The effect of Internet and screen time on mental health in adolescent student: A meta-analysis of observational studies

Extensive use of the Internet and screen is related to mental health in adolescents. Several factors influence this association, including use time, content, and gender. Therefore, we conducted this meta-analysis to investigate the impact of the above factors on the association between Internet/screen time and mental health. We searched for adolescent cohort studies using the PubMed, Embase, and Cochrane Library databases. The interventions included Internet and screen usage with different durations and content. The primary outcomes were depression and anxiety. We performed subgroup analyses to explore the effect size of various factors. The heterogeneity was evaluated by I ² statistic. We choose random or fixed effect models according to I ² statistics. This study meta-analyzed 30 studies with 151779 adolescents. The pool odds ratio (OR) indicates depression (OR: 1.096, 95% CI: 1.080, 1.112) and anxiety (OR: 1.343, 95% CI: 1.167, 1.546) risk in adolescents with extended screen time. This association is influenced by gender and screen content. Watching TV does not elevate the risk of depression (OR: 0.810, 95% CI: 0.720, 0.900) and anxiety (OR: 0.980, 95% CI: 0.870, 1.110) for males and even reduces depression risk when they watch TV for less than two hours every day (< 1h/d: OR: 0.720, 95% CI: 0.550, 0.940; 1-2h/d: OR: 0.790, 95% CI: 0.650, 0.960). However, watching TV increases anxiety risk for females (OR: 1.120, 95% CI: 1.020, 1.220) when the time is more than two hours daily (OR: 1.240, 95% CI: 1.100, 1.410). Depression (gaming: OR: 1.150, 95% CI: 1.240, 1.820; digital/social media: OR: 1.140, 95% CI: 1.050, 1.230) and anxiety risk (gaming: OR: 1.780, 95% CI: 1.460, 2.170) increase in females who use screens on gaming and digital/social media. Males have a higher anxiety risk (OR: 1.280, 95% CI: 1.140, 1.440) when Internet time exceeds half an hour daily (0.5-2h/d: OR: 1.240, 95% CI: 1.070, 1.430; > 2h/d: OR: 1.300, 95% CI: 1.170, 1.450). The impact of Internet and screen usage on adolescents’ mental health is affected by screen content, gender, and time. Selecting appropriate screen content and controlling the time based on different gender are suitable methods to decrease the risk of depression and anxiety in adolescents.