Impact on adolescent mental health of replacing screen-use with exercise: A prospective cohort study
Open accessAbstract
Background Screen-based device use could increase the risk of adolescent depression. Distinct modalities of screen-use may have differential effects on mental health. We used compositional data analysis to examine how theoretically replacing different screen-uses with exercise might influence future adolescent emotional distress.Methods In 4,599 adolescents (55% female) from a nationally-representative, prospective cohort, we used time-use diary data at age 14 to estimate daily screen use (television, social media, video game, general computer use) and exercise (team sport and individual exercise). The outcome was emotional distress at age 17, assessed using the emotional symptoms subscale of the Strengths and Difficulties Questionnaire.Results Theoretically replacing 60 min of total screen time with exercise at age 14 was associated with a 0.05 (95%CI -0.08, -0.02) score reduction on the emotional symptoms' subscale at 17 in fully-adjusted models. Replacing 60 min of television or social media use with team sports was associated with a reduction of 0.17 (95%CI, -0.31, -0.04) and 0.15 (95%CI, -0.29, -0.01) in emotional symptom scores, respectively. We found no change in emotional symptom scores when replacing video game or general computer use with team sport, or when replacing any screen time with individual exercise.Limitations No direct measure of depressive symptoms at follow-up.Conclusions Replacing any screen time with exercise could reduce emotional distress, but the largest effect sizes were associated with replacing time in television watching and social media with team sports. Recommendations to limit screen-use in adolescents may require a nuanced approach for protecting mental health.
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Smartphone and social media use has been associated with depression and internalizing symptoms.
“Smartphone and social media use has been associated with depression [23, 24, 26, 27] and internalizing symptoms [52].”
From The associations between screen time and mental health in adolescents: a systematic review (2023) · cites this paper as [24]
The Main findings report that replacing social-media time with team sports was associated with lower emotional symptom scores. The Introduction identifies those scores as a component of internalising symptoms, supporting the social-media portion of the claim. The paper does not establish an association specifically for smartphone use. (LLM, conf=0.84)
Experimental — accuracy not yet measuredTheoretical replacement of 60 min of television or social media use by team sports at age 14 was associated with a reduction in emotional symptom scores at age 17.
“In another more recent study, the theoretical replacement of 60 min of television or social media use by team sports at age 14 years was associated with a reduction in emotional symptom scores at age 17 years, respectively [24].”
From The associations between screen time and mental health in adolescents: a systematic review (2023) · cites this paper as [24]
Some studies noted that replacing screen time with physical activity showed a positive effect on associations with mental health.
“From the records reviewed, some studies noted that replacing screen time with physical activity showed a positive effect on associations with mental health [24, 33, 34].”
From The associations between screen time and mental health in adolescents: a systematic review (2023) · cites this paper as [24]
Social media use was associated with poor mental health and impaired mental well-being.
“Here, social media use was associated with poor mental health and impaired mental well-being [24, 26, 27, 37, 48, 59].”
From The associations between screen time and mental health in adolescents: a systematic review (2023) · cites this paper as [24]
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The associations between screen time and mental health in adolescents: a systematic review
Santos, R. M. S., Mendes, C. G., Sen Bressani, G. Y., de Alcantara Ventura, S., de Almeida Nogueira, Y. J., de Miranda, D. M., & Romano-Silva, M. A. (2023) · BMC Psychology · doi:10.1186/s40359-023-01166-7 · Cited by 311 · see citing works
- Authors
- Kandola, A., del Pozo Cruz, B., Hayes, J. F., Owen, N., Dunstan, D. W., & Hallgren, M.
- Affiliations
- University College London (GB)
- Baker Heart and Diabetes Institute (AU)
- Karolinska Institutet (SE)
- Corresponding author
- Kandola, Aaron
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 301
- Pages
- 240-247
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4206207690
- Cited by
- 30
- References
- 53
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 7 · 2022: 5
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by-nc-nd)
- Deakin Research Online (Deakin University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Economic and Social Research Council (ES/P000592/1)
- National Health and Medical Research Council (1003960, 1078360)
- Wellcome Trust
- State Government of Victoria
- UCLH Biomedical Research Centre
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast
- Macmillan Cancer Support
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Education › Child Development and Digital Technology
- Keywords
- adolescent mental health, screen time, physical activity, emotional distress, depression, team sports, social media, television viewing, video games, computer use, compositional data analysis, time use, Strengths and Difficulties Questionnaire
- MeSH terms
- Adolescent Health, Screen Time, Psychological Distress, Team Sports, Adolescent, Psychology, Adolescent, Computers, Female, Humans, Male, Mental Health, Prospective Studies, Sports, Television, Exercise, Video Games, Sedentary Behavior, Social Media
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