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The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis
Open accessAbstract
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 [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]
In the citing paper
“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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BackgroundHow 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 19
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 19
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 18
“A further meta-anlyses confirmed these findings but indicate a significant associations only in femals but not in males [15].”
ResultWilson, 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
“This is potentially explained by increasing societal understanding of associations between excessive screen time and psychological distress (Wang et al., 2019).”
BackgroundRoy, 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
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 21
Júdice, P. B., Sousa‐Sá, E., & Palmeira, A. L. (2023) · Journal of Prevention · doi:10.1007/s10935-023-00724-4 · Cited by 21
“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.”
BackgroundSitting 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 18
“…2019; Jones et al., 2019; Katzmarzyk et al., 2019; Labonté-LeMoyne et al., 2020; Magnon et al., 2018; Melvin et al., 2020; Patterson et al., 2018; Wang et al., 2019), cancers (Jones et al., 2019; Katzmarzyk et al., 2019; Magnon et al., 2018; Melvin et al., 2020; Owen et al., 2020; Patterson et…”
BackgroundInfluentialChen, 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
“Past studies on television SV have produced inconsistent findings [20, 22, 58].”
BackgroundWang, D., Zhang, Y., Guo, Z., & Lu, S. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1542340 · Cited by 15
Mattiello, R., Ayala, C. O., Pedron, F. F., Ferreira, I. C. S., Ley, L. L. G., Paungartner, L. M., Martins, M. D. S., Bagatini, M. A., Batista, N. O. W., Cecagno, P. O. M., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-063902 · Cited by 17
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
“A meta-analysis [34] further showed that pooled associations between screen-”
BackgroundLiang, 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
“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].”
ResultZarza-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 15
“Similarly, another recent meta-analysis reported an increased risk of developing depression when sedentary behaviour was higher [11].”
BackgroundResult24-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
“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].”
BackgroundPrakasha, G. S., Kenneth, A., & Lapina, M. (2023) · Kontakt · doi:10.32725/kont.2023.021 · Cited by 14
“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).”
BackgroundYang, Y., Wang, Y., & Yang, L. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.012 · Cited by 14
Wiguna, T., Minayati, K., Kaligis, F., Teh, S. D., Sourander, A., Dirjayanto, V. J., Krishnandita, M., Meriem, N., & Gilbert, S. (2024) · Heliyon · doi:10.1016/j.heliyon.2023.e23325 · Cited by 13
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
“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.”
AlKhenaizi, A. K., Shakeeb, F. N., Fredericks, S., & Gaynor, D. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-093655 · Cited by 17
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
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
“Patients with depression are typically inactive, and a sedentary lifestyle increases the risk of depression [3,4].”
Blaine, R. E., Bowling, A. B., Kaur, R., & Davison, K. K. (2021) · Childhood Obesity · doi:10.1089/chi.2020.0335 · Cited by 14
“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.”
Çiftçi, B., & Demirhan, F. (2022) · International Journal of Occupational Safety and Ergonomics · doi:10.1080/10803548.2022.2090132 · Cited by 13
Schroyer, D. (2020) · The Gerontologist · doi:10.1093/geront/gnaa095 · Cited by 13
Teuber, M., Leyhr, D., Moll, J., & Sudeck, G. (2022) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2022.1024996 · Cited by 11
“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).”
BackgroundIssa, 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 14
“Screen time was also positively 278 correlated with anxiety and depressive symptoms, as well as insomnia [27,42,43].”
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 14
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 15
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
“In contrast, SB, has been identified as a risk factor for mental disorders in the population [47, 49, 51, 52].”
Henríquez‐Beltrán, M., Zapata-Lamana, R., Ibarra-Mora, J., Sepúlveda-Martin, S., Martínez-González, L., & Cigarroa, I. (2022) · Andes pediatrica · doi:10.32641/andespediatr.v93i2.3734 · Cited by 11
“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,)”
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
“There was additional evidence of the dose-response relationship between screen-based sedentary behavior and depression (15, 35).”
Background
Metadata
- Authors
- Wang, X., Li, Y., & Fan, H.
- Affiliations
- Shanxi Medical University (CN)
- Southern Medical University (CN)
- Corresponding author
- Wang, Xiao
- Fan, Haoliang
- Venue
- BMC Public Health
- Published
- 2019-11-14
- Volume
- 19
- Issue
- 1
- Pages
- 1524-1524
- ISSN
- 1471-2458 (ISSN-L)
- 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
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- 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 › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Social Sciences › Human Factors and Ergonomics › 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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