Sedentary behavior and indicators of mental health in school-aged children and adolescents: A systematic review
Abstract
Objective The presented systematic review aims at giving a comprehensive overview of studies assessing the relationship between sedentary behavior and indicators of mental health in school-aged children and adolescents.Methods Six online databases (MEDLINE, EMBASE, PsycINFO, PsycARTICLES, CINAHL and SPORTDiscus) as well as personal libraries and reference lists of existing literature were searched for eligible studies.Results Ninety-one studies met all inclusion criteria. There was strong evidence that high levels of screen time were associated with more hyperactivity/inattention problems and internalizing problems as well as with less psychological well-being and perceived quality of life. Concerning depressive symptoms, self-esteem, eating disorder symptoms, and anxiety symptoms, no clear conclusion could be drawn. But, taking quality assessment into account, self-esteem was negatively associated with sedentary behavior, i.e. high levels of time engaging in screen-based sedentary behavior were linked to lower scores in self-esteem.Conclusions Overall, the association between sedentary behavior and mental health indicators was rather indeterminate. Future studies of high quality and with an objective measure of sedentary behavior will be necessary to further examine this association as well as to investigate longitudinal relationships and the direction of causality. Furthermore, more studies are needed to identify moderating and mediating variables.
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A 2015 systematic review concluded there was strong evidence to support a positive association between screen time and hyperactivity/inattention symptoms in children and adolescents.
“Synthesizing data from eight cross-sectional and three longitudinal studies, a systematic review from 2015 concluded that there was strong evidence to support a positive association between screen time and hyperactivity/inattention symptoms in children and adolescents [56].”
From Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study (2024) · cites this paper as [56]
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Carson, V., Hunter, S., Kuzik, N., Gray, C. E., Poitras, V. J., Chaput, J.-P., Saunders, T. J., Katzmarzyk, P. T., Okely, A. D., Connor Gorber, S., et al. (2016) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2015-0630 · Cited by 1,380 · see citing works
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“One review suggested there was a curvilinear relationship between screentime and depressive symptoms.(21) Overall the quality of included reviews was moderate, with only one high-quality review and three low-quality reviews included.”
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Screen Time and Problem Behaviors in Children: Exploring the Mediating Role of Sleep Duration
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Is screen time associated with anxiety or depression in young people? Results from a UK birth cohort
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“Ferguson [6] concluded that computer gaming is not significantly associated with inattention, while another study [38] found an association between Internet use in general and ADHD symptom levels.”
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“Synthesizing data from eight cross-sectional and three longitudinal studies, a systematic review from 2015 concluded that there was strong evidence to support a positive association between screen time and hyperactivity/ inattention symptoms in children and adolescents [56].”
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Adolescent social media use and well-being: a systematic review and thematic meta-synthesis
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“Whilst evidence is emerging to suggest that there are varying associations between different types of screen time and depressive symptoms, findings are inconsistent and primarily based on cross-sectional data (Hoare et al., 2016; Liu et al., 2016; Suchert et al., 2015).”
BackgroundResultInfluentialScreen time, physical activity and self-esteem in children: The Ulm birth cohort study
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Impact on adolescent mental health of replacing screen-use with exercise: A prospective cohort study
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The association between screen time and reported depressive symptoms among adolescents in Sweden
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Bidirectional association between sedentary behaviour and depressive symptoms in adolescent girls
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Hoare, E., Thorisdóttir, I. E., Kristjansson, A. L., Sigfusdóttir, I. D., Hayward, J., Allender, S., Strugnell, C., Reavley, N., Patton, G., Berk, M., et al. (2019) · Mental Health & Prevention · doi:10.1016/j.mhp.2019.200166 · Cited by 9 · see citing works
- Authors
- Suchert, V., Hanewinkel, R., & Isensee, B.
- Affiliations
- Institute for Therapy and Health Research (DE)
- Corresponding author
- Suchert, Vivien
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 76
- Pages
- 48-57
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W1981519474
- Cited by
- 329
- References
- 125
- Citations by year
- 2026: 14 · 2025: 22 · 2024: 30 · 2023: 19 · 2022: 84 · 2021: 30 · 2020: 36 · 2019: 30 · 2018: 18 · 2017: 22 · 2016: 21 · 2015: 3
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- German Cancer Aid (110012)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Education › Child Development and Digital Technology
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- sedentary behavior, screen time, mental health, children, adolescents, internalizing problems, psychological well-being, quality of life, self-esteem, depressive symptoms, eating disorder symptoms, anxiety symptoms
- MeSH terms
- Adolescent, Psychology, Adolescent, Child, Psychology, Child, Child, Preschool, Computers, Cross-Sectional Studies, Female, Humans, Male, Mental Health, Self Concept, Television, Sedentary Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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