The assumption that psychiatric vulnerability automatically translates into greater digital addiction risk deserves scrutiny. A counterintuitive pattern has emerged from a controlled clinical study: despite carrying heavier psychological burdens, adults with epilepsy appear to engage less with the digital behaviors — smartphone addiction, social media use, and phubbing — that are increasingly linked to poor mental health outcomes in the general population.
This cross-sectional study enrolled 102 adults with epilepsy and 102 age- and sex-matched healthy controls, administering validated instruments measuring phubbing behavior, nomophobia (fear of being without a smartphone), smartphone addiction, social media addiction, depression, and anxiety. Healthy controls scored significantly higher across all digital behavioral addiction measures (p < 0.01), while the epilepsy group registered markedly elevated depressive symptom scores (p < 0.001). Crucially, anxiety — quantified via the Hospital Anxiety and Depression Scale anxiety subscale — emerged as the dominant predictor of problematic digital behaviors in both groups, independently of epilepsy status. Clinical epilepsy variables such as seizure frequency and medication burden showed minimal association with digital addiction patterns.
The inverse relationship between epilepsy and digital overuse is intriguing and demands careful interpretation. Reduced social media engagement in this population may reflect stigma-driven social withdrawal, restricted social participation, or cautious avoidance of screen stimuli in photosensitive individuals — rather than any protective psychological mechanism. This distinction matters enormously: lower digital use in this context may signal social isolation rather than healthier habits. The finding that anxiety, not disease severity, drives problematic digital behavior aligns with the broader psychopathological literature linking emotional dysregulation to compulsive technology use. As a cross-sectional, single-center design, causality cannot be established, and selection bias toward higher-functioning outpatients is likely. Still, this study meaningfully repositions anxiety — rather than neurological diagnosis — as the primary clinical lever for addressing digital addiction risk.
