Behavioural Addictions Among Healthcare Workers and Medical Students: Systematic Review and Meta-analysis

Abstract

Objective: This study aimed to systematically evaluate the prevalence, correlates, and mental health outcomes of behavioural addictions—including Internet Gaming Disorder (IGD), Internet Addiction (IA), Social Media Addiction (SMA), and Work Addiction (WA)—among healthcare professionals (HCPs) and medical students.
Methods: A systematic search of PubMed, Web of Science, Scopus, and PsycINFO was conducted from January 2017 to September 2025 following PRISMA 2020 guidelines. Only observational studies reporting prevalence, risk factors, or outcomes of behavioural addictions in healthcare professionals or medical students were included. Data extraction covered study characteristics, assessment instruments, prevalence estimates, and associated psychological or occupational outcomes. Risk of bias was assessed using the Joanna Briggs Institute Prevalence Checklist. Random-effects meta-analyses were performed, with subgroup analyses based on profession, addiction type, and geographic region.
Results: A total of 27 cross-sectional studies involving approximately 23,000 participants from 12 countries were included. Pooled prevalence estimates were high across all addiction types: IGD (2.1–20.0%), IA (11.1–75.5%), SMA (55.2–68.8%), and WA (23.7–70.7%). IGD and IA were more common among medical students, SMA among nurses, and WA among physicians—particularly emergency doctors. Behavioural addictions were consistently associated with depression, anxiety, insomnia, burnout, reduced academic performance, and work–family conflict. Risk of bias was generally low to moderate, while heterogeneity was explained by differences in measurement tools, cut-offs, and cultural factors.
Conclusions: Behavioural addictions are highly prevalent among healthcare professionals and trainees, often exceeding rates observed in the general population. Given their strong associations with mental health problems and occupational impairment, standardized diagnostic tools, targeted interventions, and institution-level policies are urgently needed to mitigate their impact on workforce well-being and patient safety.

Keywords

• Behavioural addictions
• Internet Gaming Disorder
• Internet Addiction
• Work Addiction
• Social Media Addiction
• Healthcare professionals
• Medical students
• Meta-analysis

References

1. Grant JE, Potenza MN, Weinstein A, Gorelick DA. Introduction to behavioral addictions. Am J Drug Alcohol Abuse. 2010;36:233-41. doi:10.3109/00952990.2010.491884.
2. Ulisse K, Albitar J, Aromin JT, Berry J. Emerging interventions in behavioral addictions: a narrative review of psychedelics and neuromodulation. Brain Sci. 2025;15. doi:10.3390/brainsci15090980.
3. Brand M, Wegmann E, Stark R, Muller A, Wolfling K, Robbins TW, et al. The interaction of person-affect-cognition-execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neurosci Biobehav Rev. 2019;104:1-10. doi:10.1016/j.neubiorev.2019.06.032.
4. Kılınçel S, Muratdağı G. Evaluation of factors affecting social media addiction in adolescents during the COVID-19 pandemic. Annals of Clinical and Analytical Medicine. 2021;12:447-51. doi:10.4328/acam.20541.
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. doi:10.1176/appi.books.9780890425596
6. Reed GM, First MB, Kogan CS, Hyman SE, Gureje O, Gaebel W, et al. Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry. 2019;18:3-19. doi:10.1002/wps.20611.
7. Shanafelt TD, West CP, Sinsky C, Trockel M, Tutty M, Wang H, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general us working population between 2011 and 2023. Mayo Clin Proc. 2025;100:1142-58. doi:10.1016/j.mayocp.2024.11.031.
8. Koutsimani P, Montgomery A, Georganta K. The relationship between burnout, depression, and anxiety: a systematic review and meta-analysis. Front Psychol. 2019;10:284. doi:10.3389/fpsyg.2019.00284.

9. Andreassen CS. Workaholism: An overview and current status of the research. J Behav Addict. 2014;3:1-11. doi:10.1556/JBA.2.2013.017.
10. Sussman S, Lisha N, Griffiths M. Prevalence of the addictions: a problem of the majority or the minority? Eval Health Prof. 2011;34:3-56. doi:10.1177/0163278710380124.
11. Hall LH, Johnson J, Watt I, Tsipa A, O'Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One. 2016;11:e0159015. doi:10.1371/journal.pone.0159015.
12. Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, et al. Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis. JAMA Intern Med. 2018;178:1317-31. doi:10.1001/jamainternmed.2018.3713.
13. Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 2016;316:2214-36. doi:10.1001/jama.2016.17324.
14. Mata DA, Ramos MA, Bansal N, Khan R, Guille C, Di Angelantonio E, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314:2373-83. doi:10.1001/jama.2015.15845.
15. Griffiths MD, Demetrovics Z, Atroszko PA. Ten myths about work addiction. J Behav Addict. 2018;7:845-57. doi:10.1556/2006.7.2018.05.
16. Cheng C, Li AY. Internet addiction prevalence and quality of (real) life: a meta-analysis of 31 nations across seven world regions. Cyberpsychol Behav Soc Netw. 2014;17:755-60. doi:10.1089/cyber.2014.0317.
17. Stevens MW, Dorstyn D, Delfabbro PH, King DL. Global prevalence of gaming disorder: a systematic review and meta-analysis. Aust N Z J Psychiatry. 2021;55:553-68. doi:10.1177/0004867420962851.
18. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71.
19. Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13:147-53. doi:10.1097/XEB.0000000000000054.
20. Gao Y, Ye H, Hong S, Bai X, Gan X. Workaholism among nurses in China: a nationwide cross-sectional survey. BMC Nurs. 2025;24. doi:10.1186/s12912-025-03455-5.
21. Liang X, Yin Y, Zhang L, Liu F, Jia Y, Liu X, et al. Work addiction in nurses: a cross-sectional correlational study of latent profile analysis and burnout. BMC Nurs. 2025;24. doi:10.1186/s12912-025-03102-z.
22. Luo A, Kong W, He H, Li Y, Xie W. Status and influencing factors of social media addiction in chinese medical care professionals: a cross-sectional survey. Front Psychol. 2022;13. doi:10.3389/fpsyg.2022.888714.
23. Xiang H, Liu L, Su X, Yang Y, Xue H, Liu B, et al. The association between a stress-is-enhancing mindset and internet gaming disorder was mediated by behavioral disengagement among medical undergraduate students: a multi-center survey in China. BMC Psychiatry. 2025;25. doi:10.1186/s12888-025-06910-4.
24. Xu C, Liao M, Hong Y. Rejection sensitivity and problematic internet use among medical students: a moderated mediation model involving loneliness and self-control. Behav Sci (Basel). 2025;15. doi:10.3390/bs15050589.
25. Zong Z, Sun F, Sun H, Su S, Wei B. The relationship between career calling and presenteeism: the role of workaholism and self-compassion. Aust J Psychol. 2025;77. doi:10.1080/00049530.2024.2445247.
26. Agrawal M, Rajaram S, Kumar G. Internet addiction and psychological health in adolescent Indian medical students: a cross-sectional study. Basic Clin Neurosci. 2024;15:477-88. doi:10.32598/bcn.2021.3295.2.
27. Kumar A, Gupta A, Raj D, Kumar A. Pattern and correlates of internet gaming disorder among medical students – a cross-sectional study from a tertiary care health institute, Rajasthan. J Educ Health Promot. 2024;13. doi:10.4103/jehp.jehp_2026_23.
28. Murugan Y, Thakkar D, Ram R, Dhanapal K. Associations between cognitive disengagement syndrome, internet addiction, and internet gaming disorder among medical students – a cross-sectional study. Ind Psychiatry J. 2024. doi:10.4103/ipj.ipj_325_23.
29. Al AF, Mercan Başpınar M, Basat O. The relationship of job satisfaction with nomophobia and social media addiction in healthcare professionals: a cross-sectional study. Bagcilar Medical Bulletin. 2022;7:311-8. doi:10.4274/BMB.galenos.2022.2022-06-052.
30. Aydın EF, Alay H, Yılmaz S, Can FK. The interplay between problematic internet use, anxiety, depression and functional impairment in front-line healthcare workers during the COVID-19 pandemic. Psychiatry Investig. 2024;21:736-45. doi:10.30773/pi.2023.0022.
31. Tat RM, Golea A, Vancu G, Grecu M-B, Puticiu M, Hermenean A, et al. Burnout, work addiction and stress-related growth among emergency physicians and residents: a comparative study. Behav Sci (Basel). 2025;15. doi:10.3390/bs15060730.
32. Al Asqah MI, Al Orainey AI, Shukr MA, Al Oraini HM, Al Turki YA. The prevalence of internet gaming disorder among medical students at King Saud University, Riyadh, Saudi Arabia. Saudi Med J. 2020;41:1359-63. doi:10.15537/smj.2020.12.05584.
33. Alfaya MA, Abdullah NS, Alshahrani NZ, Alqahtani AAA, Algethami MR, Al Qahtani ASY, et al. Prevalence and determinants of social media addiction among medical students in a selected university in Saudi Arabia: a cross-sectional study. Healthcare. 2023;11(10):1370. doi:10.3390/healthcare11101370.
34. Alshammari TK, Rogowska AM, Alobaid AM, Alharthi NW, Albaker AB, Alshammari MA. Examining anxiety and insomnia in internship students and their association with internet gaming disorder. J Clin Med. 2024;13. doi:10.3390/jcm13144054.
35. El-Gazar HE, Elgohari H, Loutfy A, Shawer M, El-Monshed AH, Abou Zeid MAG, et al. Does internet addiction affect the level of emotional intelligence among nursing students? a cross-sectional study. BMC Nurs. 2024;23. doi:10.1186/s12912-024-02191-6.
36. Hussein AHM, Ramadan LZT, Atalla ADG. Workaholism and work-family conflict among critical care nurses: a cross-sectional study. BMC Nurs. 2025;24. doi:10.1186/s12912-025-03465-3.
37. Dawadi P, Khadka S, Maharjan S, Baniya A, Khadka S, Thapa S, et al. Internet addiction among undergraduate medical students of a medical college: a descriptive cross-sectional study. J Nepal Med Assoc. 2022;60:533-6. doi:10.31729/jnma.7548.
38. Mohamed KO, Soumit SM, Elseed AA, Allam WA, Soomit AM, Humeda HS. Prevalence of internet addiction and its associated risk factors among medical students in Sudan: a cross-sectional study. Cureus. 2024. doi:10.7759/cureus.53543.
39. Traore B, Aguilo Y, Hassoune S, Nani S. Determinants of internet addiction among medical students in Casablanca: a cross-sectional study. Global Health Journal. 2023;7:101-9. doi:10.1016/j.glohj.2023.04.005.
40. Fernández-Martínez E, Sutil-Rodríguez E, Liébana-Presa C. Internet addiction and emotional intelligence in university nursing students: A cross-sectional study. Heliyon. 2023;9. doi:10.1016/j.heliyon.2023.e19482.
41. Butoi MA, Vancu G, Marcu R-C, Hermenean A, Puticiu M, Rotaru LT. The role of personality in explaining burnout, work addiction, and stress-related growth in prehospital emergency personnel. Healthcare. 2025;13. doi:10.3390/healthcare13020193.
42. Puticiu M, Grecu M-B, Rotaru LT, Butoi MA, Vancu G, Corlade-Andrei M, et al. Exploring burnout, work addiction, and stress-related growth among prehospital emergency personnel. Behav Sci (Basel). 2024;14. doi:10.3390/bs14090851.
43. Azevedo WFd, Mathias LAdST. Work addiction and quality of life: a study with physicians. Einstein (São Paulo). 2017;15:130-5. doi:10.1590/s1679-45082017ao3960.
44. Ahmad A, Hassan Rizvi A, Uzair M, Bashir H, Amin M. Prevalence of internet addiction and its relation with depression, anxiety and stress in medical students of Pakistan. Psychol Health Med. 2025:1-10. doi:10.1080/13548506.2025.2545020.
45. Bakker AB, Demerouti E. The job demands‐resources model: state of the art. Journal of Managerial Psychology. 2007;22:309-28. doi:10.1108/02683940710733115.
46. Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1:27-41. doi:10.1037/1076-8998.1.1.27.