Global Burden Of Problematic Internet Use: An Umbrella Review and Metanalysis
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Importance
Problematic use of the internet (PUI) behaviors, including problematic gaming, social media use, smartphone use, and general internet use, have been increasingly studied worldwide. So far it is unclear what the global prevalence of PUI is.
Objective
To critically appraise existing systematic reviews and meta-analyses on the prevalence of PUI behaviors and generate aggregated global prevalence estimates across different manifestations and definitions.
Data Sources
MEDLINE (Ovid), Embase (Ovid), Scopus, Web of Science, CINAHL, and the Cochrane Review Library were searched for relevant articles from database inception to the most recent available search prior to manuscript preparation. Searches targeted systematic reviews and meta-analyses reporting prevalence for PUI-related behaviors.
Study Selection
Systematic reviews and meta-analyses of observational studies reporting prevalence estimates for problematic gaming, problematic internet use, problematic smartphone use, problematic social media use, or sexting were included. Scoping reviews were retained for descriptive synthesis only.
Data Extraction and Synthesis
An umbrella review methodology was used. Data extraction and methodological appraisal were conducted using AMSTAR-2 to assess the quality of included systematic reviews up to February 2026. Primary studies included in each review were extracted and pooled using random-effects meta-analysis. Analyses were conducted to estimate pooled prevalence with 95% confidence intervals (CIs) and heterogeneity across non-overlapping primary studies. Small-study effects were examined.
Main Outcomes and Measures
Global pooled prevalence estimates for PUI behaviors, including problematic gaming, problematic internet use, problematic smartphone use, problematic social media use, and sexting.
Results
Eleven reviews (10 systematic reviews and 1 scoping review) met inclusion criteria, representing data from 3 145 428 individuals, of whom 3 030 023 were included in pooled prevalence analyses. Across regions, pooled prevalence estimates were 6% (95% CI, 5%–7%) for problematic gaming, 16% (95% CI, 15%–17%) for problematic internet use, 32% (95% CI, 28%–35%) for problematic smartphone use, and 23% (95% CI, 19%–28%) for problematic social media use. Substantial heterogeneity (I 2 > 99%) was observed across primary studies, reflecting variation in study methodologies, sampled populations, and definitions of PUI behaviors.
Conclusions and Relevance
PUI behaviors appear to affect a substantial proportion of the global population. However, methodological concerns were common, with 9 of 10 systematic reviews rated as having low or critically low confidence according to AMSTAR-2. Evidence remains concentrated in East Asia and Europe, and many reviews combine heterogeneous populations and sampling strategies. Additional high-quality epidemiological research, including underrepresented regions is needed to refine prevalence estimates, clarify risk factors, and support the development of standardized criteria for PUI behaviors.
Key Points
Question
What is the global prevalence of problematic use of the internet (PUI) behaviors across major subtypes, based on an umbrella review of existing reviews and a meta-analysis of nonoverlapping primary studies?
Findings
In this umbrella review of 11 reviews and random-effects meta-analysis of 753 nonoverlapping primary studies including 3 030 023 individuals, pooled prevalence estimates were 6% for problematic gaming, 16% for problematic internet use, 32% for problematic smartphone use, and 23% for problematic social media use. Findings indicated substantial between-study heterogeneity, and most included systematic reviews were rated low or critically low in methodological quality.
Meaning
These findings suggest that PUI behaviors affect a substantial proportion of the global population, but more methodologically rigorous and geographically representative epidemiological research is needed to generate more precise and comparable prevalence estimates across clinical and population samples.
