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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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Sedentary Behavior and Risk of Depression in Older Adults: A Systematic Meta-Analysis
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“Furthermore, sufficient sleep was linked to lower alcohol consumption (OR = 1.37, p = 0.015), as proper rest is associated with reduced stress and improved decision-making, which lowers the likelihood of drinking to alleviate stress (84).”
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“Screen time usage among Indigenous Peoples may also be higher than Canadian guidelines [8], which is linked to depression [21].”
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“Gradually, indirect effects may occur, including obesity [5], high blood pressure [6], variation of lipoprotein parameters [7] and depression [8].”
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Stakeholder perspectives on digital wellbeing in Saudi Arabia: a cross-sectional survey
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“Previous studies implied that prolonged screening might also lead to poor health (Biswas et al., 2015; Zhai et al., 2015; Wang et al., 2019; Mougharbel and Goldfield, 2020).”
BackgroundMaciel, G. P., da Costa, B. G. G., Bezerra, I. N., da Silva, K. S., Lopes, I. E., de Castro, V. H. S., & Filho, V. C. B. (2023) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2023.10.027 · Cited by 3
Zheng, A., Pahlen, S., Vo, T., Lawrence, F., Dungore, F., Lor, E., Bowman, N. D., Corley, R. P., Friedman, N. P., Wadsworth, S. J., et al. (2024) · Computers in Human Behavior · doi:10.1016/j.chb.2024.108401 · Cited by 6
Al-akshar, S., Ibrahim, S. T., & Katapally, T. R. (2024) · PLOS Digital Health · doi:10.1371/journal.pdig.0000448 · Cited by 4
The influence of health-promoting schools on the students’ active and sedentary behaviour
Valencia‐Peris, A., Sanchis-Francés, L., & Chinchilla-Ramírez, C. (2025) · Psychology Society & Education · doi:10.21071/pse.v17i1.17384 · Cited by 3
“This trend is influenced by a combination of factors, including an increase in academic demands, as well as a rise in screen time associated with both educational and recreational activities (Wang et al., 2019).”
Wei, X., Li, S., Yue, W., Zhang, Z., Wei, J., Wang, L., Hu, B., Long, N., Li, C., Hou, B., et al. (2025) · BMC Public Health · doi:10.1186/s12889-025-22030-w · Cited by 3
“A meta-analysis revealed that people with a longer SB duration had a 1.28-fold greater risk of depression than did those who spent less time sitting in front of a screen [9].”
InfluentialGoux, D., & Eric Maurin, A. (2025) · The Economic Journal · doi:10.1093/ej/ueaf025 · Cited by 3
Stewart, C., Bennett-Fakahau, I., Nada‐Raja, S., & Stewart, K. (2024) · Kōtuitui New Zealand Journal of Social Sciences Online · doi:10.1080/1177083x.2024.2347409 · Cited by 3
“Excessive screen time, a prevalent issue in New Zealand (Norton 2022), has been linked to elevated levels of anxiety and depression (Maras et al. 2015; Wang et al. 2019).”
Tian, H., Wang, A., Wu, H., Zhou, C., Zhang, Z., & Wang, J. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1425060 · Cited by 4
“The meta-analysis revealed that SE-SB is linked to an increased risk of depression (51).”
BackgroundWang, W., Wu, M., Yuan, X., Wang, X., Ma, L., Li, L., & Zhang, L. (2025) · JMIR Mental Health · doi:10.2196/71264 · Cited by 3
“Several investigations have explored associations between smartphone use behaviors—including smartphone screen time of use, number of smartphone unlocks, and text message volume—and mental health outcomes [5-8].”
Self-citationWagner, J. A., Bermúdez‐Millán, A., Berthold, S. M., Buckley, T., Buxton, O. M., Feinn, R., Kong, S., Kuoch, T., Master, L., Scully, M. F., et al. (2022) · Stress and Health · doi:10.1002/smi.3189 · Cited by 5
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“Individuals with a severe mental illness may under- or overestimate their symptom profiles [12].”
BackgroundFaúndez-Casanova, C., Alfaro, C. A., Vilaza, C. D., Oyarce, L. R., Albornoz, T. S., Amigo, L. S., & Castillo-Retamal, F. (2023) · Retos · doi:10.47197/retos.v49.94971 · Cited by 3
Lim, S. X., Lim, C. G. Y., Müller‐Riemenschneider, F., van Dam, R. M., Sim, X., Chong, M. F., & Chia, A. (2023) · Preventive Medicine · doi:10.1016/j.ypmed.2023.107821 · Cited by 3
Singh, A., Lekha, P. P. S., Jadhav, B. N., & Azeez, E. P. A. (2025) · Adolescent Psychiatry · doi:10.2174/0122106766351202250110055724 · Cited by 2
What if You Let Them Stand? A 2-Year Follow-up on Sit-Stand Desk
Silva, H., Teno, S. C., & Júdice, P. B. (2025) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000003438 · Cited by 3
Wan, Z., Cai, S., & Mo, H. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121326 · Cited by 2
Carlander, A., Cassel, S., Höök, M. J., Lundgren, O., Bagge, A. L., & Löf, M. (2026) · Acta Paediatrica · doi:10.1111/apa.70524 · Cited by 2
“Our general finding that screen time was negatively associated with mental health agreed with most studies [3–7, 9, 10, 24].”
Zhang, G.-X., Zhao, R. Z., Zhang, W., Yu, W., Zhang, X.-J., Gao, S., Leal, I. R. O., Carrilllo-Vico, A., Toledo, M. C., O′Farrill, Z., et al. (2021) · Neurology Perspectives · doi:10.1016/j.neurop.2021.10.004 · Cited by 3
“Studies have found that the daily amount of time spent looking at the screen is much higher than recommended for adults, which can contribute to mental illnesses, such as depression, etc.(36) During the COVID-19 pandemic, more than half of the population experienced changes in their eating habits, decreased physical a…”
Subjective impact of COVID-19 pandemic on youth with tic and OCD spectrum disorders
Tomczak, K. K., Worhach, J., Nguyen, S. T. T., Liu, S., Hoeppner, S. S., Zhang, B., & Greenberg, E. (2023) · Personalized Medicine in Psychiatry · doi:10.1016/j.pmip.2023.100103 · Cited by 2
“Previous research has found that excessive screen use (>2 h) in children and adolescents has been associated with higher risk of depression [38,39].”
BackgroundRole of polygenic risk scores in the association between chronotype and health risk behaviors
Zhang, Y., Li, S., Xie, Y., Xiao, W., Xu, H., Jin, Z., Li, R., Wan, Y., & Tao, F. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05337-z · Cited by 2
“Mental health, as one of the common effects leading to HRB, have also been reported in several studies [40, 41], with some studies finding the interaction between clock genes and mental health to be related to sleep behavior problems [42].”
ResultBreasts as a perceived barrier to physical activity in Mexican women: A cross-sectional study
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“Recent evidence suggests an association between sedentary behavior and depressive symptoms (9).”
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Prevalence of Unhealthy Lifestyle Behaviours in Children and Adolescents with Mental Disorders
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Hatha Yoga: efeito da prática nos níveis de ansiedade e depressão em estudantes universitários
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Specific Types of Screen-Based Sedentary Time and Depressive Symptoms in Adolescents
Shande, L. (2022) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2022.018542 · Cited by 1
Sedentary behavior and mental health in older adults
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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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