Original Article

Addictive Use of Smartphones and Mental Disorders in University Students


Objective: Despite the awareness of smartphone addiction, low findings and lack of validated standards have led to insufficient information in this area. This study aimed to examine the relationship between mobile phone dependency and mental disorders in students in Iran, while controlling for the impact of gender, age, educational levels, and marital status.
Method: In this cross-sectional study, a sample of 1400 university students (445 males and 955 females) aged 18-35 years were selected from 3 cities of Tehran, Isfahan and Karaj. The participants filled out a set of questionnaires: Cell Phone Dependency Questionnaire (CPDQ), Millon Multiaxial Clinical Inventory, and participated in interviews. Data were analyzed using multiple logistic regression method via SPSS-22 software.
Results: In terms of controlling the demographic variables, the results revealed that bipolar disorder, depression, anxiety, somatization, dependent personality disorder, and compulsive personality disorder could increase the possibility of mobile phone addiction by 4.2, 4.2, 1.2, 2.8, 3.1, and 3.2 folds, respectively (P < 0.05). However, other disorders and demographic characteristics did not have any significant effects on the equation.
Conclusion: The results can help better understand the relationship between psychological syndromes and smartphone addiction and can also facilitate further studies in this field. In addition, those students with smartphone addiction should be provided with different preventative strategies. Moreover, a growing range of stimulating applications may trigger the risk of addiction.

1. Sapacz M, Rockman G, Clark J. Are we addicted to our cell phones? Comput Human Behav. 2016;57:153-9.
2. Lin YH, Lin YC, Lee YH, Lin PH, Lin SH, Chang LR, et al. Time distortion associated with smartphone addiction: Identifying smartphone addiction via a mobile application (App). J Psychiatr Res. 2015;65:139-45.
3. Kim J-H, Seo M, David P. Alleviating depression only to become problematic mobile phone users: Can face-to-face communication be the antidote? Comput Human Behav. 2015;51:440-7.
4. Saling LL, Haire M. Are you awake? Mobile phone use after lights out. Comput Human Behav. 2016;64:932-7.
5. Bae S-M. The relationship between the type of smartphone use and smartphone dependence of Korean adolescents: National survey study. Child Youth Serv Rev. 2017;81:207-2011.
6. Walsh SP, White KM, Young RM. Over-connected? A qualitative exploration of the relationship between Australian youth and their mobile phones. J Adolesc. 2008;31(1):77-92.
7. Argumosa-Villar L, Boada-Grau J, Vigil-Colet A. Exploratory investigation of theoretical predictors of nomophobia using the Mobile Phone Involvement Questionnaire (MPIQ). J Adolesc. 2017;56:127-35.
8. Cazzulino F, Burke RV, Muller V, Arbogast H, Upperman JS. Cell phones and young drivers: a systematic review regarding the association between psychological factors and prevention. Traffic Inj Prev. 2014;15(3):234-42.
9. Elhai JD, Dvorak RD, Levine JC, Hall BJ. Problematic smartphone use: A conceptual overview and systematic review of relations with anxiety and depression psychopathology. J Affect Disord. 2017;207:251-9.
10. Haigney D, Westerman SJ. Mobile (cellular) phone use and driving: a critical review of research methodology. Ergonomics. 2001;44(2):132-43.
11. McEvoy SP, Stevenson MR, McCartt AT, Woodward M, Haworth C, Palamara P, et al. Role of mobile phones in motor vehicle crashes resulting in hospital attendance: a case-crossover study. BMJ. 2005;331(7514):428.
12. Selwyn N. Schooling the Mobile Generation: The future for schools in the mobile-networked society. Br J Sociol Educ. 2003;24(2):131-44.
13. Lepp A, Barkley JE, Karpinski AC. The relationship between cell phone use, academic performance, anxiety, and satisfaction with life in college students. Comput Human Behav. 2014;31:343-50.
14. David P, Kim J-H, Brickman JS, Ran W, Curtis CM. Mobile phone distraction while studying. New media & society. 2015;17(10):1661-79.
15. Elhai JD, Yang H, Fang J, Bai X, Hall BJ. Depression and anxiety symptoms are related to problematic smartphone use severity in Chinese young adults: Fear of missing out as a mediator. Addict Behav. 2020;101:105962.
16. Han L, Geng J, Jou M, Gao F, Yang H. Relationship between shyness and mobile phone addiction in Chinese young adults: Mediating roles of self-control and attachment anxiety. Computers in Human Behavior. 2017;76:363-71.
17. Billieux J. Problematic use of the mobile phone: a literature review and a pathways model. Current Psychiatry Reviews. 2012;8(4):299-307.
18. Peele S, Brodsky A. Love and Addiction. NewYork: Taplinger; 1979.
19. Contractor AA, Frankfurt SB, Weiss NH, Elhai JD. Latent-level relations between DSM-5 PTSD symptom clusters and problematic smartphone use. Computers in human behavior. 2017;72:170-7.
20. Contractor AA, Weiss NH, Tull MT, Elhai JD. PTSD's relation with problematic smartphone use: Mediating role of impulsivity. Computers in Human Behavior. 2017;75:177-83.
21. Çağan Ö, Ünsal A, Çelik N. Evaluation of College Students’ the Level of Addiction to Cellular Phone and Investigation on the Relationsship between the Addiction and the Level of Depression. Procedia Soc Behav Sci. 2014;114(2014):831-9.
22. Alavi SS, Mohammadi MR, Jannatifard F, Mohammadi Kalhori S, Sepahbodi G, BabaReisi M, et al. Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder. Iran J Psychiatry. 2016;11(2):115-9.
23. Alavi SS, Ferdosi M, Jannatifard F, Eslami M, Alaghemandan H, Setare M. Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views. Int J Prev Med. 2012;3(4):290-4.
24. Demirci K, Akgönül M, Akpinar A. Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students. J Behav Addict. 2015;4(2):85-92.
25. Choliz M. Mobile phone addiction: a point of issue. Addiction. 2010;105(2):373-4.
26. Körmendi A, Brutoczki Z, Vegh BP, Szekely R. Smartphone use can be addictive? A case report. J Behav Addict. 2016;5(3):548-52.
27. Chen YF. The relationship of mobile phone use to addiction and depression amongst American college students. Mobile Communication and Social Change. 2004;10:344-52.
28. Babadi-Akashe Z, Zamani BE, Abedini Y, Akbari H, Hedayati N. The relationship between mental health and addiction to mobile phones among university students of Shahrekord, Iran. Addict Health. 2014;6(3-4):93-9.
29. Leung L. Linking psychological attributes to addiction and improper use of the mobile phone among adolescents in Hong Kong. J Child Media. 2008;2(2):93-113.
30. Jun S. The reciprocal longitudinal relationships between mobile phone addiction and depressive symptoms among Korean adolescents. Computers in Human Behavior. 2016;58:179-86.
31. Beranuy M, Oberst U, Carbonell X, Chamarro A. Problematic Internet and mobile phone use and clinical symptoms in college students: The role of emotional intelligence. Computers in Human Behavior. 2009;25(5):1182-7.
32. Hawi NS, Rupert MS. Impact of e-Discipline on Children's Screen Time. Cyberpsychol Behav Soc Netw. 2015;18(6):337-42.
33. Lee Y-K, Chang C-T, Lin Y, Cheng Z-H. The dark side of smartphone usage: Psychological traits, compulsive behavior and technostress. Computers in Human Behavior. 2014;31:373-83.
34. Samaha M, Hawi NS. Relationships among smartphone addiction, stress, academic performance, and satisfaction with life. Computers in Human Behavior. 2016;57:321-5.
35. Schou Andreassen C, Billieux J, Griffiths MD, Kuss DJ, Demetrovics Z, Mazzoni E, et al. The relationship between addictive use of social media and video games and symptoms of psychiatric disorders: A large-scale cross-sectional study. Psychol Addict Behav. 2016;30(2):252-62.
36. Romano M, Roaro A, Re F, Osborne LA, Truzoli R, Reed P. Problematic internet users' skin conductance and anxiety increase after exposure to the internet. Addict Behav. 2017;75:70-4.
37. Seo DG, Park Y, Kim MK, Park J. Mobile phone dependency and its impacts on adolescents’ social and academic behaviors. Computers in Human Behavior. 2016;63:282-92.
38. Hadlington LJ. Cognitive failures in daily life: Exploring the link with Internet addiction and problematic mobile phone use. Computers in Human Behavior. 2015;51:75-81.
39. Rosen LD, Whaling K, Rab S, Carrier LM, Cheever NA. Is Facebook creating “iDisorders”? The link between clinical symptoms of psychiatric disorders and technology use, attitudes and anxiety. Computers in Human Behavior. 2013;29(3):1243-54.
40. Matthews M, Murnane E, Snyder J, Guha S, Chang P, Doherty G, et al. The double-edged sword: A mixed methods study of the interplay between bipolar disorder and technology use. Computers in Human Behavior. 2017;75:288-300.
41. Weiss NH, Tull MT, Viana AG, Anestis MD, Gratz KL. Impulsive behaviors as an emotion regulation strategy: examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients. J Anxiety Disord. 2012;26(3):453-8.
42. Aljomaa SS, Al.Qudah MF, Albursan IS, Bakhiet SF, Abduljabbar AS. Smartphone addiction among university students in the light of some variables. Computers in Human Behavior. 2016;61:155-64.
43. Soderqvist F, Carlberg M, Hardell L. Use of wireless telephones and self-reported health symptoms: a population-based study among Swedish adolescents aged 15-19 years. Environ Health. 2008;7:18.
44. Kuss DJ, van Rooij AJ, Shorter GW, Griffiths MD, van de Mheen D. Internet addiction in adolescents: Prevalence and risk factors. Computers in Human Behavior. 2013;29(5):1987-96.
45. Goodman E, Huang B. Socioeconomic status, depressive symptoms, and adolescent substance use. Arch Pediatr Adolesc Med. 2002;156(5):448-53.
46. Sanchez-Martinez M, Otero A. Factors associated with cell phone use in adolescents in the community of Madrid (Spain). Cyberpsychol Behav Soc Netw. 2009;12(2):131-7.
47. Klerman GL. Clinical epidemiology of suicide. J Clin Psychiatry. 1987;48 Suppl:33-8.
48. Lewinsohn PM, Rohde P, Klein DN, Seeley JR. Natural course of adolescent major depressive disorder: I. Continuity into young adulthood. J Am Acad Child Adolesc Psychiatry. 1999;38(1):56-63.
49. Mok JY, Choi SW, Kim DJ, Choi JS, Lee J, Ahn H, et al. Latent class analysis on internet and smartphone addiction in college students. Neuropsychiatr Dis Treat. 2014;10:817-28.
50. Caparros BC, Hoz EV. Millon clinical multiaxial inventory III (MCMI-III) and communication styles in a sample of university students. Span J Psychol. 2013;16:E85.
51. Kawasaki N, Tanei S, Ogata F, Burapadaja S, Loetkham C, Nakamura T, et al. Survey on cellular phone usage on students in Thailand. J Physiol Anthropol. 2006;25(6):377-82.
52. Alavi SS, Maracy MR, Jannatifard F, Ojaghi R, Rezapour H. The psychometric properties of cellular phone dependency questionnaire in students of Isfahan: A pilot study. J Educ Health Promot. 2014;3:71.
53. Niecke A, Peters K, Samel C, Forster K, Lungen M, Pfaff H, et al. Mental Disorders in People Affected by Thalidomide. Dtsch Arztebl Int. 2017;114(10):168-74.
54. Duarte-Guerra LS, Coelho BM, Santo MA, Wang YP. Psychiatric disorders among obese patients seeking bariatric surgery: results of structured clinical interviews. Obes Surg. 2015;25(5):830-7.
55. Sharifi A, Molavi H, Namdari K.Diagnostic validity of Millon Clinical Multiaxial Inventory-III (MCMI-III).[Journal of knowledge and research in psycology(Persian)].2008;27-38.
56. Randler C, Wolfgang L, Matt K, Demirhan E, Horzum MB, Besoluk S. Smartphone addiction proneness in relation to sleep and morningness-eveningness in German adolescents. J Behav Addict. 2016;5(3):465-73.
57. Valkenburg PM, Peter J. Preadolescents' and adolescents' online communication and their closeness to friends. Dev Psychol. 2007;43(2):267-77.
58. Otero-Lopez JM, Villardefrancos E. Prevalence, sociodemographic factors, psychological distress, and coping strategies related to compulsive buying: a cross sectional study in Galicia, Spain. BMC Psychiatry. 2014;14:101.
59. Beranuy Fargues M, Chamarro Lusar A, Graner Jordania C, Carbonell Sanchez X. [Validation of two brief scales for Internet addiction and mobile phone problem use]. Psicothema. 2009;21(3):480-5.
60. Lopez-Fernandez O, Honrubia-Serrano ML, Freixa-Blanxart M. [Spanish adaptation of the "Mobile Phone Problem Use Scale" for adolescent population]. Adicciones. 2012;24(2):123-30.
61. Mohammadi M, Alavi SS, Farokhzad P, Jannatifard F, Mohammadi Kalhori S, Sepahbodi G, et al. The Validity and Reliability of the Persian Version Test of Mobile Phone Dependency (TMD). Iran J psychiatry. 2015;10(4):265-72
62. De-Sola J, Talledo H, Rodriguez de Fonseca F, Rubio G. Prevalence of problematic cell phone use in an adult population in Spain as assessed by the Mobile Phone Problem Use Scale (MPPUS). PLoS One. 2017;12(8):e0181184.
63. De-Sola Gutierrez J, Rodriguez de Fonseca F, Rubio G. Cell-Phone Addiction: A Review. Front Psychiatry. 2016;7:175.
64. Das A, Sharma MK, Thamilselvan P, Marimuthu P. Technology Addiction among Treatment Seekers for Psychological Problems: Implication for Screening in Mental Health Setting. Indian J Psychol Med. 2017;39(1):21-7.
65. Mohammadi Kalhori S, Mohammadi MR, Alavi SS, Jannatifard F, Sepahbodi G, Baba Reisi M, et al. Validation and Psychometric Properties of Mobile Phone Problematic Use Scale (MPPUS) in University Students of Tehran. Iran J psychiatry. 2015;10(1):25-31
66. Farahani M, Alavi SS, Mirzamani Bafghi M, Esmaili Alamuti S, Taghavi Z, Mohammadi MR. Psychological Factors Including Demographic Features, Mental Illnesses, and Personality Disorders as Predictors in Internet Addiction Disorder. Iran J psychiatry. 2018; 13(2):103-10.
67. Abbasi M, Sadeghi H, Pirani Z, Vatandoust L. Behavioral activation and inhibition system's role in predicting addictive behaviors of patients with bipolar disorder of Roozbeh Psychiatric Hospital. Iran J Nurs Midwifery Res. 2016;21(6):616-21.
68. Hendershot CS, George WH. Alcohol and sexuality research in the AIDS era: trends in publication activity, target populations and research design. AIDS Behav. 2007;11(2):217-26.
69. Martinotti G, Mandelli L, Di Nicola M, Serretti A, Fossati A, Borroni S, et al. Psychometric characteristic of the Italian version of the Temperament and Character Inventory--revised, personality, psychopathology, and attachment styles. Compr Psychiatry. 2008;49(5):514-22.
70. Di Nicola M, Tedeschi D, Mazza M, Martinotti G, Harnic D, Catalano V, et al. Behavioural addictions in bipolar disorder patients: role of impulsivity and personality dimensions. J Affect Disord. 2010;125(1-3):82-8.
71. Lagerberg TV, Andreassen OA, Ringen PA, Berg AO, Larsson S, Agartz I, et al. Excessive substance use in bipolar disorder is associated with impaired functioning rather than clinical characteristics, a descriptive study. BMC Psychiatry. 2010;10:9.
72. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J psychiatry. 2019;14(1):1-15.
73. Weidman AC, Fernandez KC, Levinson CA, Augustine AA, Larsen RJ, Rodebaugh TL. Compensatory internet use among individuals higher in social anxiety and its implications for well-being. Pers Individ Dif. 2012;53(3):191-5.
74. Jafarkarimi H, Sim ATH, Saadatdoost R, Hee JM. Facebook Addiction among Malaysian Students. Int J Information Edu Technol. 2016;6(6):465-9.
75. Hwang K-H, Yoo YS, Cho O-H. Smartphone Overuse and Upper Extremity Pain, Anxiety, Depression, and Interpersonal Relationships among College Students. The Journal of the Korea Contents Association. 2012;12(10):365–75.
76. Cerutti R, Presaghi F, Spensieri V, Valastro C, Guidetti V. The Potential Impact of Internet and Mobile Use on Headache and Other Somatic Symptoms in Adolescence. A Population-Based Cross-Sectional Study. Headache. 2016;56(7):1161-70.
77. Tavakolizadeh J, Atarodi AR, Ahmadpour S, Pourgheisar A. The Prevalence of Excessive Mobile Phone Use and its Relation with Mental Health Status and Demographic Factors among the Students of Gonabad University of Medical Sciences in 2011 -2012. Razavi Int J Med. 2014;2.
78. Mohammadi MR, Alavi SS, Ahmadi N, Khaleghi A, Kamali K, Ahmadi A, et al. The prevalence, comorbidity and socio-demographic factors of depressive disorder among Iranian children and adolescents: To identify the main predictors of depression. J Affect Disord. 2019;247:1-10.
79. Nourthrup D.A. The problem of the self-report in servey research.Institute for social research.1996;11(3): 834-1729.
80. Frankfort-Nachmias C, Nachmias D. Research methods in the social sciences(5th ed.) London: St Martin's Press.1996.
IssueVol 15 No 2 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijps.v15i2.2681
Mental Disorders Smart Mobile Phone Addiction Student

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How to Cite
Alavi SS, Ghanizadeh M, Farahani M, Jannatifard F, Jannatifard F, Esmaili Alamuti S, Mohammadi MR. Addictive Use of Smartphones and Mental Disorders in University Students. Iran J Psychiatry. 15(2):96-104.