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

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

doi:10.1016/j.psycom.2025.100205

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

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

^*Corresponding author for this work

Social Policy, Sociology and Criminology

Research output: Contribution to journal › Article › peer-review

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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.

Original language	English
Article number	100205
Number of pages	8
Journal	Psychiatry Research Communications
Volume	5
Issue number	1
Early online date	27 Feb 2025
DOIs	https://doi.org/10.1016/j.psycom.2025.100205
Publication status	Published - Mar 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Screen time
Depression
Suicidal ideation
Non-linearity

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10.1016/j.psycom.2025.100205Licence: Creative Commons: Attribution (CC BY)

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Cite this

@article{84c36bfcb85d44c3b221a58e9ac90cbd,

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

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{\textquoteright} 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.",

keywords = "Screen time, Depression, Suicidal ideation, Non-linearity",

author = "Qian Li and Chan, \{Kylie Kai-yi\} and Ramos, \{Miguel R.\} and Xin Wang and Wong, \{Samuel Yeung-shan\} and Xue Yang",

year = "2025",

month = mar,

doi = "10.1016/j.psycom.2025.100205",

language = "English",

volume = "5",

journal = "Psychiatry Research Communications",

number = "1",

}

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T1 - Non-linear relationships and interaction effects between different types of screen time and mental health issues among Hong Kong adolescents

AU - Li, Qian

AU - Chan, Kylie Kai-yi

AU - Ramos, Miguel R.

AU - Wang, Xin

AU - Wong, Samuel Yeung-shan

AU - Yang, Xue

PY - 2025/3

Y1 - 2025/3

N2 - 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.

AB - 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.

KW - Screen time

KW - Depression

KW - Suicidal ideation

KW - Non-linearity

U2 - 10.1016/j.psycom.2025.100205

DO - 10.1016/j.psycom.2025.100205

M3 - Article

VL - 5

JO - Psychiatry Research Communications

JF - Psychiatry Research Communications

IS - 1

M1 - 100205

ER -

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

Abstract

UN SDGs

Keywords

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