Aim
Adolescents have experienced disruption in their daily routines, including changes in health behaviors such as an increased sedentary behavior and increased smartphone usage. The aim of this study was to assess the association of health behaviors with mental health problems.
Method
Five cross-sectional surveys (February 2021 to May 2022) were performed during the pandemic assessing physical activity, smartphone usage, depressive symptoms (Patient Health Questionaire-9 (PHQ-9)), anxiety symptoms (Generalized Anxiety Disorder Scale 7 (GAD-7)), sleep quality (Insomnia Severity Index 7 (ISI-7)), and stress (Perceived Stress Scale 10 (PSS-10)). In total, N = 7201 adolescents (age: 14–20 years ((MW ± SD): 16.63 ± 1.49 years); 70.2% female, 18.8% migration background) participated.
Results
A strong increase in mobile phone usage as well as a decrease in physical activity as compared to pre-pandemic data were observed (p < 0.001). Compared to the lowest smartphone user group (<1 h/d), the adjusted odds ratios (aOR) for depressive symptoms increased with increasing smartphone usage to 1.98 (3–4 h/d), 3.30 (5–6 h/d), 4.96 (7–8 h/d), and 6.79 (>8 h/d). High utilizers (>8 h/d) were also more likely to experience clinically relevant anxiety, insomnia, or stress symptoms (aORs 3.23–5.75) compared to those using the smartphone less than 1 h/d.
Conclusion
Results highlight the need for measures to promote responsible smartphone usage as well as to increase physical activity, so as to promote mental health in adolescence.