Sedentary Behaviour and Mental Health in Children and Adolescents: A Meta-analysis

Abstract

Background: A growing body of research is emerging examining the associations between sedentary behaviour and mental health in young people. The magnitude of the impact sedentary behaviour has on the mental health of young people has not been examined, though this has been investigated for physical health conditions. The aim of this article is to examine the associations between sedentary behaviour and mental health in young people aged 5-18 years of age using meta-analysis. Methods: Published studies in the English language were located via manual and computerised searches of PubMed, Science Direct, SPORTDiscus, PsychINFO, Medline, Web of Science, Cochrane Library, and Google Scholar databases. Included were observational studies assessing an association between at least one sedentary behaviour and at least one aspect of mental health in young people aged 5-18 years. Effect sizes (ESs) were calculated for each study and an overall effect size was computed. Average effect sizes were also calculated for moderator variables. Results: Thirty-five studies were included (n=373,512); most studies examined screen-time as sedentary behaviour and five mental health outcomes were identified (depression, anxiety, self-esteem, psychological distress, and quality of life). The summary effect was small and significant (ES = -0.30, 95% confidence intervals = -0.20, -0.45, p<0.001), suggesting that sedentary behaviour is negatively associated with mental health in young people. Moderator analysis showed that television viewing had the largest effect size (ES = -0.47, 95% confidence intervals = -0.35, -0.62, p<0.001). Moreover, depression seems to be the main mental health outcome affected by sedentary behaviour (ES = 0.55, 95% confidence intervals = 0.42, 0.68, p<0.001). Conclusions: There was a small but a significant negative association between sedentary behaviour and mental health. High levels of sedentary behaviour are associated with increased depressive symptoms. This finding is consistent with a systematic review on adults which indicated that sedentary behaviour is significantly associated with mental health problems.