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Problematic Social Media Use 'Improved by Therapy'

Interventions to help people with problematic social media use were effective in boosting their mental wellbeing, according to a new meta-analysis of existing studies by researchers at University College London (UCL).

The most notable improvements were in depression, with 70% of studies assessed showing a significant improvement after intervention. However, therapy-based interventions were substantially more effective than simple abstinence programs, and the authors cautioned that healthcare professionals should be aware that simply limiting time spent on social media was unlikely to be beneficial on its own.

Social media had "dramatically changed how people communicate, form relationships, and perceive each other", the researchers noted, and while this was beneficial to some users, and could offer social support, there was evidence linking use with psychological problems, particularly in young people.

Problematic Social Media Use Correlated With Depression

The authors of the study, published in the Journal of Medical Internet Research, defined 'problematic' use as pre-occupation with social media that distracted from primary tasks and caused the user to neglect responsibilities in other aspects of their life. 

Previous research, such as a 2021 Swedish study, had suggested that problematic social media use can interfere with daily life and lead to poor mental wellbeing, including depression, anxiety, stress, loneliness, and addictive behaviours. In particular, high levels of social media use correlate with significantly greater odds of depression. A study by the University of Bath published last year found that a week-long break from social media led to significant improvements in people's mental health, including levels of anxiety and depression.

For the latest investigation researchers performed a literature review of experimental studies evaluating the effectiveness of social media use interventions in improving mental well-being in adults. The search of papers spanning 2004 to June 2022 was completed across three databases, yielding 23 studies for inclusion in the analysis. 

CBT Was the Most Effective Intervention

Of the studies reviewed, nine (39%) found improvements in mental well-being; seven (30%) found mixed effects, and seven found no effect on mental well-being. However, looking specifically at therapy-based interventions, using techniques like cognitive behavioural therapy (CBT), the researchers found enhanced effectiveness, with 83% (5/6) of these studies showing significant improvements in mental well-being, far more than either limiting use of or full abstinence from social media, for which 20% (1/5) and 25% (3/12), respectively, of studies showed mental health improvements.

Depression was the most frequently investigated and most notably improved outcome, with 70% (7/10) of studies showing a significant improvement after intervention, while other outcomes showed more varied results.

Lead author, Dr Ruth Plackett, a senior research fellow at UCL's Institute of Epidemiology and Health, said: "Mental health issues are on the rise, as is the number of people who use social media. Health and care professionals should be aware that reducing time spent on social media is unlikely to benefit mental wellbeing on its own.

"Instead, taking a more therapy-based approach and reflecting on how and why we are interacting with social media, and managing those behaviours, could help improve mental health."

GPs "Should Proactively Explore Social Media Use"

Co-author Dr Patricia Schartau, a GP and clinical lecturer in primary care at the Institute, said: "As primary care physicians, we should proactively explore social media use and its effects on mental health in patients who present with anxiety and/or low mood in order to give those patients the opportunity to benefit from treatment, including some of the more effective interventions outlined in our review."

The authors acknowledged limitations of their analysis, including that most (22/23, 96%) assessed studies were of poor quality, mainly due to selection bias, as a majority (16/23, 70%) used convenience sampling of university students. 

Asked to comment by Medscape News UK, Professor Bernadka Dubicka of the Royal College of Psychiatrists said that although the study found that therapy improved mental wellbeing for some users, its conclusions were limited, including by the poor quality of existing evidence. 

Limiting Social Media Use Alone Unlikely To Be Sufficient 

"This review highlights the need for more research about the impact of social media on people’s mental health, particularly young people and those with existing mental health problems," she said. She added that further research was also needed "to determine who may benefit from different interventions, including therapy and limiting social media use".

In a comment to the Science Media Centre, Professor Stella Chan, Charlie Waller chair in evidence-based psychological treatment at the University of Reading, said that although over a third of the studies included reported improvement, the majority had either mixed findings or showed no improvement. In addition, almost all were "not scientifically robust". While describing the results as "encouraging", she said the key implication in a real-world setting was that limiting social media use itself "is unlikely to be sufficient in improving mental health".

The study was funded by the National Institute for Health and Care Research's Applied Research Collaboration North Thames.

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