Association of excessive mobile usage with generalized anxiety disorder in psychiatric outpatient setting : a matched case control study

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Generalized anxiety disorder (GAD) is an important psychiatric morbidity. Its prevalence ranges from 1.7% to 7%. Factors having causal association with GAD have been classified into genetic and psychological factors. One important contextual factor is the concept of repetitive thoughts (RTs). GAD is the unconstructive outcome of different types of RTs. Worry is the most important of these RTs for causing GAD. Mobile phone is a communication technology gadget. It is reported to be one of the most omnipresent electronic devices. Though it is a communication device, its repetitive purposeless usage could get out of one's control. Excessive mobile phone usage has been the focus of recent research. The pattern of mobile phone usage leading to RTs and GAD is unknown. We hypothesized that addictive behavior related to mobile phone use is associated with GAD. The objective of our current study is to check the association between GAD and excessive mobile phone usage. Further, we also wanted to assess the association between frequency of SMS exchange and frequency of call with GAD. Method: In-order to achieve the specified objective we carried out a matched casecontrol study. The study was carried out in Psychiatric clinics of Aga Khan University Hospital and Jinnah Postgraduate Medical Center Karachi. Cases were individuals with GAD. Hospital Anxiety and depression scale adjusted for anxiety (HADS — A) was used to identify patients with GAD. Two controls, matched for age, gender and site were recruited from medical outpatient department. Cell phone addiction scale was used to collect information on mobile phone usage. Quantitative aspect of mobile phone use was determined by mobile exposure questionnaire. Conditional logistic regression was used to compute the crude and adjusted odds ratio using SPSS version 19. Results: A total of 200 cases and 402 controls were enrolled. The mean age (± SD) in years for cases and controls was 21.9 (3.4) and 21.6 (3.6). Three models were constructed based on excessive mobile phone usage, frequency of SMSs sent and frequency of calls received as the main exposure variables. The association of GAD was found to be significant for excessive mobile phone usage (adjusted OR = 2.1; 95% CI: 1.4, 3.0) and frequency of sent SMSs (adjusted OR = 1.8; 95% CI: 1.2, 2.6). Frequency of calls exchanged was not significant in the final model. (adjusted OR = 1.2; 95% CI: Q.8, 1.9). Conclusion and recommendations: This study showed a significant association between excessive mobile phone usage and GAD. Additionally more than fifty SMSs sent per day were found to be associated with GAD. Cohort study is needed to explore causal association between excessive mobile phone usage and GAD. Phenomenological inquiries are needed to explore precise thought constructs responsible for this association. Psychiatrists should advice patients with GAD to regulate their mobile phone usage.

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