Lima Santos João Paulo, Soehner Adriane M, Biernesser Candice L, Ladouceur Cecile D, Versace Amelia
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
Magnetic Resonance Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
JAMA Pediatr. 2025 Jun 23. doi: 10.1001/jamapediatrics.2025.1718.
With the widespread adoption of screen-based devices among adolescents, there is growing concern that more screen time could contribute to mental health problems such as depression. It is thus critical to identify potential mediating factors that could help explain this potential risk relationship. Recent evidence indicates that more screen time could impact sleep duration and brain structural connectivity (ie, white matter organization), which are critical for emotional health. Notably, sleep duration is a modifiable behavior that health care providers can easily target.
To identify the association between screen time during late childhood and depressive symptoms in early adolescence, and to investigate whether these associations are mediated by sleep duration and white matter organization.
DESIGN, SETTING, AND PARTICIPANTS: This prospective study was conducted from January 2024 to June 2024. Data from the Adolescent Behavior Cognitive Development (ABCD) Study were used to identify clinical and neuroimaging characteristics of participants at late childhood (T1; defined as aged 9-10 years) and early adolescence (T2; defined as age 11-13 years). Children and their parent/caregiver were recruited across 21 US cities. Participants with no past/current psychiatric disorders at T1 were selected for analyses. Initial analyses were conducted in 2024 and finalized in February 2025.
Outcomes included screen time assessed using a self-report questionnaire, sleep duration assessed using the Munich Chronotype Questionnaire, and depressive symptoms characterized using the Child Behavior Checklist. Neurite orientation dispersion and density imaging and a tract profile approach were used to characterize the orientation dispersion index of 3 white matter tracts that are known to be implicated with depression: cingulum bundle, forceps minor, and uncinate fasciculus.
Analyses included 976 participants (460 children [47.1%] were female, mean [SD] age was 9.9 [0.6] years at T1 and 11.9 [0.6] years at T2). Each additional hour of daily screen time at T1 was associated with a 0.12-point (95% CI, 0.04-0.20; P = .008) increase in Child Behavior Checklist depressive score at T2. Shorter sleep duration and worse cingulum bundle organization (greater orientation dispersion index) at T2 mediated 36.4% (95% CI, 18.2%-63.6%) of the association between more screen time and more depressive symptoms.
Results of this study show that more screen time in late childhood was associated with more depressive symptoms, potentially due to shorter sleep and worse white matter organization during early adolescence. These findings emphasize the importance of promoting healthy habits and balancing screen time with adequate sleep.
随着基于屏幕的设备在青少年中广泛使用，人们越来越担心更多的屏幕使用时间可能会导致诸如抑郁症等心理健康问题。因此，识别可能有助于解释这种潜在风险关系的潜在中介因素至关重要。最近的证据表明，更多的屏幕使用时间可能会影响睡眠时间和脑结构连接性（即白质组织），而这两者对情绪健康至关重要。值得注意的是，睡眠时间是一种可改变的行为，医疗保健提供者可以轻松针对这一行为进行干预。
确定童年晚期的屏幕使用时间与青春期早期抑郁症状之间的关联，并调查这些关联是否由睡眠时间和白质组织介导。
设计、设置和参与者：这项前瞻性研究于2024年1月至2024年6月进行。来自青少年行为认知发展（ABCD）研究的数据用于识别童年晚期（T1；定义为9至10岁）和青春期早期（T2；定义为11至13岁）参与者的临床和神经影像学特征。在美国21个城市招募了儿童及其父母/照顾者。选择在T1时没有过去/当前精神疾病的参与者进行分析。初步分析于2024年进行，并于2025年2月最终确定。
结局包括使用自我报告问卷评估的屏幕使用时间、使用慕尼黑昼夜节律问卷评估的睡眠时间以及使用儿童行为检查表表征的抑郁症状。使用神经突方向离散度和密度成像以及一种束状轮廓方法来表征3条已知与抑郁症有关的白质束的方向离散指数：扣带束、小钳和钩束。
分析纳入了976名参与者（460名儿童[47.1%]为女性，T1时的平均[标准差]年龄为9.9[0.6]岁，T2时为11.9[0.6]岁）。T1时每天屏幕使用时间每增加1小时，与T2时儿童行为检查表抑郁评分增加0.12分（95%置信区间，0.04 - 0.20；P = .008）相关。T2时较短的睡眠时间和较差的扣带束组织（更大的方向离散指数）介导了更多屏幕使用时间与更多抑郁症状之间36.4%（95%置信区间，18.2% - 63.6%）的关联。
这项研究的结果表明童年晚期更多屏幕使用时间与更多抑郁症状相关，这可能是由于青春期早期睡眠时间较短和白质组织较差所致。这些发现强调了促进健康习惯以及平衡屏幕使用时间与充足睡眠的重要性。
