Peer Reviewed Articles About Relationship Between Anxiety and Technology

• Journal List
• J Med Internet Res
• 5.22(8); 2020 Aug
• PMC7481866

J Med Cyberspace Res. 2020 Aug; 22(8): e16388.

Relationship Betwixt Depression and the Utilise of Mobile Technologies and Social Media Among Adolescents: Umbrella Review

Monitoring Editor: Gunther Eysenbach

Jorge Arias-de la Torre, MSc, PhD, ^{# ane, 2, iii, 4} Elisa Puigdomenech, MSc,^{# 3, five} Xavier García, MSc,³ Jose M Valderas, Md, PhD, Prof Dr,⁶ Francisco Jose Eiroa-Orosa, MSc, PhD,⁷ Tania Fernández-Villa, MSc, PhD,⁴ Antonio J Molina, MSc, PhD,⁴ Vicente Martín, MD, PhD, Prof Dr,^{ii, 4} Antoni Serrano-Blanco, MD, PhD,^{two, 8} Jordi Alonso, Doctor, PhD, Prof Dr,^{2, 9, 10} and Mireia Espallargues, MD, PhD^{iii, 5}

ⁱ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom,

² CIBER Epidemiología y Salud Pública, Barcelona, Spain,

³ Bureau for Wellness Quality and Assessment of Catalonia, Barcelona, Spain,

^four Plant of Biomedicine, University of Leon, Leon, Spain,

⁵ Health Services and Chronic Diseases Enquiry Network, Barcelona, Spain,

⁶ Health Services and Policy Research Group, Academy of Exeter Medical Schoolhouse, Exeter, United Kingdom,

⁷ Section of Personality, Assessment and Psychological Handling, Department of Clinical Psychology and Psychobiology, Academy of Barcelona, Barcelona, Spain,

⁸ Parc Sanitari Sant Joan de Déu, Barcelona, Espana,

⁹ Health Services Enquiry Group, Hospital del Mar Medical Research Plant, Barcelona, Spain,

¹⁰ Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,

Jorge Arias-de la Torre, Institute of Psychiatry, Psychology and Neuroscience, Rex'due south College London, xvi De Crespigny Park, Denmark Hill campus, London, SE5 8AF, United Kingdom, Phone: 44 634722677, Email: moc.liamg@errotaledsairaegroj.

Jorge Arias-de la Torre

¹ Institute of Psychiatry, Psychology and Neuroscience, King'southward College London, London, United Kingdom,

² CIBER Epidemiología y Salud Pública, Barcelona, Espana,

^three Agency for Wellness Quality and Assessment of Catalonia, Barcelona, Espana,

^four Establish of Biomedicine, Academy of Leon, Leon, Spain,

Elisa Puigdomenech

ⁱⁱⁱ Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain,

^v Wellness Services and Chronic Diseases Research Network, Barcelona, Spain,

Xavier García

³ Bureau for Health Quality and Cess of Catalonia, Barcelona, Espana,

Jose M Valderas

⁶ Health Services and Policy Inquiry Group, University of Exeter Medical School, Exeter, United kingdom of great britain and northern ireland,

Francisco Jose Eiroa-Orosa

⁷ Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain,

Tania Fernández-Villa

⁴ Institute of Biomedicine, University of Leon, Leon, Espana,

Antonio J Molina

⁴ Institute of Biomedicine, University of Leon, Leon, Kingdom of spain,

Vicente Martín

ⁱⁱ CIBER Epidemiología y Salud Pública, Barcelona, Spain,

⁴ Establish of Biomedicine, University of Leon, Leon, Spain,

Antoni Serrano-Blanco

² CIBER Epidemiología y Salud Pública, Barcelona, Spain,

⁸ Parc Sanitari Sant Joan de Déu, Barcelona, Spain,

Jordi Alonso

² CIBER Epidemiología y Salud Pública, Barcelona, Spain,

⁹ Health Services Enquiry Group, Infirmary del Mar Medical Enquiry Institute, Barcelona, Spain,

^x Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,

Mireia Espallargues

^three Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain,

^v Health Services and Chronic Diseases Research Network, Barcelona, Espana,

Received 2019 Sep 25; Revisions requested 2020 May 14; Revised 2020 May 21; Accustomed 2020 Jun 3.

Abstract

Groundwork

Despite the relevance of mobile technologies and social media (MTSM) for adolescents, their association with depressive disorders in this population remains unclear. While there are previous reviews that have identified the use of MTSM as a risk factor for developing low, other reviews have indicated their possible preventive effect.

Objective

The aim of this review was to synthesize the current evidence on the association between MTSM utilise and the development or prevention of depressive disorders in adolescents.

Methods

An umbrella review was conducted using data published up to June 2019 from PubMed/MEDLINE, PsycINFO, Web of Science, and The Cochrane Library. Systematic reviews focusing on the adolescent population (upwards to 20 years quondam) and low and its potential relationship with MTSM apply were included. Screening of titles, abstracts, and total texts was performed. After selecting the reviews and given the heterogeneity of the result variables and exposures, a narrative synthesis of the results was carried out.

Results

The search retrieved 338 documents, from which 7 systematic reviews (iii meta-analyses) were selected for data extraction. There were 11-70 studies and 5582-46,015 participants included in the 7 reviews. All reviews included quantitative research, and two reviews too included qualitative studies. A statistically significant clan between social media and developing depressive symptoms was reported in 2 reviews, while v reviews reported mixed results.

Conclusions

Excessive social comparing and personal involvement when using MTSM could exist associated with the development of depressive symptomatology. Even so, MTSM might promote social support and fifty-fifty go a betoken of assist for people with low. Due to the mixed results, prospective research could be valuable for providing stronger evidence.

Keywords: mobile technologies and social media, low, adolescents, review

Introduction

Low is one of the nigh frequently occurring mental diseases worldwide, generating significant disability, dependence, and expenditure for health systems [1-4]. As shown in previous literature [5-10], boyhood is a specially relevant period for developing depressive disorders. Information technology should be noted that during boyhood, depressive symptomatology may exist broader than in adulthood, manifesting itself through irritability, aggression, avoidance, or other behaviors in improver to the typical depressive behaviors [11]. Furthermore, during this menses, young people tin can exist particularly influenced past sociocontextual factors, such as the use of mobile technologies and social media (MTSM). Nevertheless, the effect of the exposure to these technologies on the development of depressive disorders in this age group remains unclear.

The employ of MTSM has greatly increased over recent years, particularly since the 1990s, and adolescents can now be considered "digital natives," meaning they have been exposed to mobile devices and technologies like cellphones or tablets since birth [12-xiv]. This generalized exposure to social media implies a change in the way adolescents interact and communicate, naturally integrating the use of these technologies within their schemes of social perception [15,16]. Therefore, the use of MTSM could be especially relevant, given the potential influence on adolescents' health, specifically their mental health and the evolution or prevention of depression.

One of the main uses of MTSM amid adolescents is communication and social interaction with their peer groups through various means, including instant messaging apps (eg, WhatsApp and social networks). A few that stand up out for their use in this population are Instagram, Snapchat, Twitter, and Facebook [15,17]. Using MTSM could evidence benign in the sense that they may promote creativity, increase presence and social participation, and provide adolescents with quick access to different types of information, including that related to promoting healthy behaviors and habits [12,13,18]. However, the use of MTSM could also be related to problems similar addictive internet beliefs, absenteeism and failure in school, deterioration of family unit relationships and friendships, and different physical and mental health issues (including cocky-inflicted actual impairment, eating disorders, and depression) [12,13,19]. Furthermore, MTSM apply may also promote behavior that is damaging to health including, among other things, autolytic behavior, suicide, violence, and specific harmful behaviors such as cyberbullying, grooming, or sexting that are derived from the use of these technologies. Despite the affluence of literature, including systematic reviews and meta-analyses, almost of the existing evidence is based on cross-sectional studies or surveys. Pooling or synthesizing data and using the broadest possible arroyo (eg, an umbrella review) could exist valuable in determining the current knowledge on whether the use of MTSM is the cause or issue of depressive symptomatology.

Although there is a wide variety of advantages and disadvantages that the apply of new technologies can present for immature people, the influence that their use could accept on developing low is unclear. Therefore, the aim of this review was to synthesize the evidence available on the association (intensity and direction) between low and the use of MTSM in adolescents.

Methods

Study Design and Information Sources

An umbrella review on the association between the use of MTSM and low was conducted, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria (PRISMA), and registered in PROSPERO. The post-obit databases were used equally sources of information: PubMed/MEDLINE, PsycINFO, Spider web of Science, and Cochrane Reviews. All documents included in these databases published up to June 2019 were considered.

A search filter (Multimedia Appendix ane) was specifically designed to attain the study objectives, taking into account pathology, target population, exposure (social network OR social media OR mobile telephone OR *phone), and the languages in which the search was performed. After carrying out a preliminary search and observing the number of systematic reviews and meta-analyses establish also equally the differences between the studies, an additional filter for report design was included. The filter was designed for PubMed/MEDLINE and adapted for other databases. The search strategy was based on previous studies in other areas with the intention of maximizing the number of identified documents [xx,21]. In addition, the references in the final selected studies were used to identify other systematic reviews and meta-analyses, and key authors were contacted.

Inclusion and Exclusion Criteria

The PICO (Population, Intervention, Comparison, and Consequence) criteria were used to identify and include reviews in English that focused on the adolescent population (upwardly to 20 years onetime), depression (in a broad sense, non specific diagnoses like major depressive disorder or dysthymia), and the possible relationship between depression and the use of MTSM.

Reviews that included studies with participants older than 20 years and studies that did not differentiate the effect by age group, if they included people older than twenty years, were excluded. Due to difficulties in extrapolating the results for the full general adolescent population, studies on genetic or environmental factors and studies carried out in specific population groups, like those with specific characteristics or pathologies (eg, attention arrears hyperactivity disorder), were excluded. Finally, studies focusing on treatments administered through an electronic device or the internet every bit well as opinion manufactures and proposals with theoretical or conceptual frameworks that were not based on a systematic literature review or meta-assay were also excluded.

Review Procedure

A review of titles, abstracts, and full texts was carried out independently by two expert reviewers (JAT and XG), and discrepancies were resolved by a third researcher (EP) with expertise in conducting systematic reviews. Subsequently report selection, a synthesis of the evidence obtained from the 7 selected reviews was carried out. The quality of each review was considered past taking into account the quality of the studies evaluated and the tools used to appraise the studies. Owing to heterogeneity in the characteristics of the studies and in the presentation of outcome variables and exposures, a meta-analysis of the results was non possible; therefore, a narrative synthesis of the results was carried out. Information from the included reviews was extracted and summarized in 2 tables of evidence [22].

Results

The search retrieved 338 articles (154 from PubMed, lxxx from the Cochrane Library, 41 from PsycINFO, 55 from Spider web of Science, and viii from a manual search). After removing 34 duplicates, a total of 304 studies were deemed potentially eligible. The total text of 20 documents was reviewed, and 13 articles were excluded (vii non-systematic or narrative reviews, 5 documents based on other pathologies, and 1 for the inability to differentiate between results reported for adults versus adolescents). Finally, vii systematic reviews were selected for information extraction (Figure 1) [21,23-30].

Flow diagram of the review process.

Table ane shows the characteristics of the included systematic reviews, all of which were published between 2014 and 2019. In these reviews, PsycINFO, Medline, and CINAHL databases were searched most frequently. 2 reviews explored dissertations and thesis databases [25,31]. Most reviews assessed the relationship between depression and utilise of social networks in general [23,25,26,28] or problematic Facebook use in particular [31]. Ane study by Wu et al [29] reviewed the clan between internet use in general and depression. Wellbeing, anxiety, and loneliness were as well assessed in 2 reviews [26,29]. There were 11-70 studies and 5582-46,015 participants included in the reviews. Most studies included in the reviews were quantitative and used cantankerous-sectional and survey-based data. While 2 reviews used specific criteria adult by the authors to appraise the quality of studies [29,31], 4 used validated assessment tools [21,23,26,28], and 1 did not specify the tool [25]. In addition, 2 meta-analyses were included [25,31].

Tabular array one

Characteristics of the included reviews.

Writer (year)	Objective of the review	Databases searched	Number of studies included	Number of participants	Quality assessment of studies included	Methodology
Best et al (2014) [21]	To assess the impact of social media utilize on mental wellbeing in young people	ASSIAa, Advice abstracts, CINAHL, ERICb, Medline (Ovid), PsycINFO (Ovid), SCOPUS, SSCIc	43	NSd	Specific criteria developed past the authors of the review	32 quantitative, ix qualitative, ii mixed methods or others
Wu et al (2016) [29]	To examine the clan between internet utilize, social connectedness, and levels of depression, feet, and loneliness	CINAHL, ERIC, Psychology and Behavioral Series Collection, Scientific discipline and Technology Collection, EBSCO social sciences database	12	5582	Specific criteria developed past the authors of the review	9 quantitative (all cross-sectional), i mixed methods, and 2 qualitative
Seabrook et al (2016) [26]	To examine the relationship between the use of social networks and depression and anxiety likewise as links with wellbeing and potential mediators and moderators of these relationships	PsycINFO, MEDLINE (Ovid), Scopus, IEEE Xplore, CINAHL, Instruction Resource Information Center, SSCI, Communication and Mass Media Consummate	lxx	46,015	Adaptation of the Cochrane bias tool	NS
McCrae et al (2017) [23]	To examine the association betwixt social media (websites used primarily for social interaction) and low or depressive symptoms	Medline, PsycINFO, EMBASE	eleven	12,646	Robins-Idue east, Cochrane Collaboration Methods Grouping Tool to appraise gamble of bias in cohort studies	Quantitative (7 cross-sectional, 4 longitudinal)
Marino et al (2018) [31]	To examine the clan between Facebook utilize (problematic, abusive, overuse, compulsive) and psychological disorders in adolescents and young adults	PsycINFO, PubMed, Scopus, ResearchGate, Google Scholar, Dissertation Abstracts International, Pro-Quest Dissertations and Theses Open up, Open Access Theses and Dissertations	23	13,929	Specific criteria adult past the authors of the review	Quantitative
Keles et al (2019) [28]	To examine the influence of using social networks on depression in adolescents	PsycINFO, Medline, EMBASE, CINAHL, SSCI	13	21,231	NIHf	Quantitative (12 cantankerous-sectional, 1 longitudinal)
Yoon et al (2019) [25]	To examine the relationship between the employ of social networking sites and depression	PsycINFO, PubMed, ProQuest Dissertations & Theses Global	55	22,099	NS	Quantitative

Table 2 shows the results of the included reviews. Four studies were undertaken specifically with adolescents (age range 10-21 years) [21,23,28,29]. Seabrook et al [26] also included adults in their review (ii studies with adults and 18 studies with the general population), and Marino et al [31] reported a mean age range of 16.5-32.4 years. While 2 reviews reported a positive association between depressive symptoms and social media use (overall random effects pooled estimate: r=0.13, 95% CI 0.05-0.2) [23] and problematic Facebook use (r=0.34, 95% CI 0.28-0.39) [31], the other five reviews reported mixed associations between social media use and depression. Keles et al [28] reported a positive association for the relationships betwixt time spent on social media and depression and between social media addiction and depression. Two reviews reported a gender influence with mixed furnishings [23]. McCrae et al [23] found that 4 studies reported girls having more depressive symptoms related to social media utilise and two studies showed that boys were more likely to bear witness depressive symptoms. The remainder of the studies included in their review did non show a gender result. In the review past Keles et al [28], i study found that social media might have negative effects in girls but could be considered a positive leisure activity for boys, and 2 studies did not show gender effects. In addition to mixed results for the associations between social media use and wellbeing, associations with feet and loneliness were likewise found [21,26,29].

Table two

Results of the included reviews.

Author (year)	Sample (number of studies) or historic period (years)	Utilise of MTSMa	Association(southward)	Gender effect	Other associations
All-time et al (2014) [21]	Adolescents (age range non specified)	Communication and social interaction	Mixed results in the association of social media technologies and depression	Does not distinguish nor consider this factor	Mixed results on self-esteem, social support, loneliness, and cyberbullying
Wu et al (2016) [29]	ten-21	Use of internet and related technologies	1 of 5 studies establish that social media engineering science utilise can lead to depressive feelings; 4 of 5 studies did not detect an clan.	Takes into account the population of the studies (10 mixed gender, 2 merely boys), but not in terms of the results	Mixed results on social connectivity, feet, and loneliness
Seabrook et al (2016) [26]	Adolescents (8), young adults (40), full general population (18), adults (2), clinical depression (1), others (ane)	Use of social networks	Mixed results: positive interactions, social support, and connectivity in social networks related with lower levels of depression; negative interactions and social comparison related with higher levels of low	Not considered every bit a variable in the included studies but considered in the give-and-take of the results	Mixed results for anxiety and wellbeing
McCrae et al (2017) [23]	ten-17 (one written report included "high school students" but did not specify age range)	Use of social media	Minor but statistically significant overall correlation between social media use and depressive symptoms	4 studies found that girls had more depressive symptoms related to social media employ; two studies showed that boys were more than likely to bear witness depressive symptoms; the residue showed no gender differences	NSb
Marino et al (2018) [31]	Mean 21.nine (SD 3.97); 16.5-32.4 (mean age range)	Problematic Facebook utilize	Association between problematic Facebook use and depression	Proportion of girls (60.7%) did not moderate the issue	Correlation between problematic Facebook use and psychological distress was greater in samples with a higher mean age.
Keles et al (2019) [28]	thirteen-18	Fourth dimension spent, action (quality and quantity of user's engagement and interaction with social media sets and other users), investment (time spent on social media), addiction (land of existence dependent on social media)	Time spent: 1 study showed association, 1 did not, ii did not notice association; activity: ii studies showed positive association, and ane did not; investment: three studies showed association; addiction: iii studies showed positive association	iv studies measured the consequence of gender between social media–related variables and mental health outcomes. 2 studies did not find effects on gender, while i found that social media might have negative furnishings in girls and can be considered a positive leisure activity for boys. Facebook had a negative touch on on both genders.	There was a relationship betwixt age, heavy social media use, and negatively internalizing symptoms. Younger adolescents were more likely to experience internalizing symptoms (beingness anxious, depressed, withdrawn). Most studies highlighted the fact that the relationships observed were too complex for straightforward statements and mediating and moderating factors should exist taken into account.
Yoon et al (2019) [25]	17.83-24.76 (mean historic period range)	Use of SNSc: time spent and SNS checking; social comparison and "upwards" social comparison	Positive statistically meaning deviation betwixt depression and time spent on its employ, frequency of employ, social comparing, and "upwards" comparison	No difference	NS

Word

The results from the included reviews advise that social comparison and excessive personal involvement by adolescents when using MTSM could be related to the development of depressive symptoms. However, the use of MTSM when properly adapted could as well promote healthy behaviors, meliorate social back up, and even go a indicate of access of information and help for adolescents at risk of depression.

Both mobile technologies and social media are important aspects of how we interact today and have transformed the way in which the generations adopting MTSM and digital natives communicate [18,32]. The use of MTSM presents great opportunities in terms of creativity and ways of learning but can too entail certain risks such every bit isolation and restricted social interaction. Despite this, studying the possible effects on health, specifically on depression, of adolescents using MTSM is a relatively recent miracle. Every bit such, it should be noted that all reviews included in this study were published in the concluding v years.

The evidence from dissimilar studies published until at present, and particularly since 2017, suggests a positive and meaning association between some aspects of social media utilise and the presence of depressive symptoms among adolescents [23-25]. Two relevant factors that increased the magnitude of this association were the problematic use of social networks and excessive social comparison [23-25]. In that location is less relevant bear witness pointing to other factors related to the undesirable furnishings of social networks, like a higher level of personal interest on the networks, defined every bit the degree of exposure and personal information that adolescents publish on networks or the exposure to content that promotes depressive-like behaviors [27,28]. Finally, it is worth mentioning that a high volume of studies indicating associations between the utilize of social networks and other undesirable effects like feet, harassment, or net or smartphone addiction was identified [21,26,28-30]. Regarding internet habit, the full usage time, frequency of consultation, and other variables related to excess use, both in frequency and fourth dimension, may be more relevant than the variables found in this study, which focus specifically on depressive symptomatology.

It should exist noted that the impact of the identified factors, specially of social comparison, on the development of low might exist affected by the level of the welfare and wealth of the family unit [7-12]. Appropriately, those who are from families with lower socioeconomic status might have a high take chances of developing depression when exposed to more wealthy people. In addition, these factors might exist especially related to the development of some specific depressive symptoms (eg, sleep bug or diminished ability to call back or concentrate). Farther longitudinal inquiry focused on specific factors, like family surround, and accounting for specific depressive symptoms might be valuable in preventing the potential evolution of low in MTSM users.

Emphasizing the fact that social networks do not necessarily imply a negative impact on young people'south moods, other studies have described the desirable effects that social media apply might take [12,33,34]. In this sense and in line with the results of these studies, the evidence found in this study suggests that social networks can promote social back up and even get points of access to information and help for people with depressive disorders [26,27]. Every bit suggested, the use of MTSM under adult supervision might be related to promoting healthy use of MTSM, every bit well every bit preventing possible negative consequences that ascend like depressive symptomatology [35]. In addition, the use of new technologies could facilitate immature people's connection with multiple social circles, reducing their perception of loneliness or isolation [29].

Some studies identified differences between boys and girls in the impact that social networks have on developing depressive symptoms. Previous inquiry proposed [xxx] that the prevalence of intensive use of mobile technologies might exist greater in women than in men. Furthermore, the use of mobile technologies could be mainly for relational purposes amongst teenage women and instrumental or for leisure among teenage men, making women more than likely to be exposed to the effects of social networks [23,24,28]. Although the meta-analysis past McCrae et al [23] did not make up one's mind a theoretical footing for the potential differences, there are some studies included within the analysis and ane report included in the systematic review by Keles et al [28] that show a greater correlation betwixt social comparison and depression in women. This might allow us to hypothesize that focusing preventive measures on social comparison in adolescent women and on leisure platforms, similar gaming platforms, in boyish men could be effective in preventing the undesirable furnishings of social networks and mobile technology use amid adolescents. Further research aimed at proving this hypothesis could be valuable.

Several limitations of the current study deserve word. Outset is the lack of longitudinal or experimental evidence in relation to the utilize of social networks and mobile technologies and their impact on depressive symptomatology. In this sense, most of the studies included in the literature reviewed were cross-sectional and survey-based, precluding the establishment of causal relationships between variables. As such, it is difficult to decide whether the utilize of social networks and mobile technologies is the cause or consequence of depressive symptomatology, and further longitudinal studies to test these hypotheses could be valuable. We should also mention the possible heterogeneity of health problems and of the patterns made or activities observed in the studies when using MTSM. While some were focused on clinical low diagnosed by a professional, others were focused on less valid depression criteria, which could limit the comparability of the reviews included. Furthermore, some of the reviews included cyberspace addicts. Despite this, the broad aim of this review was to make up one's mind the relationship between depressive disorders and the use of MTSM, which we consider completed through the studies included in this article, independent of the depression metrics and specific populations used in the selected reviews.

Another limitation is the lack of solid evidence or a conceptual framework on the specific behaviors, like online gaming or uploading photos to social networks, that could be related to depressive symptomatology. This lack of evidence may be due to the relative novelty of the social network phenomenon and the shortage of valid, reliable wellness information pertaining to it. However, certain behaviors that could be related to the development of depression as a protective factor were identified, like searching for help or preventive information. Another limitation is that but reviews in English were included, perhaps omitting scientific literature written in other languages. Finally, nosotros should mention the limitation of having actively excluded studies on cyberbullying, addiction to new technologies, or other symptoms and harmful behaviors that could be role of or related to a depressive disease. Given their importance and the affluence of evidence on these phenomena, these behaviors deserve to be treated as separate entities, and, equally previous research suggests, specific reviews should exist performed on these behaviors [21,26].

In conclusion, our study shows that, during boyhood, the use of MTSM and specially excessive social comparison and personal involvement when using it could be associated with developing depressive symptomatology. Nevertheless, the adaptive utilise of MTSM could as well aid prevent the development of depression, promote social support, and even become a point of information access and help for people with depressive disorders or symptoms. Other variables, similar time spent on the internet and social networks, the frequency of consultation, and factors related to excess use, both in frequency and in time, may be more relevant in developing other problems like internet addiction. Due to the heterogeneity in methodology and the contradictory findings from the reviews included in this umbrella review, prospective research, especially longitudinal accomplice studies and randomized controlled trials, could be valuable in providing stronger evidence on these relationships.

Acknowledgments

We acknowledge Antoni Parada and Kayla Smith for their support and CIBER Epidemiology and Public Health (CIBERESP) for its funding.

Abbreviations

ASSIA	Applied Social Sciences Index and Abstracts
ERIC	Instruction Resource Information Center
MTSM	mobile technologies and social media
NIH	National Institutes of Wellness Quality Assessment Tool for Observational Cohort and Cantankerous-Sectional Studies
NS	not specified
PICO	Population, Intervention, Comparison and Effect
PRISMA	Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria
SSCI	Social Sciences Citation Alphabetize

Appendix

Multimedia Appendix 1

PubMed/MEDLINE filter.

Footnotes

Conflicts of Interest: None declared.

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Articles from Journal of Medical Internet Inquiry are provided here courtesy of Gunther Eysenbach

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481866/

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