Non-linear relationships and interaction effects between different types of screen time and mental health issues among Hong Kong adolescents

Psychiatry research communications Pub Date : 2025-03-01 DOI:10.1016/j.psycom.2025.100205

Qian Li , Kylie Kai-yi Chan , Miguel R. Ramos , Xin Wang , Samuel Yeung-shan Wong , Xue Yang

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Abstract

Background

Non-linear relationship of different types of screen time with adolescent mental health problems remains unclear.

Objective

To identify non-linear relationships of internet gaming and social media use with probable depression and suicidal ideation and the thresholds in male and female adolescents.

Participants and setting

A school-based survey was conducted in 11,750 Hong Kong adolescents in 2020–2022.

Methods

An anonymous questionnaire was used to assess screen time and mental health. Generalized additive models (GAM) and generalized linear mixed models (GLMM) were conducted to analyze gender-specific non-linear relationships, interaction effects, and dose-dependent relationships between screen time and mental health.

Results

Probable depression (64.3% vs. 52.0%) and suicidal ideation (35.0% vs. 24.6%) were more prevalent among girls. GAM revealed a U-shaped relationship between internet gaming time and probable depression (threshold: 1.5 h/day)/suicidal ideation (threshold: 2 h/day) in boys, but not in girls. GLMM showed that internet gaming within 1 h/day was associated with reduced suicidal ideation in boys (OR[95%CI] = 0.72[0.53, 0.99]) compared to non-users. For girls, social media use>1 h/day was associated with higher risks of probable depression (ORs range from 1.59 to 2.16, all p < 0.05) and suicidal ideation (ORs = 1.35 to 2.00, ps < 0.005) compared to non-users. However, boys’ social media use>2 h/day was associated with a higher risk of probable depression, but not for suicidal ideation. Positive interactions of internet gaming and social media use with mental health were found across genders (ps < 0.001).

Conclusions

This study suggests a conservative cutoff of 1-h daily use for internet games and social media, respectively, for girls and boys. Regulating internet gaming and social media use concurrently may benefit adolescent mental health.

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香港青少年不同类型屏幕时间与心理健康问题的非线性关系及互动效应

不同类型的屏幕时间与青少年心理健康问题之间的非线性关系尚不清楚。目的探讨网络游戏和社交媒体使用与青少年抑郁和自杀意念的非线性关系及其阈值。参与者和背景一项以学校为基础的调查在2020-2022年间对11750名香港青少年进行了调查。方法采用不记名问卷调查方法，对屏幕时间与心理健康状况进行评估。采用广义加性模型（GAM）和广义线性混合模型（GLMM）分析屏幕时间与心理健康之间的性别非线性关系、相互作用效应和剂量依赖关系。结果女孩中抑郁症（64.3%比52.0%）和自杀意念（35.0%比24.6%）发生率较高。GAM揭示了网络游戏时间与男孩抑郁（阈值：1.5小时/天）/自杀意念（阈值：2小时/天）之间的u型关系，但在女孩中没有。GLMM显示，与不玩网络游戏的男孩相比，每天玩1小时网络游戏的男孩自杀意念减少（OR[95%CI] = 0.72[0.53, 0.99]）。对于女孩来说，每天使用社交媒体1小时与患抑郁症的风险较高相关(or范围为1.59至2.16，均为p <；0.05)和自杀意念(or = 1.35 ~ 2.00, p <；0.005)。然而，男孩每天使用2小时社交媒体与更高的抑郁风险相关，但与自杀意念无关。网络游戏和社交媒体的使用与心理健康的积极互动在性别中都被发现(ps <；0.001)。这项研究表明，女孩和男孩每天使用网络游戏和社交媒体的时间分别为1小时。同时规范网络游戏和社交媒体的使用可能有益于青少年的心理健康。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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