Is physical inactivity associated with depressive symptoms in adolescents with high screen time? Evidence from a developing country

Abstract

Background Increasing levels of screen use and physical inactivity in developing countries may be deleterious for adolescent mental health. This study aimed to examine how physical inactivity is associated with concurrent depressive symptoms among adolescents with high recreational screen time in Bangladesh.

Methods A self-administered survey was conducted among 898 secondary school students of Dhaka city, Bangladesh. High screen-time was assessed using the Adolescent Sedentary Activity Questionnaire (ASAQ), with a cut-off of >2 h/day. Scores ≥10 on the 10-item Center for Epidemiological Studies Depression Scale (CESD10) suggested depressive symptoms. The Three-Day Physical Activity Recall (3DPAR) instrument was used to estimate physical activity, with those doing ≤60 min/day of moderate-vigorous physical activity (MVPA) classified as not meeting MVPA recommendations. Of the 599 adolescents who were determined to have high recreational screen time (>2 h/day), 505 completed the CESD10, and form the basis for this analysis.

Results Of the adolescents with high recreational screen time, 32% did not meet MVPA recommendations and 25% reported depressive symptoms. Generalized estimating equations modelling on CESD scores showed that depressive symptoms were more prevalent among adolescents with high screen time who also did not meet MVPA recommendations (OR 2.37; 95% CI: 1.23–4.59), after adjusting for a set of confounders including sociodemographic, psychosocial and lifestyle factors.

Conclusions Adolescents in Dhaka city with high recreational screen time and not meeting physical activity recommendations are also likely to have depressive symptoms. More research is needed to understand the causal directions of these relationships.