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Prospective relationships of adolescents’ screen-based sedentary behaviour with depressive symptoms: the Millennium Cohort Study

Published online by Cambridge University Press:  19 February 2021

A. Kandola Open the ORCID record for A. Kandola [Opens in a new window] ,
N. Owen ,
D. W. Dunstan  and
M. Hallgren
A. Kandola*
Affiliation:
Division of Psychiatry, University College London, London, UK
N. Owen
Affiliation:
Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne, Australia Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia
D. W. Dunstan
Affiliation:
Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Australia Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
M. Hallgren
Affiliation:
Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
*
Author for correspondence: Aaron Kandola, E-mail: [email protected]
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Abstract

Background

Frequent use of screen-based devices could be a modifiable risk factor for adolescent depression, but findings have been inconsistent and mostly from cross-sectional studies. We examined prospective associations of video gaming, social media, and internet use with depressive symptoms in adolescents.

Methods

A total of 11 341 adolescents from the Millennium Cohort Study, a representative, UK population-based. The main outcome was depressive symptoms from a Moods and Feelings Questionnaire (age 14). Exposures were frequency of video game, social media, and internet use (age 11). Physical activity (effect modifier) was measured by self-report.

Results

The fully adjusted models indicated that boys playing video games most days, at least once a week, and at least once a month at age 11 had lower depression scores at age 14 by 24.2% (IRR = 0.77, 95% CI 0.66–0.91), 25.1% (IRR = 0.75, 95% CI 0.62–0.90), and 31.2% (IRR = 0.69, 95% CI 0.57–0.83), compared with playing less than once a month/never. In girls, compared with less than once a month/never, using social media most days at age 11 was associated with 13% higher depression scores at age 14 (IRR = 1.13, 95% CI 1.05–1.22). We found some evidence of associations between using the internet most days and depressive symptoms compared with less than once a month/never in boys (IRR = 0.86, 95% CI 0.75–1.00). More frequent video game use was consistently associated with fewer depressive symptoms in boys with low physical activity, but not in those with high physical activity.

Conclusions

Different types of screen-time may have contrasting associations with depressive symptoms during adolescence. Initiatives to address adolescents’ screen-time may require targeted approaches.

Keywords

Sedentary behaviourscreen timedepressionadolescentsvideo gamesphysical activity
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 15 , November 2022 , pp. 3531 - 3539
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Bailey, A. P., Hetrick, S. E., Rosenbaum, S., Purcell, R., & Parker, A. G. (2018). Treating depression with physical activity in adolescents and young adults: A systematic review and meta-analysis of randomised controlled trials. Psychological Medicine, 48(7), 1068–1083. https://doi.org/10.1017/S0033291717002653.CrossRefGoogle Scholar
Batelaan, N. M., Seldenrijk, A., Bot, M., van Balkom, A. J. L. M., & Penninx, B. W. J. H. (2016). Anxiety and new onset of cardiovascular disease: Critical review and meta-analysis. British Journal of Psychiatry, 208(03), 223–231. https://doi.org/10.1192/bjp.bp.114.156554.CrossRefGoogle ScholarPubMed
Bertha, E. A., & Balázs, J. (2013). Subthreshold depression in adolescence: A systematic review. European Child & Adolescent Psychiatry, 22(10), 589–603. https://doi.org/10.1007/s00787-013-0411-0.CrossRefGoogle ScholarPubMed
Biddle, S. J. H., García Bengoechea, E., & Wiesner, G. (2017). Sedentary behaviour and adiposity in youth: A systematic review of reviews and analysis of causality. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 1–21. https://doi.org/10.1186/s12966-017-0497-8.CrossRefGoogle ScholarPubMed
Blomfield Neira, C. J., & Barber, B. L. (2014). Social networking site use: Linked to adolescents’ social self-concept, self-esteem, and depressed mood. Australian Journal of Psychology, 66(1), 56–64. https://doi.org/10.1111/ajpy.12034.CrossRefGoogle Scholar
Boers, E., Afzali, M. H., Newton, N., & Conrod, P. (2019). Association of screen time and depression in adolescence. JAMA Pediatrics, 173(9), 853. https://doi.org/10.1001/jamapediatrics.2019.1759.CrossRefGoogle ScholarPubMed
Bone, J. K., Lewis, G., & Lewis, G. (2020). The role of gender inequalities in adolescent depression. The Lancet Psychiatry, 6, 471–472. https://doi.org/10.1016/S2215-0366(20)30081-X.CrossRefGoogle Scholar
Choi, E., Shin, S. H., Ryu, J. K., Jung, K. I., Kim, S. Y., & Park, M. H. (2020). Commercial video games and cognitive functions: Video game genres and modulating factors of cognitive enhancement. Behavioral and Brain Functions, 16(1), 2. https://doi.org/10.1186/s12993-020-0165-z.CrossRefGoogle ScholarPubMed
Connelly, R., & Platt, L. (2014). Cohort profile: UK millennium cohort study (MCS). International Journal of Epidemiology, 43(6), 1719–1725. https://doi.org/10.1093/ije/dyu001.CrossRefGoogle ScholarPubMed
Ekelund, U., Tarp, J., Fagerland, M. W., Johannessen, J. S., Hansen, B. H., Jefferis, B. J., … Lee, I. M. (2020). Joint associations of accelero-meter measured physical activity and sedentary time with all-cause mortality: A harmonised meta-analysis in more than 44 000 middle-aged and older individuals. British Journal of Sports Medicine, 54(24), 1499–1506. https://doi.org/10.1136/bjsports-2020-103270.CrossRefGoogle ScholarPubMed
Green, J. (2020). A tutorial on modelling health behaviour as count data with Poisson and negative binomial regression. https://doi.org/10.31219/osf.io/ux9et.CrossRefGoogle Scholar
Hallgren, M., Dunstan, D. W., & Owen, N. (2020). Passive versus mentally active sedentary behaviors and depression. Exercise and Sport Sciences Reviews, 48(1), 20–27. https://doi.org/10.1249/JES.0000000000000211.CrossRefGoogle ScholarPubMed
Hallgren, M., Nguyen, T.-T.-D., Owen, N., Stubbs, B., Vancampfort, D., Lundin, A., … Lagerros, Y. T. (2019). Cross-sectional and prospective relationships of passive and mentally active sedentary behaviours and physical activity with depression. The British Journal of Psychiatry, 217(2), 413–419. https://doi.org/10.1192/bjp.2019.60.CrossRefGoogle Scholar
Hallgren, M., Owen, N., Stubbs, B., Zeebari, Z., Vancampfort, D., Schuch, F., … Trolle Lagerros, Y. (2018). Passive and mentally-active sedentary behaviors and incident major depressive disorder: A 13-year cohort study. Journal of Affective Disorders, 241, 579–585. https://doi.org/10.1016/J.JAD.2018.08.020.CrossRefGoogle ScholarPubMed
Hernan, M. A., & Robins, J. M. (2020). Causal inference: What if. Boca Ranton: Chapman & Hall/CRC.Google Scholar
Hoare, E., Milton, K., Foster, C., & Allender, S. (2016). The associations between sedentary behaviour and mental health among adolescents: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 108. https://doi.org/10.1186/s12966-016-0432-4.CrossRefGoogle ScholarPubMed
Huang, Y., Li, L., Gan, Y., Wang, C., Jiang, H., Cao, S., … Lu, Z. (2020). Sedentary behaviors and risk of depression: A meta-analysis of prospective studies. Translational Psychiatry, 10(1), 1–10. https://doi.org/10.1038/s41398-020-0715-z.CrossRefGoogle ScholarPubMed
Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M., & Stubbs, B. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience & Biobehavioral Reviews, 107, 525–539. https://doi.org/10.1016/J.NEUBIOREV.2019.09.040.CrossRefGoogle ScholarPubMed
Kandola, A., Lewis, G., Osborn, D. P. J., Stubbs, B., & Hayes, J. F. (2020). Depressive symptoms and objectively measured physical activity and sedentary behaviour throughout adolescence: A prospective cohort study. The Lancet Psychiatry, 7, 262–271.CrossRefGoogle ScholarPubMed
Keles, B., McCrae, N., & Grealish, A. (2020). A systematic review: The influence of social media on depression, anxiety and psychological distress in adolescents. International Journal of Adolescence and Youth, 25(1), 79–93. https://doi.org/10.1080/02673843.2019.1590851.CrossRefGoogle Scholar
Khouja, J. N., Munafò, M. R., Tilling, K., Wiles, N. J., Joinson, C., Etchells, P. J., … Cornish, R. P. (2019). Is screen time associated with anxiety or depression in young people? Results from a UK birth cohort. BMC Public Health, 19(1), 82. https://doi.org/10.1186/s12889-018-6321-9.CrossRefGoogle ScholarPubMed
Krasnova, H., Veltri, N. F., Eling, N., & Buxmann, P. (2017). Why men and women continue to use social networking sites: The role of gender differences. Journal of Strategic Information Systems, 26(4), 261–284. https://doi.org/10.1016/j.jsis.2017.01.004.CrossRefGoogle Scholar
Kühn, S., Gleich, T., Lorenz, R. C., Lindenberger, U., & Gallinat, J. (2014a). Playing super Mario induces structural brain plasticity: Gray matter changes resulting from training with a commercial video game. Molecular Psychiatry, 19(August 2013), 265–271. https://doi.org/10.1038/mp.2013.120.CrossRefGoogle ScholarPubMed
Kühn, S., Lorenz, R., Banaschewski, T., Barker, G. J., Büchel, C., Conrod, P. J., … Gallinat, J. (2014b). Positive association of video game playing with left frontal cortical thickness in adolescents. PLoS ONE, 9(3), e91506. https://doi.org/10.1371/journal.pone.0091506.CrossRefGoogle ScholarPubMed
Liu, M., Wu, L., & Yao, S. (2016). Dose-response association of screen time-based sedentary behaviour in children and adolescents and depression: A meta-analysis of observational studies. British Journal of Sports Medicine, 50(20), 1252–1258. https://doi.org/10.1136/bjsports-2015-095084.CrossRefGoogle ScholarPubMed
Machado, M. O., Veronese, N., Sanches, M., Stubbs, B., Koyanagi, A., Thompson, T., … Carvalho, A. F. (2018). The association of depression and all-cause and cause-specific mortality: An umbrella review of systematic reviews and meta-analyses. BMC Medicine, 16(1), 112. https://doi.org/10.1186/s12916-018-1101-z.CrossRefGoogle ScholarPubMed
McLeod, G. F. H., Horwood, L. J., & Fergusson, D. M. (2016). Adolescent depression, adult mental health and psychosocial outcomes at 30 and 35 years. Psychological Medicine, 46(7), 1401–1412. https://doi.org/10.1017/S0033291715002950.CrossRefGoogle ScholarPubMed
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. Adolescents: Results from the national comorbidity survey replication–adolescent supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/J.JAAC.2010.05.017.CrossRefGoogle ScholarPubMed
Mojtabai, R., Olfson, M., & Han, B. (2016). National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics, 138(6), e20161878. https://doi.org/10.1542/peds.2016-1878.CrossRefGoogle ScholarPubMed
Orben, A., & Przybylski, A. K. (2019). Screens, teens, and psychological well-being: Evidence from three time-use-diary studies. Psychological Science, 30(5), 682–696. https://doi.org/10.1177/0956797619830329.CrossRefGoogle ScholarPubMed
Patton, G. C., Coffey, C., Romaniuk, H., Mackinnon, A., Carlin, J. B., Degenhardt, L., … Moran, P. (2014). The prognosis of common mental disorders in adolescents: A 14-year prospective cohort study. The Lancet, 383(9926), 1404–1411. https://doi.org/10.1016/S0140-6736(13)62116-9.CrossRefGoogle ScholarPubMed
Pearson, N., Braithwaite, R. E., Biddle, S. J. H., van Sluijs, E. M. F., & Atkin, A. J. (2014). Associations between sedentary behaviour and physical activity in children and adolescents: A meta-analysis. Obesity Reviews, 15(8), 666–675. https://doi.org/10.1111/obr.12188.CrossRefGoogle ScholarPubMed
Primack, B. A., Shensa, A., Sidani, J. E., Whaite, E. O., Lin, L. Y., Rosen, D., … Miller, E. (2017). Social Media Use and perceived social isolation Among young adults in the U.S. American Journal of Preventive Medicine, 53(1), 1–8. https://doi.org/10.1016/j.amepre.2017.01.010.CrossRefGoogle ScholarPubMed
Prince, S. A., Adamo, K. B., Hamel, M., Hardt, J., Connor Gorber, S., & Tremblay, M. (2008). A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 5(1), 56. https://doi.org/10.1186/1479-5868-5-56.CrossRefGoogle ScholarPubMed
Przybylski, A. K., & Weinstein, N. (2017). A large-scale test of the goldilocks hypothesis. Psychological Science, 28(2), 204–215. https://doi.org/10.1177/0956797616678438.CrossRefGoogle ScholarPubMed
Robinson, A., Bonnette, A., Howard, K., Ceballos, N., Dailey, S., Lu, Y., & Grimes, T. (2019). Social comparisons, social media addiction, and social interaction: An examination of specific social media behaviors related to major depressive disorder in a millennial population. Journal of Applied Biobehavioral Research, 24(1), e12158. https://doi.org/10.1111/jabr.12158.CrossRefGoogle Scholar
Rohde, K., Keller, M., La Cour Poulsen, L., Blüher, M., Kovacs, P., & Böttcher, Y. (2019). Genetics and epigenetics in obesity. Metabolism: Clinical and Experimental, 92, 37–50.CrossRefGoogle ScholarPubMed
Santini, Z. I., Jose, P. E., York Cornwell, E., Koyanagi, A., Nielsen, L., Hinrichsen, C., … Koushede, V. (2020). Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): A longitudinal mediation analysis. The Lancet Public Health, 5(1), e62–e70. https://doi.org/10.1016/S2468-2667(19)30230-0.CrossRefGoogle ScholarPubMed
Schuch, F. B., Vancampfort, D., Firth, J., Rosenbaum, D. J., Ward, P. B., Silva, E., … Stubbs, B. (2018). Physical activity and incident depression: A meta-analysis of prospective cohort studies. American Journal of Psychiatry, 175(7), 631–648. https://doi.org/10.1176/appi.ajp.2018.17111194.CrossRefGoogle ScholarPubMed
Sharp, C., Goodyer, I. M., & Croudace, T. J. (2006). The Short Mood and Feelings Questionnaire (SMFQ): A unidimensional item response theory and categorical data factor analysis of self-report ratings from a community sample of 7-through 11-year-Old children. Journal of Abnormal Child Psychology, 34(3), 365–377. https://doi.org/10.1007/s10802-006-9027-x.CrossRefGoogle ScholarPubMed
Steene-Johannessen, J., Hansen, B. H., Dalene, K. E., Kolle, E., Northstone, K., Møller, N. C., … Ekelund, U. (2020). Variations in accelerometry measured physical activity and sedentary time across Europe – harmonized analyses of 47497 children and adolescents. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 38. https://doi.org/10.1186/s12966-020-00930-x.CrossRefGoogle Scholar
Suchert, V., Hanewinkel, R., & Isensee, B. (2015). Sedentary behavior and indicators of mental health in school-aged children and adolescents: A systematic review. Preventive Medicine, 76, 48–57. https://doi.org/10.1016/J.YPMED.2015.03.026.CrossRefGoogle ScholarPubMed
Teychenne, M., Ball, K., & Salmon, J. (2010). Sedentary behavior and depression among adults: A review. International Journal of Behavioral Medicine, 17(4), 246–254. https://doi.org/10.1007/s12529-010-9075-z.CrossRefGoogle ScholarPubMed
Thapar, A., Collishaw, S., Pine, D. S., & Thapar, A. K. (2012). Depression in adolescence. The Lancet, 379(9820), 1056–1067. https://doi.org/10.1016/S0140-6736(11)60871-4.CrossRefGoogle ScholarPubMed
Tremblay, M. S., Aubert, S., Barnes, J. D., Saunders, T. J., Carson, V., Latimer-Cheung, A. E., … Chinapaw, M. J. M. (2017). Sedentary Behavior Research Network (SBRN) – terminology consensus project process and outcome. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 75. https://doi.org/10.1186/s12966-017-0525-8.CrossRefGoogle Scholar
Tremblay, M. S., LeBlanc, A. G., Kho, M. E., Saunders, T. J., Larouche, R., Colley, R. C., … Gorber, S. (2011). Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 98. https://doi.org/10.1186/1479-5868-8-98.CrossRefGoogle ScholarPubMed
van Ekris, E., Wijndaele, K., Altenburg, T. M., Atkin, A. J., Twisk, J., Andersen, L. B., … Chinapaw, M. (2020). Tracking of total sedentary time and sedentary patterns in youth: A pooled analysis using the International Children's Accelerometry Database (ICAD). International Journal of Behavioral Nutrition and Physical Activity, 17(1), 65. https://doi.org/10.1186/s12966-020-00960-5.CrossRefGoogle ScholarPubMed
Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications. JAMA Psychiatry, 72(4), 334. https://doi.org/10.1001/jamapsychiatry.2014.2502.CrossRefGoogle ScholarPubMed
Wang, X., Li, Y., & Fan, H. (2019). The associations between screen time-based sedentary behavior and depression: A systematic review and meta-analysis. BMC Public Health, 19(1), 1–9. https://doi.org/10.1186/s12889-019-7904-9.CrossRefGoogle ScholarPubMed
World Health Organisation. (2017). Depression and Other Common Mental Disorders Global Health Estimates. Geneva. Retrieved from http://apps.who.int/iris/bitstream/10665/254610/1/WHO-MSD-MER-2017.2-eng.pdf.Google Scholar
Zhai, L., Zhang, Y., & Zhang, D. (2015). Sedentary behaviour and the risk of depression: A meta-analysis. British Journal of Sports Medicine, 49(11), 705–709. https://doi.org/10.1136/BJSPORTS-2014-093613.CrossRefGoogle ScholarPubMed
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