Association Between Self-Reported Pornographic Consumption Habits and Anxiety and Depression: A Systematic Review and Meta-Analysis

Objectives: This study aims to investigate the association between self-reported pornographic consumption habits and anxiety and depression. Methods: We systematically searched PubMed, Embase, Cochrane, and PsycINFO for all studies that examined anxiety and depression across consumption habits in pornographic content consumers (PCCs). PRISMA reporting guidelines were followed. Random effects meta-analyses were conducted for the primary analysis using correlation coefficients (CORs) and standardised mean differences (SMDs). A synthesis without a meta-analysis approach was further performed to examine factors affecting pornography consumption. Results: A total of 19 studies were included. The overall meta-analysis indicated significant positive correlations between pornographic consumption and both anxiety (COR = 0.16; 95% CI: 0.08; 0.25) and depression (COR = 0.24; 95% CI: 0.15; 0.32). Exploratory study-level subgroup analyses suggested that problematic consumption or addiction, but not general consumption, was associated with anxiety and depression. A stronger anxiety correlation was also observed in samples with a mean age ≤25 years compared with older users (COR = 0.22 vs. COR = 0.16; p = 0.0321). Systematically reviewing the studies showed that male gender and younger age significantly increased pornographic content consumption. Conclusions: The study found significant positive correlations between pornographic consumption and both anxiety and depression, with an increased effect on younger users. These findings suggest that pornography consumption habits may be important to psychosocial assessment, although substantial heterogeneity, residual confounding, and the observational nature of the evidence preclude causal inference.