The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis

Wang, Xiao; Li, Yuexuan; Fan, Haoliang

doi:10.1186/s12889-019-7904-9

Cited by 299Physical Activity and HealthErgonomics and Musculoskeletal DisordersImpact of Technology on Adolescents

The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis

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Wang, Xiao, Li, Yuexuan, Fan, Haoliang·2019·BMC Public Health

DOI 10.1186/s12889-019-7904-9PMC PMC6857327

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Abstract

Background: The use of computers/TV has become increasingly common worldwide after entering the twenty-first century and depression represents a growing public health burden. Understanding the association between screen time-based sedentary behavior (ST-SB) and the risk of depression is important to the development of prevention and intervention strategies. Methods: We searched the electronic databases of Medline, Embase and the Cochrane Library. The odds ratio (OR) with corresponding 95% confidence intervals (CIs) was adopted as the pooled measurement. Subgroup analyses were investigated by stratified meta-analyses based on age, gender and reference group (reference category of screen time, e.g. 2 h/day, 4 h/day). Results: There were 12 cross-sectional studies and 7 longitudinal studies met the inclusion criteria. Overall, the pooled OR was 1.28 with high heterogeneity (I 2 = 89%). Compared to those who reported less SB, persons reporting more SB had a significantly higher risk of depression. When the gender was stratified, the pooled OR was 1.18 in female groups while no significant association was observed in males. Among the 19 studies, 5 studies used a reference group with ST = 2 h/days (pooled OR = 1.46), 9 studies used ≥4 h as a reference group (pooled OR = 1.38), 2 studies used 1 h as a reference group (pooled OR = 1.07) and for the remaining 3 studies, hours of ST were calculated as a continuous variable (pooled OR = 1.04). Conclusions: ST-SB is associated with depression risk and the effects vary in different populations. In addition, valid objective measures of SB should be developed in future studies.

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More screen time has been associated with depressive symptoms among children and adolescents in several systematic reviews.
“More screen time has been associated with depressive symptoms among children and adolescents in several systematic reviews [11, 12, 43–50].”
From Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study (2024) · cites this paper as [49]
The results of the current review largely align with past systematic reviews, which have concluded that there is a positive association between screen time and depressive symptoms, and a weak association between screen time and both anxiety and self-esteem.
“The results of the current review largely align with past systematic reviews, which have concluded that there is a positive association between screen time and depressive symptoms (Hoare et al., 2016;Liu et al., 2016;Stiglic & Viner, 2019;Wang et al., 2019), and a weak association between screen time and both anxiety and self-esteem (Stiglic & Viner, 2019).”
From The relationship between screen time and mental health in young people: A systematic review of longitudinal studies (2021) · cites this paper as Wang et al., 2019

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Oberle, E., Ji, X. R., Kerai, S., Guhn, M., Schonert-Reichl, K. A., & Gadermann, A. M. (2020) · Preventive Medicine · doi:10.1016/j.ypmed.2020.106291 · Cited by 149 · see citing works
Effects of Acute and Chronic Exercises on Executive Function in Children and Adolescents: A Systemic Review and Meta-Analysis
Liu, S., Yu, Q., Li, Z., Cunha, P. M., Zhang, Y., Kong, Z., Wang, L., Chen, S., & Cai, Y. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.554915 · Cited by 152 · see citing works
“When EF are impaired, children generally show abnormalities in social functions, emotions, and cognition (Goodall et al., 2018; Wang et al., 2019), often accompanied by learning difficulties, conduct disorders, and maladaptive phenomena (Rocha et al.”
Background
Health behaviors and mental health during the COVID-19 pandemic: A longitudinal population-based survey in Germany
Mata, J., Wenz, A., Rettig, T., Reifenscheid, M., Möhring, K., Krieger, U., Friedel, S., Fikel, M., Cornesse, C., Blom, A. G., et al. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114333 · Cited by 143 · see citing works
“For example, longer screen times are related to poorer mental health and less physical activity (Allen et al., 2019; Wang et al., 2019).”
Depression and lifestyle: Focusing on nutrition, exercise, and their possible relevance to molecular mechanisms
Kunugi, H. (2023) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13551 · Cited by 112 · see citing works
“looking at screens such as computers and televisions) and risk of depression.(179) A meta-analysis of studies on children and adolescents also reported an association between screen time and risk of depression, with 1 h per day having the lowest risk and with the risk of depression increasing as the number of hours in…”
Background
Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study
Nagata, J. M., Al-Shoaibi, A. A. A., Leong, A. W., Zamora, G., Testa, A., Ganson, K. T., & Baker, F. C. (2024) · BMC Public Health · doi:10.1186/s12889-024-20102-x · Cited by 103 · see citing works
Digital screen time during the COVID-19 pandemic: a public health concern
Sultana, A., Tasnim, S., Hossain, M. M., Bhattacharya, S., & Purohit, N. (2021) · F1000Research · doi:10.12688/f1000research.50880.1 · Cited by 90 · see citing works
The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011–2012
Almohamad, M., Krall, E. A., Mofleh, D. I., & Spartano, N. L. (2022) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.13669 · Cited by 91 · see citing works
The influence of sedentary behaviour on mental health among children and adolescents: A systematic review and meta-analysis of longitudinal studies
Zhang, J., Yang, S. X., Wang, L., Han, L. H., & Wu, X. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.03.018 · Cited by 94 · see citing works
Musculoskeletal disorders in video gamers – a systematic review
Tholl, C., Bickmann, P., Wechsler, K., Froböse, I., & Grieben, C. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-05614-0 · Cited by 86 · see citing works
“Moreover, plenty of other health risk factors like depression in adults [65] and children [66] or obesity in childhood [67] have been linked to screen-based activities.”
Background
Association between Emotional Eating and Frequency of Unhealthy Food Consumption among Taiwanese Adolescents
Bui, C., Lin, L.-Y., Wu, C.-Y., Chiu, Y.-W., & Chiou, H. (2021) · Nutrients · doi:10.3390/nu13082739 · Cited by 75 · see citing works
“As for sedentary behavior, similar to a recent study [55], we classified screen-time-based sedentary behavior as spending ≥2 h/day watching TV, playing video games, or using a computer/mobile phone.”
Method
Combined healthy lifestyle and depressive symptoms: a meta-analysis of observational studies
Wang, X., Arafa, A., Liu, K., Eshak, E. S., Hu, Y., & Dong, J.-Y. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.04.030 · Cited by 69 · see citing works
“On the contrary, compared with those who reported less screen time-based sedentary behavior, persons reporting more sedentary behavior had a higher risk of depression (1.28 [1.17, 1.39]) (Wang et al., 2019).”
InfluentialSelf-citation
Screen time and depression risk: A meta-analysis of cohort studies
Li, L., Zhang, Q., Zhu, L., Zeng, G., Huang, H., Zhuge, J., Kuang, X., Yang, S., Yang, D., Chen, Z., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1058572 · Cited by 71 · see citing works
Time to Think “Meta”: A Critical Viewpoint on the Risks and Benefits of Virtual Worlds for Mental Health
Paquin, V., Ferrari, M., Sekhon, H., & Rej, S. (2023) · JMIR Serious Games · doi:10.2196/43388 · Cited by 68 · see citing works
Exploring the Heart–Mind Connection: Unraveling the Shared Pathways between Depression and Cardiovascular Diseases
Sobolewska-Nowak, J., Wachowska, K., Nowak, A., Orzechowska, A., Szulc, A., Płaza, O., & Gałecki, P. (2023) · Biomedicines · doi:10.3390/biomedicines11071903 · Cited by 72 · see citing works
“Research has shown that physical inactivity can be considered a risk factor for depression [62].”
Background
Extra-Curricular Activities and Well-Being: Results From a Survey of Undergraduate University Students During COVID-19 Lockdown Restrictions
Finnerty, R., Marshall, S. A., Imbault, C., & Trainor, L. J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.647402 · Cited by 71 · see citing works
Clusters of healthy lifestyle behaviours are associated with symptoms of depression, anxiety, and psychological distress: A systematic review and meta-analysis of observational studies
Bourke, M., Wang, H., McNaughton, S. A., Thomas, G., Firth, J., Trott, M., & Cairney, J. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102585 · Cited by 65 · see citing works
Symptoms of depression are related to sedentary behavior and sleep duration in elderly individuals: A cross-sectional study of 49,317 older Chinese adults
Luo, Y., Li, Y., Xie, J., Duan, Y., Gan, G., Zhou, Y., Luo, X., Wang, J., Chen, Z., Zhang, Q., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.102 · Cited by 54 · see citing works
Self-citation
Physical Activity, Screen-Based Sedentary Behavior and Physical Fitness in Chinese Adolescents: A Cross-Sectional Study
Dong, X., Ding, L., Zhang, R., Ding, M., Wang, B., & Yi, X. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.722079 · Cited by 51 · see citing works
Smartphone Screen Time Among University Students in Lebanon and Its Association With Insomnia, Bedtime Procrastination, and Body Mass Index During the COVID-19 Pandemic: A Cross-Sectional Study
Hammoudi, S. F., Mreydem, H. W., Ali, B. T. A., Saleh, N. O., Chung, S., Hallit, S. R., & Salameh, P. (2021) · Psychiatry Investigation · doi:10.30773/pi.2021.0120 · Cited by 50 · see citing works
Prospective relationships of adolescents’ screen-based sedentary behaviour with depressive symptoms: the Millennium Cohort Study
Kandola, A., Owen, N., Dunstan, D. W., & Hallgren, M. (2022) · Psychological Medicine · doi:10.1017/s0033291721000258 · Cited by 48 · see citing works
“Another meta-analysis that included adults also found the association between screen time and depressive symptoms was not present in males (Wang, Li, & Fan, 2019).”
Background
Validated assessment tools for screen media use: a systematic review.
Perez, O., Garza, T., Hindera, O., Beltran, A., Musaad, S. M., Dibbs, T., Singh, A., Chug, S., Sisson, A., Kumar Vadathya, A., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0283714 · Cited by 44 · see citing works
Bridging the relationship between physical exercise and mental health in adolescents based on network analysis
Yang, M.-B., Si, S., Zhang, K., Xi, M., & Zhang, W. (2024) · PsyCh Journal · doi:10.1002/pchj.756 · Cited by 46 · see citing works
“…relationship between physical exercise and mental health based on the sum-scores of psychological scales, the exact relationship between physical exercise and mental health remains unclear (Do et al., 2022; Recchia et al., 2023; Rossi et al., 2021; Vaquero-Solís et al., 2020; Wang et al., 2019).”
Background
Testing Bidirectional, Longitudinal Associations Between Disturbed Sleep and Depressive Symptoms in Children and Adolescents Using Cross-Lagged Models
Marino, C., Andrade, B. F., Montplaisir, J., Petit, D., Touchette, E., Paradis, H., Côté, S., Tremblay, R., Szatmari, P., & Boivin, M. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.27119 · Cited by 39 · see citing works
Digital screen time usage, prevalence of excessive digital screen time, and its association with mental health, sleep quality, and academic performance among Southern University students
Kaewpradit, K., Ngamchaliew, P., & Buathong, N. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1535631 · Cited by 69 · see citing works
The impact of sleep, physical activity and sedentary behaviour on symptoms of depression and anxiety before and during the COVID-19 pandemic in a sample of South African participants
Lewis, R., Roden, L. C., Scheuermaier, K. D., Gómez-Olivé, F. X., Rae, D. E., Iacovides, S., Bentley, A., Davy, J., Christie, C. J.-A., Zschernack, S., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-02021-8 · Cited by 47 · see citing works
“Page 6/27 Before Lockdown During Lockdown ISI score 4 (0, 26)f 10 (0, 28)f Bedtime regularity 2 (1, 7)f 4 (1, 7)f Wake-up time regularity 1 (1, 7)f 3 (1, 7)f Sleep duration regularity 2 (1, 7)f 4 (1, 7)f MPA (min/day) 30 (0, 180)a 10 (0, 180)b VPA (min/day) 30 (0, 180)a 15 (0, 180)b Total screen time (min/day) 464 ± 2…”
Sedentary Behavior and Lack of Physical Activity among Children in Indonesia
Hanifah, L., Nasrulloh, N., & Sufyan, D. L. (2023) · Children · doi:10.3390/children10081283 · Cited by 103 · see citing works
“Unfortunately, this sedentary lifestyle has serious consequences for physical and mental health [45,46].”
Background
International trends in screen-based behaviours from 2012 to 2019
Harvey, D. L., Milton, K. E., Jones, A., & Atkin, A. J. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106909 · Cited by 40 · see citing works
“research has linked higher amounts of screen time with negative physical and psychological health outcomes, including cardiovascular disease, all-cause mortality and depression (LeBlanc et al., 2017; Stamatakis et al., 2011; Wang et al., 2019).”
Background
Associations of 24-Hour Movement Behavior with Depressive Symptoms and Anxiety in Children: Cross-Sectional Findings from a Chinese Sample
Lu, S., Cheval, B., Yu, Q., Hossain, M. M., Chen, S., Taylor, A., Bao, R., Doig, S. R., Li, J., Wang, T., et al. (2021) · Healthcare · doi:10.3390/healthcare9111532 · Cited by 40 · see citing works
“Such a newly developed research paradigm can help researchers to understand the association of meeting the 24-HMB guidelines with health outcomes in a more comprehensive manner [11,12,23].”
Background
Classroom Movement Breaks Reduce Sedentary Behavior and Increase Concentration, Alertness and Enjoyment during University Classes: A Mixed-Methods Feasibility Study
Peiris, C. L., O’Donoghue, G., Rippon, L., Meyers, D., Hahne, A., De Noronha, M., Lynch, J., & Hanson, L. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115589 · Cited by 38 · see citing works
“Introduction High volumes of sedentary behaviour are associated with increased risk of poor health outcomes including all-cause mortality, obesity, cardiovascular disease, type 2 diabetes mellitus, cancer [1], depression [2] and anxiety [3].”
Background
Timing of sedentary behaviour and access to sedentary activities in the bedroom and their association with sleep quality and duration in children and youth: a systematic review
Saunders, T. J., McIsaac, T., Campbell, J., Douillette, K., Janssen, I., Tomasone, J. R., Ross‐White, A., Prince, S. A., & Chaput, J. (2022) · Health Promotion and Chronic Disease Prevention in Canada · doi:10.24095/hpcdp.42.4.03 · Cited by 45 · see citing works
Effects of limiting digital screen use on well-being, mood, and biomarkers of stress in adults
Pedersen, J., Rasmussen, M. G. B., Sørensen, S. O., Mortensen, S. R., Olesen, L. G., Brage, S., Kristensen, P. L., Puterman, E. M., & Grøntved, A. (2022) · npj Mental Health Research · doi:10.1038/s44184-022-00015-6 · Cited by 39 · see citing works
The Associations between Meeting 24-Hour Movement Guidelines (24-HMG) and Self-Rated Physical and Mental Health in Older Adults—Cross Sectional Evidence from China
Luo, L., Cao, Y., Hu, Y., Wen, S., Tang, K., Ding, L., & Song, N. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013407 · Cited by 39 · see citing works
“Previous studies carried out have found that the three guidelines of adequate physical activity (PA ≥ 150 min/week) [11,12], restricted sedentary time (sedentary time ≤ 480 min/day, and/or screen time ≤180 min/day) [13,14] and good sleep duration (to meet age-specific needs) [15,16] were each associated with physical…”
Background
Digital screen time during COVID-19 pandemic: A public health concernPreprint
Sultana, A., Tasnim, S., Bhattacharya, S., Hossain, M. M., & Purohit, N. (2020) · doi:10.31235/osf.io/e8sg7 · Cited by 36 · see citing works
The relationships between screen time and mental health problems among Chinese adults
Zhang, Y., Li, Q., Hu, W., Zhan, N., Zou, J., Wang, J., & Geng, F. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.11.017 · Cited by 34 · see citing works
Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use
Johnstad, P. G. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1268339 · Cited by 37 · see citing works
Unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents
Cao, R., Gao, T.-T., Ren, H., Hu, Y.-Y., Qin, Z.-Y., Liang, L., Li, C., & Mei, S.-L. (2021) · International Journal of Social Psychiatry · doi:10.1177/0020764021996739 · Cited by 27 · see citing works
“In China, smoking and drinking among adolescents have been commonly reported (Wang et al., 2019).”
Background
Sedentary behavior is associated with the mental health of university students during the Covid-19 pandemic, and not practicing physical activity accentuates its adverse effects: cross-sectional study
Barbosa, B. C. R., de Menezes-Júnior, L. A. A., de Paula, W., Chagas, C. M. D. S., Machado, E. L., de Freitas, E. D., Cardoso, C. S., Vidigal, F. D. C., Nobre, L. N., da Silva, L. S., et al. (2024) · BMC Public Health · doi:10.1186/s12889-024-19345-5 · Cited by 41 · see citing works
“Epidemiological studies have demonstrated that increased time spent on SB is associated with adverse health outcomes, including chronic non-communicable diseases (NCDs), mental disorders, and premature mortality [14, 30, 31].”
BackgroundInfluential
Effects of 8-week high-intensity interval training and moderate-intensity continuous training on bone metabolism in sedentary young females
Lu, M., Li, M., Yi, L., Li, F., Feng, L., Ji, T., Zang, Y., & Qiu, J. (2022) · Journal of Exercise Science & Fitness · doi:10.1016/j.jesf.2022.01.001 · Cited by 33 · see citing works
A review of the 257 meta-analyses of the differences between females and males in prevalence and risk, protective factors, and treatment outcomes for mental disorder
Kayrouz, R., Karin, E., Staples, L., Dear, B. F., Nielssen, O. B., & Titov, N. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06848-7 · Cited by 38 · see citing works
Satisfaction with Life: Mediating Role in the Relationship between Depressive Symptoms and Coping Mechanisms
Almeida, D., Monteiro, D., & Rodrigues, F. F. (2021) · Healthcare · doi:10.3390/healthcare9070787 · Cited by 30 · see citing works
Dog ownership and adults’ objectively-assessed sedentary behaviour and physical activity
Koohsari, M. J., Shibata, A., Ishii, K., Kurosawa, S., Yasunaga, A., Hanibuchi, T., Nakaya, T., McCormack, G. R., & Oka, K. (2020) · Scientific Reports · doi:10.1038/s41598-020-74365-6 · Cited by 30 · see citing works
Internet use, physical activity and depressive symptoms in older adults: A cross-lagged panel analysis
Liu, N., Wang, Y., & Li, Z. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.201 · Cited by 27 · see citing works
Nighttime smartphone use, sleep quality, and mental health: investigating a complex relationship
Andersen, T. O., Sejling, C., Jensen, A. K., Drews, H. J., Ritz, B. R., Varga, T. V., & Rod, N. H. (2023) · SLEEP · doi:10.1093/sleep/zsad256 · Cited by 31 · see citing works
The Associations Between Screen Time and Mental Health in Adults: A Systematic Review
Santos, R. M. S., Ventura, S. D. A., Nogueira, Y. J. D. A., Mendes, C. G., de Paula, J. J., de Miranda, D. M., & Romano‐Silva, M. A. (2024) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-024-00398-7 · Cited by 26 · see citing works
“Currently, and even before the conditions of isolation, adults study or work in front of computers (Wang et al., 2019).”
The effect of two types of combined training on bio-motor ability adaptations in sedentary females
Nobarı, H., Ahmadi, M., Sá, M., Pérez‐Gómez, J., Clemente, F. M., Adsuar, J. C., Minasian, V., & Afonso, J. R. (2021) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.20.11736-5 · Cited by 26 · see citing works
Juego y tareas escolares: el papel de la escuela y la familia en tiempos de confinamiento por la COVID-19
Varela, A., Vale, R. F., & Gómez, S. L. (2021) · Estudios sobre Educación · doi:10.15581/004.41.001 · Cited by 25 · see citing works
The Y‐STR landscape of coastal southeastern Han: Forensic characteristics, haplotype analyses, mutation rates, and population genetics
Fan, H., Zeng, Y., Wu, W., Liu, H., Xu, Q., Du, W., Hao, H., Liu, C., Ren, W., Wu, W., et al. (2021) · Electrophoresis · doi:10.1002/elps.202100037 · Cited by 25 · see citing works
Self-citation
A cross-sectional analysis of the association between physical activity, depression, and all-cause mortality in Americans over 50 years old
Pérez-Lasierra, J. L., Moreno‐Franco, B., González‐Agüero, A., Lobo, E., & Casajús, J. A. (2022) · Scientific Reports · doi:10.1038/s41598-022-05563-7 · Cited by 24 · see citing works
Coping strategies for COVID-19 pandemic-related stress and mental health during pregnancy
Badon, S. E., Croen, L., Ferrara, A. M., Ames, J., Hedderson, M. M., Young‐Wolff, K. C., Zhu, Y., & Avalos, L. A. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.146 · Cited by 24 · see citing works
Physical activity and sedentary behaviour-specific domains and their associations with mental health in adults: a systematic review
Teno, S. C., Silva, M. N., & Júdice, P. B. (2024) · Advances in Mental Health · doi:10.1080/18387357.2024.2324099 · Cited by 25 · see citing works
Role of Sleep and White Matter in the Link Between Screen Time and Depression in Childhood and Early Adolescence
Santos, J. P. L., Soehner, A. M., Biernesser, C. L., Ladouceur, C. D., & Versace, A. (2025) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2025.1718 · Cited by 25 · see citing works
Relationships between screen time and childhood attention deficit hyperactivity disorder: a Mendelian randomization study
Meng, Z., Ao, B., Wang, W., Niu, T., Chen, Y., Ma, X., & Huang, Y. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1441191 · Cited by 22 · see citing works
Lifestyle Prescription for Depression with a Focus on Nature Exposure and Screen Time: A Narrative Review
Balanzá‐Martínez, V., & Cervera-Martínez, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095094 · Cited by 22 · see citing works
“In other studies, individuals who spent at least two hours per day of ST-based sedentary behavior were more likely to have depression [53].”
Background
Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women
Draper, C. E., Cook, C. J., Redinger, S., Rochat, T., Prioreschi, A., Rae, D. E., Ware, L. J., Lye, S. J., & Norris, S. A. (2022) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-022-01325-w · Cited by 25 · see citing works
“Evidence also exists for the inverse relationship between sedentary behaviour and mental health in adults [23, 24] and adolescents [22, 25, 26].”
Background
Headache in Children and Adolescents: The Association between Screen Time and Headache within a Clinical Headache Population
Lund, J., Berring-Uldum, A. A., Colak, M., & Debes, N. M. (2021) · Neuropediatrics · doi:10.1055/s-0041-1740550 · Cited by 21 · see citing works
The Associations of Electronic Media Use With Sleep and Circadian Problems, Social, Emotional and Behavioral Difficulties in Adolescents
Li, T. M. H., Chan, N. Y., Li, C.-T., Chen, J., Chan, J. W. Y., Liu, Y., Li, S. X., Li, A. M., Zhang, J., & Wing, Y. K. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.892583 · Cited by 21 · see citing works
Association between sedentary behavior and depression among Japanese medical students during the COVID-19 pandemic: a cross-sectional online survey
Tashiro, T., Maeda, N., Tsutsumi, S., Komiya, M., Arima, S., Mizuta, R., Fukui, K., Nishikawa, Y., & Urabe, Y. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03997-x · Cited by 20 · see citing works
“Prolonged screen time-based sedentary behavior can affect the prevalence of depression by impairing biological functions such as central nervous system arousal and sleep disorders [10].”
Background
Influence of Prolonged Visual Display Terminal Use on Physical and Mental Conditions among Health Care Workers at Tertiary Hospitals, Taiwan
Tsou, M.-T. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19073770 · Cited by 19 · see citing works
“People who spend more than four hours using VDTs are at a higher risk of developing depression [14].”
Background
Association between meatless diet and depressive episodes: A cross-sectional analysis of baseline data from the longitudinal study of adult health (ELSA-Brasil)
Kohl, I. S., Luft, V. C., Patrão, A. L., Molina, M. D. C. B., Nunes, M. A., & Schmidt, M. I. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.09.059 · Cited by 19 · see citing works
Gender Differences in Excessive Screen Time among Chinese High School Students in Henan Province
Cui, Z., Zou, P., Lin, Z., Cao, Y., & Luo, Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010721 · Cited by 19 · see citing works
“Excessive ST may reduce social interaction and engagement, thus increasing the risk of mental health problems, such as feelings of loneliness, the likelihood of depression, and anxiety [39].”
Background
How much time in sedentary behavior is associated with probable sarcopenia in older adults?
de Souza, L. F., Danielewicz, A. L., Rech, C. R., d’Orsi, E., Mendonça, V. A., Lacerda, A. C. R., & de Avelar, N. C. P. (2022) · Geriatric Nursing · doi:10.1016/j.gerinurse.2022.09.007 · Cited by 18 · see citing works
Association between physical activity levels and depressive symptoms in patients with minor ischemic stroke
Ashizawa, R., Honda, H., Yoshizawa, K., Kameyama, Y., & Yoshimoto, Y. (2022) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2022.106641 · Cited by 17 · see citing works
The context matters - not all prolonged sitting bouts are equally related to momentary affective states: an ambulatory assessment with sedentary-triggered E-diaries
Kanning, M. K., Niermann, C. Y. N., Ebner-Primer, U., & Giurgiu, M. (2021) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-021-01170-3 · Cited by 17 · see citing works
“A further meta-anlyses confirmed these findings but indicate a significant associations only in femals but not in males [15].”
Result
“Appreciate the Little Things”: A Qualitative Survey of Men’s Coping Strategies and Mental Health Impacts During the COVID-19 Pandemic
Wilson, M. J., Seidler, Z. E., Oliffe, J. L., Toogood, N., Kealy, D., Ogrodniczuk, J. S., Walther, A., & Rice, S. (2022) · American Journal of Men s Health · doi:10.1177/15579883221099794 · Cited by 17 · see citing works
“This is potentially explained by increasing societal understanding of associations between excessive screen time and psychological distress (Wang et al., 2019).”
Background
Increased screen time and its association to migraine and tension-type headache: a cross-sectional investigation among Bangladeshi students
Roy, S., Iktidar, M. A., Chowdhury, S., Pulock, O. S., Pinky, S. D., & Sharif, A. B. (2024) · BMJ Neurology Open · doi:10.1136/bmjno-2024-000656 · Cited by 16 · see citing works
Association between health behaviors and depression: findings from the 2019 Brazilian National Health Survey
Barros, M. B. D. A., Medina, L. D. P. B., Lima, M. G., de Azevedo, R. C. S., Sousa, N. F. D. S., & Malta, D. C. (2021) · Revista Brasileira de Epidemiologia · doi:10.1590/1980-549720210010.supl.2 · Cited by 18 · see citing works
Discrepancies Between Self-reported and Objectively Measured Smartphone Screen Time: Before and During Lockdown
Júdice, P. B., Sousa‐Sá, E., & Palmeira, A. L. (2023) · Journal of Prevention · doi:10.1007/s10935-023-00724-4 · Cited by 17 · see citing works
“Research has shown, quite consistently, that increased screen time (from 3 to 4 h/day) is associated with multiple adverse health outcomes (Dunstan et al., 2010; Wang et al., 2019) and all cause mortality (Celis-Morales et al., 2018), irrespective of PA levels.”
Background
Sitting vs. standing: an urgent need to rebalance our world
Bonnet, C. T., & Cheval, B. (2022) · Health Psychology Review · doi:10.1080/17437199.2022.2150673 · Cited by 16 · see citing works
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BackgroundInfluential
Screen viewing patterns and their association with mental wellbeing and psychological distress: a cross-sectional study amongst university students
Chen, M., Padmapriya, N., Chua, X. H., Escobosa, L. L. T., Tay, A. E., Tai, B. C., Petrunoff, N., & Müller‐Riemenschneider, F. (2024) · BMC Public Health · doi:10.1186/s12889-024-19608-1 · Cited by 18 · see citing works
“Past studies on television SV have produced inconsistent findings [20, 22, 58].”
Background
Sedentary behavior and physical activity are associated with risk of depression among adult and older populations: a systematic review and dose–response meta-analysis
Wang, D., Zhang, Y., Guo, Z., & Lu, S. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1542340 · Cited by 15 · see citing works
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Longitudinal Effects of Screen Time on Depressive Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior
Hökby, S., Westerlund, J., Alvarsson, J., Carli, V., & Hadlaczky, G. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043771 · Cited by 16 · see citing works
“A meta-analysis [34] further showed that pooled associations between screen-”
Background
Association between screen time and physical activity on mental health among preschoolers: a cross-sectional study from Southwest China
Liang, Y., Jin, Q., Miao, J., Ni, X., Qian, X., Yi, X., Liu, Z., & Xue, H. (2024) · BMC Public Health · doi:10.1186/s12889-024-17722-8 · Cited by 19 · see citing works
“We also observed gender differences in the association between ST and MHP. Specifically, at the same level of ST (2–4 h/day), a slightly stronger association with MHP was observed in girls, these findings were in line with previous research [52, 53].”
Result
Interaction Effect between Physical Activity and the BDNF Val66Met Polymorphism on Depression in Women from the PISMA-ep Study
Zarza-Rebollo, J. A., Molina, E., López‐Isac, E., Pérez-Gutiérrez, A. M., Gutiérrez, B., Cervilla, J. A., & Rivera, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19042068 · Cited by 14 · see citing works
“Similarly, another recent meta-analysis reported an increased risk of developing depression when sedentary behaviour was higher [11].”
BackgroundResult
24-Hour Rest-Activity Rhythm in Middle-Aged and Older Persons with Depression
Hayashi, M., Takeshima, M., Hosoya, T., & Kume, Y. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20075275 · Cited by 14 · see citing works
“In a cross-sectional study targeting community-dwellers with mild to moderate depression and anxiety, longer sedentary times during 24 h daily periods were observed [7], and longer screen-times associated with sedentary behaviors were reported in a systematic review [8].”
Background
Social media disorder in relation to device screen time and autosuggested social media content engagement
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“This is essentially a matter of concern for parents and teachers, because it is affecting students’ academic performance as well as their mental health (Adelantado‐Renau et al., 2019a; Horowitz-Kraus and Hutton, 2018; Kim et al., 2020; Wang et al., 2019).”
Background
Association between physical activity and sedentary behavior and depression in US adults with cardiovascular disease: NHANES 2007–2016
Yang, Y., Wang, Y., & Yang, L. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.012 · Cited by 14 · see citing works
The influence of screen time on behaviour and emotional problems among adolescents: a comparison study of the pre-, peak, and post-peak periods of COVID-19
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Longitudinal Associations Between Cultural Engagement and Mental and Social Well-Being: A Fixed-Effects Analysis of the English Longitudinal Study of Ageing
Finn, S., Bone, J. K., Fancourt, D. E., Warran, K., & Mak, H. W. (2025) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbaf074 · Cited by 12 · see citing works
“Additionally, screen time (e.g., TV viewing) has been associated with poorer mental health (Wang et al., 2019) and cognitive decline (Fancourt & Steptoe, 2019b), which may also explain these differences.”
Physical activity levels, recreational screen time, sleep quality and mood among young adult healthcare students at an international university in Bahrain: a cross-sectional study
AlKhenaizi, A. K., Shakeeb, F. N., Fredericks, S., & Gaynor, D. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-093655 · Cited by 17 · see citing works
Association of Work-Related Sedentary Behavior With Mental Health and Work Engagement Among Japanese White- and Blue-Collar Workers
Sakakibara, K. S., Miyanaka, D., Tokita, M., KAWADA, M., Mori, N., Hamsyah, F., Lin, Y., & Shimazu, A. (2023) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002952 · Cited by 13 · see citing works
Nonlinear Associations between Physical Function, Physical Activity, Sleep, and Depressive Symptoms in Older Adults
Bae, S., Jang, M., Kim, G.-M., Yang, J., Thapa, N., Park, H.-J., & Park, H. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12186009 · Cited by 13 · see citing works
“Patients with depression are typically inactive, and a sedentary lifestyle increases the risk of depression [3,4].”
Promoting Sleep and Balanced Screen Time among School-Aged Children with Neurodevelopmental and Mental Health Disorders: A Parent Perspective
Blaine, R. E., Bowling, A. B., Kaur, R., & Davison, K. K. (2021) · Childhood Obesity · doi:10.1089/chi.2020.0335 · Cited by 13 · see citing works
“30 However, perhaps especially troubling children with N/MHD is that increased screen time is also associated with reduced psychological well-being, 31 slowed learning, 32 and reduced cognitive development.”
Investigating the impacts of working at home among office workers with neck pain on health status, depression and sleep quality during the COVID-19 pandemic
Çiftçi, B., & Demirhan, F. (2022) · International Journal of Occupational Safety and Ergonomics · doi:10.1080/10803548.2022.2090132 · Cited by 13 · see citing works
Media Effects on Individual Worldview and Wellness for Long-Term Care Residents Amid the COVID-19 Virus
Schroyer, D. (2020) · The Gerontologist · doi:10.1093/geront/gnaa095 · Cited by 13 · see citing works
Nudging digital physical activity breaks for home studying of university students—A randomized controlled trial during the COVID-19 pandemic with daily activity measures
Teuber, M., Leyhr, D., Moll, J., & Sudeck, G. (2022) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2022.1024996 · Cited by 11 · see citing works
“Technological advances allowing students to study in the comfort of their own homes without changing locations, as well as higher screen time have also led to an increase in sedentary behaviors (6, 7).”
Background
Association of Computer Vision Syndrome with Depression/Anxiety among Lebanese Young Adults: The Mediating Effect of Stress
Issa, R., Sfeir, M., Azzi, V., Salameh, P., Akiki, M., Akel, M., Hallit, S. R., Obeïd, S., Malaeb, D. N., & Hallit, R. R. (2023) · Healthcare · doi:10.3390/healthcare11192674 · Cited by 12 · see citing works
“Screen time was also positively 278 correlated with anxiety and depressive symptoms, as well as insomnia [27,42,43].”
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González, R. L., Noriega, C., Espín‐Lorite, E. J., García-Sastre, M., Rodríguez‐Rojo, I. C., Cuesta‐Lozano, D., & Peñacoba, C. (2022) · International Journal of Mental Health Nursing · doi:10.1111/inm.13077 · Cited by 13 · see citing works
Determinants of recreational screen time behavior following the COVID-19 pandemic among Canadian adults
Liu, S., Coulter, R., Sui, W., Nuss, K. J., & Rhodes, R. E. (2023) · Applied Physiology Nutrition and Metabolism · doi:10.1139/apnm-2022-0379 · Cited by 12 · see citing works
Replacing sedentary behavior with physical activity reduces symptoms of anxiety and depression: a study with young adults
Barbosa, B. C. R., de Menezes-Júnior, L. A. A., Fróis, L. F., Vidigal, M. C. A., de Paula, W., Chagas, C. M. D. S., Machado, E. L., Nobre, L. N., de Freitas, E. D., Vidigal, F. D. C., et al. (2025) · BMC Public Health · doi:10.1186/s12889-025-23523-4 · Cited by 13 · see citing works
“In contrast, SB, has been identified as a risk factor for mental disorders in the population [47, 49, 51, 52].”
Asociación entre problemas de sueño y rendimiento escolar: Resultados de la encuesta de salud y rendimiento escolar de la provincia del Biobío 2018
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“Resolución de tareas complejas†† Me cuesta mucho 45 (11,4) 64 (18,9) 109 (14,9) Tengo algunos problemas 146 (37,0) 133 (39,3) 279 (38,1) No tengo problemas 204 (51,6) 141 (41,7) 345 (47,1,)”
Association between clustering of unhealthy behaviors and depressive symptom among adolescents in Taiwan: A nationwide cross-sectional survey
Bui, C., Lin, L.-Y., Lin, C.-J., Chiu, Y.-W., & Chiou, H.-Y. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1049836 · Cited by 11 · see citing works
“There was additional evidence of the dose-response relationship between screen-based sedentary behavior and depression (15, 35).”
Background

MOESM3 of The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis
(19312), X. W., (1735318), Y. L., & Fan, H. (2019) · Figshare
Self-citation
Association of screen time-based sedentary behavior and the risk of depression in children and adolescents: Dose-response meta-analysis
Zou, Z., Wang, H., Wang, H., Wen, Q., & Luo, X. (2021) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) · doi:10.15761/0101-60830000000314 · Cited by 1 · see citing works
MOESM1 of The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis
Wang, X., Li, Y., & Fan, H. (2019) · Figshare · doi:10.6084/m9.figshare.10310018
Self-citation
Dose-response association of screen time-based sedentary behaviour in children and adolescents and depression: a meta-analysis of observational studies
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MOESM4 of The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis
Wang, X., (1735318), Y. L., & Fan, H. (2019) · Figshare · doi:10.6084/m9.figshare.10310039
Self-citation

Authors: Wang, X., Li, Y., & Fan, H.
Affiliations: Shanxi Medical University (CN)
Southern Medical University (CN)
Corresponding author: Wang, Xiao
Fan, Haoliang
ORCID: Wang, Xiao
Fan, Haoliang
Venue: BMC Public Health
Publisher: Springer Science and Business Media LLC
Published: 2019-11-14
Volume: 19
Issue: 1
Pages: 1524-1524
ISSN: 1471-2458 (ISSN-L)
DOI: 10.1186/s12889-019-7904-9
PMC: PMC6857327
OpenAlex: W2988909975
Cited by: 299
References: 60
Citations by year: 2026: 43 · 2025: 49 · 2024: 51 · 2023: 48 · 2022: 53 · 2021: 40 · 2020: 14 · 2016: 1
FWCI: 3.15
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: BMC Public Health (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Technology Plans to Youth R&D Innovation (QCXM201705)
Topics: Health Sciences › Medicine › Physiology › Physical Activity and Health
Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
Keywords: screen time, sedentary behavior, depression, depression risk, gender differences, reference groups, television viewing, computer use
MeSH terms: Screen Time, Adolescent, Adult, Aged, Aged, 80 and over, Computers, Cross-Sectional Studies, Depression, Depressive Disorder, Female, Humans, Male, Mental Health, Middle Aged, Television, Exercise, Young Adult, Sedentary Behavior

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The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis

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