Social Media Use and Mental Health: A Global Analysis

Comment

Response

Introduction

The relationship between mental disorders and social networks/media, seems to be the main objective of the study, but the term “COVID-19 also” appears in the choice of terms (box1). The authors explain why the term was used, but I believe that this choice could create a selection bias, the use of the internet (even without specification of the platform) was important even after other natural disasters. My concern is that other works have been lost, it would be advisable to check if it has not already been done.

Thank you for your comment. Selection bias is of great concern to the authors. We agree the use of the internet was important even after other natural disasters.

Our reasoning to include COVID-19 in our study is discussed in lines 389-399

“Moreover, the COVID-19 pandemic and social distancing have created an unprecedented setting for examining the relationship between social media usage and mental health.  Studies included in our analysis, most of which did not specify a social media platform of focus, inevitably show that while social media usage increased and was re-warding to many users looking for support when the COVID-19 pandemic hit, excessive use also led to mental health issues such as depression and anxiety.  Therefore, it can be said that social media usage during the COVID-19 pandemic is much like a double-edged sword; it can promote mental health during a pandemic, but it’s overuse can likewise hinder one’s mental health. It is likely that mental health consequences of the COVID-19 pandemic will be studied well into the future, and mental health might very well be the pandemic of year 2021.”

Methods

I think is useful to report the type of article used for the review:  original research, review, systematic review, etc

We agree that mentioning the type of article has a lot of merit. In order to save space, we chose to reference each article to the reader. In our manuscript we have included a meta-analysis. We utilized this statistical strategy in order to assemble the results of several studies into a single estimate.

Please see lines 84-94

“To identify differences among studies with different scopes, a subgroup analysis with five groups was conducted. Studies were clustered into groups depending on the social media site specified as being the focus of the study. Thus, five groups were created in-cluding: only Facebook (labeled F, n=10), only Twitter (labeled T, n=2), only Instagram (labeled I, n=2), all three social media platforms (labeled FTI, n=1), and unknown (social media platform not specified) (labeled U, n=5).

In subgroup analysis, the sample sizes and the year of publication of the study were also considered (Table 1). For the sample size, we considered the median value of the sample sizes (600) for the cut-off, and for the year of the publication studies were categorized as before 2018 and after 2018 (including 2018). To test for the existence of a publication bias, we used a funnel plot.”

It could be interesting to read the study design in table 1

Agreed! It could be very interesting however we discuss the study design several times throughout the manuscript. We discuss in in lines 63-73 & Box-1.  The authors feel that mentioning it more may be redundant.

“A literature search using PRISMA guidelines was conducted to explore the relationship between social media site usage (Facebook, Instagram, and Twitter) and mental health (Fig. 1). A multi-database search identified studies published between January 2010 and June 2020. Articles from PubMed and Google Scholar were selected to investigate the relationship of each type of social media site and mental health. While Google Scholar has wide coverage in terms of interdisciplinary scientific studies, it was supplemented and complemented by PubMed due to PubMed’s widely accessible resources and because the database has provision of MEDLINE and other National Library of Medicine (NLM) resources. Search terms were chosen to broadly capture the various ways social media and mental health have been defined and explored in the existing literature.  See Box 1 for a summary of the search strategy and selection process for the systematic review.”

Table 1: I think it's not clear (what does n/a mean?) the Author should report on the text when the comments are from the data reported in Table 1

n/a means not applicable.

the text when the comments are from the data reported in Table 1 is discussed in  lines 119-251.

Abstract

Findings could include more details instead of simply saying social media correlates with depression and other mental health disorders. Here, it is interesting which other mental health disorders, this is the key point of the review

The authors followed APA guidelines:

https://apastyle.apa.org/instructional-aids/abstract-keywords-guide.pdf

The abstract addresses the following (usually 1–2 sentences per topic):

·       key aspects of the literature review

·       problem under investigation or research question(s)

·       clearly stated hypothesis or hypotheses

·       methods used (including brief descriptions of the study design, sample, and sample size)

·       study results

·       implications (i.e., why this study is important, applications of the results or findings)

I am a big fan of short intros. Unfortunately, the present introduction is too superficial, does not clarify the relevance for the review article and does not contain the relevant literature that already exists on this topic.

What is the new to existing reviews such as by Bashir, H., & Bhat, S.A. (2017).

Effects of social media on mental health: A review. International Journal of Indian Psychology, 4 (3), 125-13? Or Wongkoblap, A., Vadillo, M. A., & Curcin, V. (2017). Researching mental health disorders in the era of social media: systematic review. Journal of medical Internet research, 19(6), e228.

Thanks for your comment. We agree!

We tried our best to keep our intro as short as we possibly could. 

Please see lines 27-61

Google scholar is not adequate for a systematic search

Agreed!  We address this comment in our limitations.

See lines 426-437

A limitation of this meta-analysis is the number of databases used to conduct a systematic review, as well as limitations inherent in using specifically Google Scholar and PubMed as databases to identify highly relevant research. Each database is limited in its focus and scope and neither is optimal for topical research. Ideally, multiple databases would provide the optimal and most comprehensive systematic review. Utilizing da-tabases like PsycINFO, MEDLINE (Ovid), Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and other educational resources should be con-sidered in future studies. Furthermore, it is well known that most users of social media tend to be in the 12-30 age range (14), limiting the generalizability of the findings to a wider audience. Additionally, only a few of the studies included in the review focused on Instagram only and all three platforms, limiting the conclusions that can be drawn about the relationships between Instagram specifically and mental health.

What was the reason to limit literature search to January 2010, why not include earlier findings

October 2010, Instagram rapidly gained popularity, with one million registered users in two months, 10 million in a year, and 1 billion as of June 2018.

Was the term only searched in the heading or in full text or Inclusion/Exclusion criteria should be described in more detail, what about comorbidities, what about study designs

Due nature of the subject matter, the authors felt that a Broader inclusion criteria and less-restrictive exclusion criteria will lead to a study that provides more information about the effects on the population.

Why covid-19, it comes out of nowhere, the search strategy means only studies related to COVID-19

See lines 389-399

Moreover, the COVID-19 pandemic and social distancing have created an unprecedented setting for examining the relationship between social media usage and mental health.  Studies included in our analysis, most of which did not specify a social media platform of focus, inevitably show that while social media usage increased and was re-warding to many users looking for support when the COVID-19 pandemic hit, excessive use also led to mental health issues such as depression and anxiety.  Therefore, it can be said that social media usage during the COVID-19 pandemic is much like a double-edged sword; it can promote mental health during a pandemic, but it’s overuse can likewise hinder one’s mental health. It is likely that mental health consequences of the COVID-19 pandemic will be studied well into the future, and mental health might very well be the pandemic of year 2021.

Also  see

lines 421-425

In March of 2020, the WHO declared the COVID-19 outbreak a global pandemic.  Global lockdowns required citizens to start spending more time at home and as a result, social media usage has both increased and changed.  More than ever, individuals have turned to social media for socialization, interaction, entertainment, and social support for their mental health

Comment

Response

-Additional discussion could be added on the potential importance of the findings regarding the connection between social networking and depression. The same goes to the observed link between self-esteem and time spent on social networking platforms

Please see  lines # 401-416

Mental health professionals and others promoting psychological health can benefit from learning more about social media and its relationship to mental health. Social media campaigns can likewise promote more knowledge and awareness of specific mental health conditions. A successful advertising campaign can bring awareness to complex mental health issues such as depression and anxiety. Such a campaign has the potential to lead to policymakers flagging or possibly deactivating accounts that promote negative mental health issues. In addition to deactivating negativity, social media sites can promote and advertise positive mental health messages which would allow the self-help promoting information to reach more people. Using certain hashtags could connect people who are suffering from these issues and give them a needed virtual support group they likely wouldn’t have attended in person due to stigma. As one example, the Royal Society for Mental Health is recommending social media platforms to create a “heavy usage” notification to pop up after too much time has been spent online. Social media is not going away, so developing a safe relationship and using social media in a healthy way may not only decrease the negative impact of social media on one’s health but may have a positive impact instead.

-Please consider improving technical quality of the manuscript in terms of correcting technical and style errors.

Updated! Thanks