Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 10, 2025
Date Accepted: Oct 30, 2025
Mobile phone addiction and suicidal behaviors in adolescents: a school-based cross-sectional study in Zhejiang Province, China
ABSTRACT
Background:
The associations between mobile phone addiction (MPA) and the risk of suicidal behaviors were inconsistent in previous studies.
Objective:
We aimed to extend the limited available evidence on this association and explore the potential mediation role of sleep quality, depression and anxiety.
Methods:
26394 adolescents aged 10–19 years were enrolled from a school-based survey with a multi-stage cluster sampling method in Zhejiang Province, China. MPA, mobile phone ownership, suicidal behaviors(suicide ideation, plans and attempt), sleep during, depression (Patient Health Questionnaire-9), and anxiety (Generalised Anxiety Disorder 7-item scale) were obtained from a self-administrated questionnaire.
Results:
MPA was observed in 4350 (16.5%) students, and mobile phone ownership was 22299 (84.5%). Students with MPA were significantly more likely to have an increased risk of suicide ideation (odds ratio [OR]: 2.717; 95% confidence interval [CI]: 2.491–2.964) and suicide attempt (OR, 5.267; 95% CI, 4.420–6.276) than their counterparts. Compared with suicide ideation, MPA had a higher risk of suicide plans (OR, 1.553; 95% CI, 1.341–1.752). Mobile phone ownership was negatively associated with suicide scores in propensity score weighting regression. Compared with participants who did not have mobile phone ownership or MPA, MPA without mobile phone ownership had the highest risk of suicide scores (β, 0.498; 95% CI, 0.407–0.588). In addition, sleep during, depression and anxiety mediated the association between MPA and suicidality.
Conclusions:
MPA was associated with suicidal behaviors in adolescents, with sleep during, depression and anxiety mediating the above relationship. Additionally, MPA without mobile phone ownership was related to a higher suicide score.
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