Kandola A, Owen N, Dunstan D W, Hallgren M
Division of Psychiatry, University College London, London, UK.
Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne, Australia.
Psychol Med. 2021 Feb 19:1-9. doi: 10.1017/S0033291721000258.
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.
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.
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.
Different types of screen-time may have contrasting associations with depressive symptoms during adolescence. Initiatives to address adolescents' screen-time may require targeted approaches.
频繁使用基于屏幕的设备可能是青少年抑郁症的一个可改变的风险因素，但研究结果并不一致，且大多来自横断面研究。我们研究了青少年视频游戏、社交媒体和互联网使用与抑郁症状之间的前瞻性关联。
共有11341名来自千禧队列研究的青少年，该研究具有代表性，以英国人群为基础。主要结局是通过情绪和情感问卷（14岁时）得出的抑郁症状。暴露因素是视频游戏、社交媒体和互联网使用的频率（11岁时）。身体活动（效应修饰因素）通过自我报告进行测量。
完全调整后的模型表明，11岁时男孩大多数日子、至少每周一次以及至少每月一次玩电子游戏，在14岁时的抑郁得分分别比每月玩不到一次/从不玩的男孩低24.2%（风险比=0.77，95%置信区间0.66-0.91）、25.1%（风险比=0.75，95%置信区间0.62-0.90）和31.2%（风险比=0.69，95%置信区间0.57-0.83）。在女孩中，与每月玩不到一次/从不玩相比，11岁时大多数日子使用社交媒体与14岁时抑郁得分高13%相关（风险比=1.13，95%置信区间1.05-1.22）。我们发现一些证据表明，与每月玩不到一次/从不玩相比，男孩大多数日子使用互联网与抑郁症状之间存在关联（风险比=0.86，95%置信区间0.75-1.00）。更频繁地玩电子游戏与身体活动少的男孩抑郁症状较少始终相关，但与身体活动多的男孩无关。
不同类型的屏幕使用时间在青少年时期与抑郁症状可能有相反的关联。解决青少年屏幕使用时间问题的举措可能需要有针对性的方法。
