Depressive and mobile phone addiction symptoms in Chinese adolescents with major depressive disorder: the mediating effect of alexithymia.

Background: Mobile phone addiction (MPA) is associated with depression, yet the underlying mechanisms are not clear. This study aimed to explore the socio-demographic and clinical correlates of MPA symptoms, the associations between depressive and MPA symptoms, and whether the associations are mediated by alexithymia among adolescents with major depressive disorder (MDD).

Methods: This cross-sectional study was conducted from January to July 2021 in seven hospitals across the northern, central, and southern regions of Anhui Province, China. MPA symptoms, depressive symptoms, and alexithymia were assessed using the Mobile Phone Addiction Scale (MPAS), the Center for Epidemiologic Studies of Depression Symptom Scale (CES-D) and the 20-item Toronto Alexithymia Scale (TAS-20), respectively.

Results: A total of 286 adolescents with MDD were included. Univariate analyses revealed that adolescents with abnormal parental marriage, poorer academic performance, higher total scores of CES-D and TAS-20, and higher subscale scores of difficulty identifying feeling (DIF) and externally oriented thinking (EOT) were likely to have more severe MPA symptoms (all P < 0.05). Multivariate linear regression analyses showed that depressive symptoms were positively correlated with the severity of MPA symptoms in adolescents with MDD (all P < 0.05). Alexithymia and EOT partially mediated the associations between depressive and MPA symptoms.

Conclusion: MPA symptoms are common in adolescents with MDD, and the effect of depressive symptoms on the severity of MPA symptoms is mediated partially through alexithymia. Therefore, effective identification and intervention for alexithymia may be important strategies to help clinical staff reduce the risk of MPA among adolescents with MDD.