Digital wearable use and mental health outcomes in Saudi Adults: a function-specific cross-sectional study

<p class="MDPI17abstract" style="margin: 0in; line-height: 150%;"><strong><span style="font-family: 'Palatino Linotype',serif;">Background</span></strong><strong>:</strong> Smartwatches are increasingly used as personal health-monitoring tools, but evidence regarding their relationship with mental wellbeing remains limited in Middle Eastern populations. This study investigated the association between smartwatch use, specific smartwatch functions, and mental health symptoms among Saudi adults.</p> <p class="MDPI17abstract" style="margin: 0in; line-height: 150%;"><strong>Methods</strong>: This cross-sectional study included 1,217 Saudi adults aged &ge;18 years recruited through social media. An online questionnaire assessed sociodemographic characteristics, smartwatch use, and mental health outcomes using the validated Arabic Depression, Anxiety, and Stress Scale-21 (DASS-21). Multiple linear regression analyses identified predictors of depression, anxiety, and stress scores.</p> <p class="MDPI17abstract" style="margin: 0in; line-height: 150%;"><strong>Results</strong>: Smartwatch use was reported by 48.9% of participants. Depression, anxiety, and stress symptoms above normal levels were reported by 49.1%, 56.1%, and 53.1% of participants, respectively. Among smartwatch functions, only activity tracking was significantly associated with mental health outcomes, showing lower anxiety scores (&beta; = &minus;2.14; 95% CI: &minus;4.54 to &minus;0.26; p = 0.035). Ex-smoking status was the strongest factor associated with higher symptom scores across all do-mains (&beta; = 3.66&ndash;4.96; all p &lt; 0.05). Higher income, male gender for anxiety and stress, and in-creasing age were associated with lower symptom scores. Overall smartwatch ownership and other functions showed no significant associations.</p> <p class="MDPI17abstract" style="margin: 0in; line-height: 150%;"><strong>Conclusion</strong>: Activity-tracking features were associated with lower anxiety symptoms, whereas overall smartwatch ownership was not associated with mental health symptoms. These findings support a function-specific approach to studying wearable technologies and mental health, but longitudinal and interventional studies are needed.</p>