Association between screen time and anxiety-depression symptoms and their comorbidity

LI Tongtong; CUI Qianqian; ZHANG Xinyang; XIE Yawen; ZHAO Danhe; GUO Tingyu; AO Yiyun; CHEN Jin; WANG Li

doi:10.16835/j.cnki.1000-9817.2025209

Volume 46 Issue 7

Jul. 2025

Turn off MathJax

Article Contents

Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2025 > 46(7): 980-984

LI Tongtong, CUI Qianqian, ZHANG Xinyang, XIE Yawen, ZHAO Danhe, GUO Tingyu, AO Yiyun, CHEN Jin, WANG Li. Association between screen time and anxiety-depression symptoms and their comorbidity[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(7): 980-984. doi: 10.16835/j.cnki.1000-9817.2025209

Citation:

LI Tongtong, CUI Qianqian, ZHANG Xinyang, XIE Yawen, ZHAO Danhe, GUO Tingyu, AO Yiyun, CHEN Jin, WANG Li. Association between screen time and anxiety-depression symptoms and their comorbidity[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(7): 980-984. doi: 10.16835/j.cnki.1000-9817.2025209

Citation:

LI Tongtong, CUI Qianqian, ZHANG Xinyang, XIE Yawen, ZHAO Danhe, GUO Tingyu, AO Yiyun, CHEN Jin, WANG Li. Association between screen time and anxiety-depression symptoms and their comorbidity[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(7): 980-984. doi: 10.16835/j.cnki.1000-9817.2025209

PDF( 983 KB)

Association between screen time and anxiety-depression symptoms and their comorbidity

doi: 10.16835/j.cnki.1000-9817.2025209

1.
Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

Received Date: 2025-03-25
Rev Recd Date: 2025-06-03

Available Online: 2025-08-02

Publish Date: 2025-07-25

Abstract

Abstract

Objective To investigate the association between screen time (ST) during leisure time and anxiety-depression symptoms among middle school students, so as to provide a basis for formulating relevant intervention measures. Methods From November to December 2023, a stratified cluster random sampling method was used to select 2 542 students from junior and senior high school in Taiyuan City. A self-designed questionnaire, the Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire (PHQ-9) were used to investigate ST and anxiety/depression symptoms among middle school students. The Logistic regression model was used to explore the association of ST with symptoms of anxiety and depression, as well as with anxiety and depression comorbiditles (CAD). Results The detection rates of anxiety symptoms, depression symptoms, and CAD were 13.69%, 15.77%, and 10.11%, respectively. The median ST was 2.00 h/d [interquartile range (IQR=2.38) for weekly averages], with 0.33 h/d (IQR=1.67) on work days and 5.00 h/d (IQR=5.50) on rest days. Logistic regression analysis indicated that the total ST of mobile phones during rest days (OR=1.07, 1.10, 1.11) and the averages ST of mobile phones over a week (OR=1.20, 1.22, 1.29), as well as the total ST of all screen types during rest days (OR=1.04, 1.04, 1.05) and the averages ST of all screen types over a week (OR=1.08, 1.09, 1.21) were positively correlated with anxiety symptoms, depression symptoms, and CAD (all P < 0.01). Conclusions Among middle school students in Taiyuan City, screen time is positively correlated with symptoms of anxiety or depression and the comorbidity of anxiety and depression, especially smartphone screen time and weekend screen use. Therefore, measures should be implemented to reduce unnecessary screen time among middle school students, especially the use of mobile phones, in order to mitigate the occurrence of anxiety and depression.
- Fixation, acular,
- Anxiety,
- Depression,
- Comorbidity,
- Mental health,
- Students

FullText(HTML)

References(29)

References

[1]	汪妍, 彭畅, 程君菡, 等. 中国5省在校中学生自杀行为流行状况及其与抑郁、焦虑关联[J]. 中国公共卫生, 2023, 39(10): 1225-1231. doi: 10.11847/zgggws1141897 WANG Y, PENG C, CHENG J H, et al. Prevalence and impact of depression and anxiety on suicidal behaviors among high school students: a cross-sectional survey in five provinces, China[J]. Chin J Public Health, 2023, 39(10): 1225-1231. (in Chinese) doi: 10.11847/zgggws1141897
[2]	张霏雨, 陶舒曼, 陶芳标. 儿童青少年常见病多病研究进展[J]. 中华预防医学杂志, 2025, 59(2): 195-201. doi: 10.3760/cma.j.cn112150-20240905-00709 ZHANG F Y, TAO S M, TAO F B. Research progress on multimorbidity of common diseases in children and adolescents[J]. Chin J Prev Med, 2025, 59(2): 195-201. (in Chinese) doi: 10.3760/cma.j.cn112150-20240905-00709
[3]	WANG M, MOU X, LI T, et al. Association between comorbid anxiety and depression and health risk behaviors among Chinese adolescents: cross-sectional questionnaire study[J]. JMIR Public Health Surveill, 2023, 9(1): e46289.
[4]	TWENGE J M, COOPER A B, JOINER T E, et al. Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005-2017[J]. J Abnorm Psychol, 2019, 128(3): 185-199.
[5]	邹志丽. 大学生视屏电子产品使用情况及其对身体健康和行为习惯的影响研究[D]. 沈阳: 中国医科大学, 2021. ZOU Z L. The electronic media use among college students and its influences on their physical health and behavioral habits[D]. Shenyang: China Medical University, 2021. (in Chinese)
[6]	曹慧, 连昕瑶, 陈媛媛, 等. 儿童青少年视屏时间及其对心理健康影响研究进展[J]. 中国学校卫生, 2023, 44(3): 462-465, 470. doi: 10.16835/j.cnki.1000-9817.2023.03.033 CAO H, LIAN X Y, CHEN Y Y, et al. Review on screen time among children and adolescents and impact on mental health[J]. Chin J Sch Health, 2023, 44(3): 462-465, 470. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.03.033
[7]	MOVGHARBEL F, GOLDFIELD G S. Psychological correlates of se-dentary screen time behaviour among children and adolescents: a narrative review[J]. Curr Obes Rep, 2020, 9(4): 493-511.
[8]	MORA-MONTEROS M, SURIS J C, CHOK L, et al. Evolution of screen use among youth between 2012 and 2020 in Switzerland[J]. Archiv De Pédiatr, 2023, 30(8): 563-566.
[9]	SPITZER R L, KROENKE K, WILLIAMS J B W, et al. A brief me-asure for assessing generalized anxiety disorder: the GAD-7[J]. Arch Int Med, 2006, 166(10): 1092-1097.
[10]	TOUSSAINT A, HVSING P, GUMZ A, et al. Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)[J]. J Affect Disord, 2020, 265: 395-401.
[11]	LEVIS B, BENEDETTI A, THOMDS B D, et al. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data Meta-analysis[J]. BMJ, 2019, 365: l1781.
[12]	KROENKE K, SPITZER R L, WILLIAMS J B. The PHQ-9: validity of a brief depression severity measure[J]. J General Int Med, 2001, 16(9): 606-613.
[13]	王萌, 陶芳标, 伍晓艳. 儿童青少年焦虑抑郁共病研究进展[J]. 中华预防医学杂志, 2022, 56(7): 1011-1016. doi: 10.3760/cma.j.cn112150-20220325-00283 WANG M, TAO F B, WU X Y. Research progress on the comorbidity of anxiety and depression in children and adolescents[J]. Chin J Prev Med, 2022, 56(7): 1011-1016. (in Chinese) doi: 10.3760/cma.j.cn112150-20220325-00283
[14]	王子瑶, 陈潇潇, 林海江, 等. 台州市中学生抑郁焦虑症状现状及其与学业负担的关系[J]. 中国学校卫生, 2023, 44(11): 1655-1659. doi: 10.16835/j.cnki.1000-9817.2023.11.014 WANG Z Y, CHEN X X, LIN H J, et al. Associations between educational burden and depression and anxiety symptoms among middle school students in Taizhou City[J]. Chin J Sch Health, 2023, 44(11): 1655-1659. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.11.014
[15]	赵海, 王路, 孙冰洁, 等. 北京市中学生抑郁焦虑现状及其与欺凌和暴力行为的关系[J]. 中国学校卫生, 2024, 45(7): 1017-1020, 1025. doi: 10.16835/j.cnki.1000-9817.2024222 ZHAO H, WANG L, SUN B J, et al. Prevalence of depression and anxiety symptoms and its relationship with bullying and violent behaviors among middle school students in Beijing[J]. Chin J Sch Health, 2024, 45(7): 1017-1020, 1025. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024222
[16]	刘颖, 施慧玲, 周洁, 等. 海口市初中生抑郁焦虑现状及影响因素调查[J]. 实用预防医学, 2024, 31(11): 1295-1299. doi: 10.3969/j.issn.1006-3110.2024.11.004 LIU Y, SHI H L, ZHOU J, et al. Status quo and influencing factors of depression and anxiety among junior middle school students in Haikou City[J]. Pract Prev Med, 2024, 31(11): 1295-1299. (in Chinese) doi: 10.3969/j.issn.1006-3110.2024.11.004
[17]	高红霞, 陈靖, 张晓红, 等. 基于随机森林算法的中学生焦虑、抑郁影响因素分析及预测模型构建[J]. 现代预防医学, 2025, 52(2): 267-273, 368. GAO H X, CHEN J, ZHANG X H, et al. Analysis of factors influencing anxiety and depression in secondary school students and construction of predictive model based on random forest algorithm[J]. Mod Prev Med, 2025, 52(2): 267-273, 368. (in Chinese)
[18]	MKHIZE M, VAN DER WESTHUIZEN C, SORSDAHL K. Prevalence and factors associated with depression and anxiety among young school-going adolescents in the western cape Province of South Africa[J]. Compreh Psychiatry, 2024, 131: 152469.
[19]	高悦, 肖婉, 魏瑞虹, 等. 童年期不良经历和积极经历与中学生抑郁焦虑症状的关联[J]. 中国学校卫生, 2024, 45(8): 1075-1079. doi: 10.16835/j.cnki.1000-9817.2024238 GAO Y, XIAO W, WEI R H, et al. Correlation of adverse and positive childhood experiences and depression and anxiety symptoms among middle school students[J]. Chin J Sch Health, 2024, 45(8): 1075-1079. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024238
[20]	CHOI K W, KIM Y K, JEON H J. Comorbid anxiety and depression: clinical and conceptual consideration and transdiagnostic treatment[J]. Adv Exper Med Biol, 2020, 1191: 219-235.
[21]	王浩, 周怡, 戴品远, 等. 浙江省中学生焦虑抑郁症状共病状况分析[J]. 中华流行病学杂志, 2023, 44(12): 1921-1927. doi: 10.3760/cma.j.cn112338-20230722-00032 WANG H, ZHOU Y, DAI P Y, et al. Comorbidity of anxiety symptoms and depression symptoms among middle and high school students in Zhejiang Province[J]. Chin J Epidemiol, 2023, 44(12): 1921-1927. (in Chinese) doi: 10.3760/cma.j.cn112338-20230722-00032
[22]	陈国平, 王志强, 孙莹, 等. 安徽省中学生校园欺凌与焦虑抑郁症状共患的关联性[J]. 中国学校卫生, 2024, 45(8): 1115-1119. doi: 10.16835/j.cnki.1000-9817.2024250 CHEN G P, WANG Z Q, SUN Y, et al. Association of school bullying with the comorbidity of anxiety and depressive symptoms among middle school students in Anhui Province[J]. Chin J Sch Health, 2024, 45(8): 1115-1119. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024250
[23]	共青团中央维护青少年权益部, 中国互联网络信息中心. 第5次全国未成年人互联网使用情况调查报告[R]. 北京: 中国互联网络信息中心, 2023. Youth League Central Committee Youth Rights Protection Department, China Internet Network Information Center. The 5th national survey on Internet use of minors[R]. Beijing: China Internet Network Information Center, 2023. (in Chinese)
[24]	张娜, 朱文丽, 张曼, 等. 《中国学龄儿童膳食指南(2022)》解读[J]. 中国学校卫生, 2022, 43(6): 805-808. doi: 10.16835/j.cnki.1000-9817.2022.06.002 ZHANG N, ZHU W L, ZHANG M, et al. Interpretation on Dietary Guidelines for Chinese School-aged Children (2022)[J]. Chin J Sch Health, 2022, 43(6): 805-808. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.06.002
[25]	Council on Communications and Media, STRASBURGER V C, HOGAN M J, et al. Children, adolescents, and the media[J]. Pediatrics, 2013, 132(5): 958-961.
[26]	HOUGHTON S, HUNTER S C, ROSENBERG M, et al. Virtually impossible: limiting Australian children and adolescents daily screen based media use[J]. BMC Public Health, 2015, 15: 5.
[27]	KJELLENBERG K, EKBLOM O, AHLEN J, et al. Cross-sectional associations between physical activity pattern, sports participation, screen time and mental health in Swedish adolescents[J]. BMJ Open, 2022, 12(8): e061929.
[28]	FORTE C, O'SULLIVAN D, MCDOWELL C P, et al. Associations between screen-time, physical activity and depressive symptoms differ based on gender and screen-time mode[J]. Europ Child Adolesc Psychiatry, 2023, 32(11): 2313-2322.
[29]	MÄNNIKKÖ N, RUOTSALAINEN H, MIETTUNEN J, et al. Associations between childhood and adolescent emotional and behavioral characteristics and screen time of adolescents[J]. Issues Ment Health Nurs, 2020, 41(8): 700-712.