title: Proposed Diagnostic Criteria for Smartphone Addiction.
abstract: BACKGROUND
  Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria.
  
  
  METHODS
  We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy.
  
  
  RESULTS
  Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use.
  
  
  CONCLUSIONS
  The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.
authors.affiliation: Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yu-Hsuan
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.|Division of New Drugs, Center for Drug Evaluation, Taiwan.
authors.forename: Chih-Lin
authors.initials: CL
authors.lastname: Chiang
authors.affiliation: Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, New Taipei City, Taiwan.
authors.forename: Po-Hsien
authors.initials: PH
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, National Taiwan University, College of Medicine, Taipei, Taiwan.
authors.forename: Li-Ren
authors.initials: LR
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Ko
authors.affiliation: Department and Graduate School of Electrical Engineering, Tamkang University Hospital, New Taipei City, Taiwan.
authors.forename: Yang-Han
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Biostatistics, Columbia Mailman School of Public Health, New York, New York, United States of America.
authors.forename: Sheng-Hsuan
authors.identifier: http://orcid.org/0000-0003-0714-2354
authors.initials: SH
authors.lastname: Lin
mesh_terms: D016739:Behavior, Addictive / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008960:Models, Psychological; D000068997:Smartphone; D055815:Young Adult