Smartphone addiction prevalence and psychological correlates among undergraduate medical students at public and private institutions in Pakistan

Abstract Objectives The aim of the study was to identify the prevalence of smartphone addiction among undergraduate MBBS students of a public and a private medical institution, to compare profiles of smartphone addiction and psychological distress among the two institutions, and to identify independent predictors of smartphone addiction. Methods An analytical cross-sectional study was done in 384 MBBS students (Public = 230, Private = 154) with the help of the proportional quota sampling. A Smartphone Addiction Scale- Short Version (SAS-SV) with gender-specific cut-offs (≥ 31 males, ≥ 33 females) was used to measure smartphone addiction. The Depression, Anxiety and Stress Scale − 21 items (DASS-21) was the measure of psychological distress. Binary logistic regression and Pearson correlation were done using the IBM SPSS version 25.0. Results The prevalence of smartphone addiction was 41.7%, with no significant difference in its prevalence between public (42.2%) and private (40.9%) institutions (p = 0.805). However, public sector students demonstrated significantly higher depression (15.17 ± 9.14 vs. 12.56 ± 10.86, p = 0.011), anxiety (15.57 ± 8.46 vs. 11.81 ± 10.80, p < 0.001), and stress scores (17.13 ± 8.73 vs. 12.58 ± 10.80, p < 0.001). In multivariate logistic regression, male gender (AOR = 1.584, 95% CI: 1.005–2.496, p = 0.048) and higher depression scores (AOR = 1.046, 95% CI: 1.004–1.089, p = 0.030) were the only independent predictors of smartphone addiction. Pearson correlation also revealed significant positive correlations between the SAS-SV scores and all DASS 21 subscales (r = 0.267–0.310, p < 0.01). Conclusion More than two-fifths of students (irrespective of institutional type) have smartphone addiction, but psychological distress is substantially greater among public sector medical students. Addiction is independently predicted by male gender and depression.