Objective To explore the impact of mobile phone dependence on academic burnout in adolescent patients with depression, and to examine the mediating role of depressive symptoms and the moderating role of sleep quality. Methods Using convenience sampling, 500 adolescent patients with depression who attended Nanning Fifth People's Hospital from April 2023 to April 2024 were enrolled as research subjects. Mobile phone dependence, academic burnout, depressive symptoms, and sleep quality were assessed using the Mobile Phone Addiction Index (MPAI), the Adolescent Student Burnout Inventory (ASBI), the Center for Epidemiologic Studies Depression Scale (CES‑D), and the Pittsburgh Sleep Quality Index (PSQI), respectively. Pearson correlation analysis was used to examine the correlations among the 4 variables—mobile phone dependence, academic burnout, depressive symptoms, and sleep quality. The PROCESS macro was employed to construct a moderated mediation model and to test the mediating effect of depressive symptoms and the moderating effect of sleep quality. Results The scores of the 500 adolescent patients with depression were (49.96 ± 14.78) points on the MPAI, (56.39 ± 11.19) points on the ASBI, (39.67 ± 13.16) points on the CES‑D, and (12.78 ± 4.13) points on the PSQI. Pearson correlation analysis showed that, among adolescent patients with depression, the MPAI score was positively correlated with the CES‑D score and the ASBI score (all P<0.05), but its correlation with the PSQI score was not statistically significant (P>0.05); the CES‑D score was positively correlated with both the ASBI score and the PSQI score (all P<0.05); the ASBI score was positively correlated with the PSQI score (P<0.05). Mediating effect analysis indicated that depressive symptoms played partial mediating role between mobile phone dependence and academic burnout in adolescent patients with depression, with a mediating effect value of 0.117 (95% CI: 0.079-0.158), accounting for 38.49% of the total effect. Moderating effect test revealed that both mobile phone dependence (β=0.379, P<0.05) and sleep quality (β=0.838, P<0.05) positively predicted depressive symptoms, and the interaction term between mobile phone dependence and sleep quality also had a statistically significant predictive effect on depressive symptoms (β=-0.081, P<0.05). Simple slope analysis showed that the positive predictive effect of mobile phone dependence on depressive symptoms was stronger for those with better sleep quality (βsimple=0.279) than for those with poorer sleep quality (βsimple=0.183). Conclusion Depressive symptoms partially mediate the relationship between mobile phone dependence and academic burnout in adolescent patients with depression; sleep quality moderates the path from mobile phone dependence to depressive symptoms, indicating that mobile phone dependence has a stronger positive predictive effect on depressive symptoms in those with better sleep quality.

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