analysis

The drop-out group at the initial cohort baseline consisted of more men (a difference of 17 percentage points), were somewhat younger (an age difference of <0.1 years), more often married (a difference of 1.4 percentage points), and more often foreign-born (8 percentage points), compared to the study population invited to participate.[29] The final study group (n = 4156) consisted of almost twice as many women as men (65% vs. 35%). Compared to the initial cohort baseline (n = 7125), the study group participants were slightly less often single (40% compared to 42%), had a slightly higher educational level (with 15% compared to 14% having college or university level education, and 5% compared to 7% having completed only elementary school), and were less often working (44% compared to 48%) and more often studying (45% compared to 41%) at baseline. The level of mobile phone use was slightly lower in the study group; 54% were categorized as low mobile phone users compared to 51% in the initial cohort baseline, while 23% compared to 26% were categorized as frequent (high) mobile phone users.

Associations between the Mobile Phone Variables at Baseline

The frequency of mobile phone use variable had low positive correlations with all of the more qualitative mobile phone variables using Spearman correlation analysis (see Table 2). Furthermore, there were low positive (or little if any) associations between most qualitative mobile phone variables, and no association between availability demands and accessibility stress.

Mobile Phone Use and Social Support

Frequency of mobile phone use had little if any association with perceived access to social support for the men (r = 0.08, p < 0.01) and no association for the women (r = −0.01, p = 0.48).

Cross-sectional Associations between Mobile Phone Variables and Mental Health Outcomes at Baseline

There were positive associations between high compared to low mobile phone use and current stress, sleep disturbances, and symptoms of depression (two items) for both the men and the women, after adjusting for relationship status, educational level, and present occupation (Table 3). Among the more qualitative mobile phone variables, availability demands was associated with current stress and symptoms of depression (two items) for the men and with all mental health outcomes for the women. Being awakened at night was associated with current stress, sleep disturbances, and symptoms of depression (one and two items) for the men and women. For the men, overuse was associated with current stress, sleep disturbances, and symptoms of depression (two items), and for the women, overuse was associated with all mental health outcomes. The strongest associations (highest PRs) were found for accessibility stress in relation to the mental health outcomes. For the men, accessibility stress was associated with current stress and symptoms of depression (one and two items), and for the women, accessibility stress was associated with all mental health outcomes.

In all cross-sectional analyses, the high category of the exposure variables generated a higher or equivalent PR compared to the medium category, indicating a dose-response relationship between the exposure variables and mental health outcomes, though not all associations were statistically significant. All but three PRs (77/80) were greater than 1.0.

Prospective Associations between Mobile Phone Variables at Baseline and Mental Health Outcomes at 1-year Follow-up

When excluding participants reporting symptoms at baseline from the analysis of the outcome variable concerned, high compared to low mobile phone use at baseline was associated with reported sleep disturbances and symptoms of depression (one item) in the men (PR 1.8, CI 1.21–2.69 and PR 1.7, CI 1.14–2.46, respectively) and symptoms of depression (two items) in the women (PR 1.5, CI 1.02–2.24), at 1-year follow-up (Table 4).

There were no clear associations between availability demands or being awakened at night and the mental health outcomes. For women, medium overuse was associated with current stress and high and medium overuse was associated with sleep disturbances. High accessibility stress was associated with current stress, sleep disturbances, and symptoms of depression (two items) for both the men and the women. In the majority of analyses (32/40), the high category of the exposure variable generated a higher PR compared to the medium category.

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