Skip to main content
NCBI home page
Medicine logoLink to Medicine
. 2025 Sep 12;104(37):e44275. doi: 10.1097/MD.0000000000044275

Knowledge mapping analysis of sedentary behavior and mental health research: A bibliometric analysis from 2004 to 2024

Yi Liu a, Zhen Zhang b, Hao Zhang c, Sisheng Tian a,*
PMCID: PMC12440563  PMID: 40958323

Abstract

Background:

Mental health issues exhibits a significant correlation with sedentary behavior (SB). To construct a scientific knowledge map of SB and mental health using bibliometric methods and to explore the research status, hotspots, and future trends in this field over the past 20 years.

Methods:

Articles were obtained in the Web of Science core collection database, with SB and mental health topics. Simultaneously, visual analysis of the included literature was cooperation among countries/institutions, core authors, active journals, and co-occurrence of keywords, and a scientific knowledge map was drawn.

Results:

From 2004 to 2024, publications on the topic of SB and mental health have shown a rapid growth trend, albeit with a slight decline after 2022. Regarding cooperative relationships, cooperation among countries, institutions, and authors is close, with the United States, Kings Coll London, among others, occupying core positions in this field. The International Journal of Environmental Research and Public Health is the most prolific journal. Current research hotspots include “association between sedentary behavior and physical activity with health,” “association of sedentary behavior with depression, anxiety, and risk factors” and “associative diseases such as obesity and cardiovascular mortality risk in children and the elderly.” Future research directions maybe “influence of sedentary behavior on sleep and specific psychological disorders.”

Conclusion:

This study underscores the significant attention given to SB and mental health over the past 2 decades, providing valuable insights and guiding future research endeavors.

Keywords: Citespace, emotional disorders, mental health, sedentary behavior, visualization

1. Introduction

Sedentary behavior (SB) refers to any activity with an energy expenditure lower than 1.5 metabolic equivalents in a state of wakefulness, such as watching TV, using a computer, sitting in transit, leaning, or lying down, occurring in various settings, including work, study, and leisure environments. Data shows that the majority of awake adults spend most of their time sitting,[1] with Chinese individuals spending an average of 160 minutes per day sitting during leisure time.[2] Particularly after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic in China, people’s mobility and activity intensity decreased, leading to an increase in sedentary time. In the post-pandemic era today, this situation has not significantly improved with the acceleration of mechanization, automation, and informatization processes. As a relatively new research area, SB has attracted increasing attention from scholars, and more and more studies have confirmed the impact of SB on health. Research shows that even with recommended levels of physical activity (PA), prolonged SB each day can still have adverse health effects, such as causing individuals to develop myopia, decreased bone density, and sleep disorders,[3] and even leading to obesity, hypertension, cardiovascular diseases,[4,5] cancer,[6] and various metabolic diseases,[7–9] becoming a major public health issue.

Furthermore, the relationship between mental health and SB has been a focus of attention.[10,11] A systematic review suggests that SB exacerbates mental health issues in children and adolescents, leading to anxiety, depression, and other psychological disorders.[12] Additionally, an analysis of data from the Global School-based Student Health Survey indicates a significant correlation between SB and anxiety and depression symptoms in both boys and girls. For instance, adolescents who spend >2 hours sitting each day have a higher risk of anxiety and depression symptoms compared to those who sit for <2 hours per day.[13] Data from the 2021 Asia’s Best Workplaces (Mainland China Region) survey reveals a high detection rate of anxiety tendencies among working professionals, with severe SB and lack of physical exercise being identified as independent risk factors for anxiety tendencies.[14] The impact of SB on mental health has become a scientific issue of great concern. However, the research progress in this field lacks clear and coherent analysis.

Bibliometrics, a scientific method gradually gaining prominence in recent years, is widely used for dynamic analysis of development trends in the medical field.[15] CiteSpace (Drexel University, Philadelphia ), developed in the Java programming environment, is a visualization tool for bibliometric analysis.[16] This software can analyze literature data in a specific research field and present it in the form of a graph, allowing for a clear understanding of the development trends and research hotspots in that field, thereby providing references for research directions in the field.[17]

2. Materials and methods

2.1. Data sources and retrieval strategies

Using the Web of Science (WOS) core collection as the database source, we conducted a literature search on January 8, 2024. The search strategy, revised based on published literature,[18–20] is as follows: TS = (“sedentary behavior” OR “sedentary behavior” OR “sedentary time”) AND TS = (([mental OR mood psychological OR psychology] AND [health OR illness OR disease* OR disorder* OR wellbeing OR well-being]) OR depress* OR anxiety). We set the time limit from January 8, 2004, to January 8, 2024. The document types included were “Article” or “Review Article,” with the language restricted to English. A total of 3092 publications were retrieved.

2.2. Data filtering

Inclusion criteria: literature that meets the search strategy. Exclusion criteria: duplicate publications; conference notices, achievements, popular science, etc; literature with incomplete information such as publication time, authors, institutions, keywords, etc, as outlined in Figure 1 for publication screening and inclusion process. During the literature evaluation process, 2 researchers independently screened the literature. When disagreements occurred: first, the 2 researchers conducted in-depth discussions on the controversial literature, carefully compared and analyzed the reasons for their different views, and referred to relevant guidelines and criteria in the field. If the differences still could not be resolved through discussion, a third senior researcher in the field was invited to participate. The final decision on whether to include the literature was made through joint discussion among the 3 of them.

Figure 1.

Figure 1.

Open in a new tab

Flowchart of literature selection.

2.3. Data processing and analysis

Citespace software is utilized for literature data analysis with the following parameter settings: time slicing focuses on literature from 2004 to 2024, with each year serving as a slice; the threshold for TOP N in each slice is set to 50, and the k value for the g-index is set to 25. For node types, including author, resource, institution, country, and keyword, the threshold is set to top N per slice = 25. Pathfinder and pruning networks graph trimming algorithms refine the graph for clarity. Betweenness centrality indicates the importance of nodes in a network (in addition to degree centrality, closeness centrality, etc). CiteSpace utilizes this metric to discover and measure the significance of literature, highlighting it with purple circles to signify its importance. Nodes with high betweenness centrality often serve as “turning points” in connecting different clusters, as frequently mentioned in CiteSpace.

3. Results

3.1. General information

We conducted a literature search on “sedentary behavior and mental health” in the literature indexed in WOS from 2004 to 2024. Ultimately, 3092 publications were included, involving 102 countries/regions, 606 institutions, 14,881 authors, and 795 journals (see Fig. 2).

Figure 2.

Figure 2.

Open in a new tab

Basic information and annual number of publications over 2004 to 2024.

3.2. Analysis of annual publication

Between 2004 and 2024, 3092 publications were produced on “sedentary behavior and mental health.” We observed that the publication output experienced a slow growth period from 2005 to 2017, followed by a rapid increase from 2018 to 2021 and a decline in activity from 2022 to 2023, indicating that related research is expected to stabilize. Specifically, there were 24 publications in 2004, which slightly decreased to 20 publications in 2005. From then until 2021, the annual publication output continued to rise, reaching 468 publications. From 2021 to 2023, the annual publication output gradually decreased but remained 297 publications. Meanwhile, the annual citation count for research on this topic consistently increased until 2022, highlighting its research significance (see Fig. 2).

3.3. Research country/regional analysis

Research in this field involves 102 countries/regions. The highest-producing country is the USA (n = 817), followed by Australia (n = 486), England (n = 467), Canada (n = 312), and the People’s Republic of China (n = 252). Among the top 10 highest producing countries, the USA has the highest centrality at 0.18, followed by Germany (centrality = 0.16), Italy (centrality = 0.13), England (centrality = 0.1), and Spain (centrality = 0.1), as shown in Table 1. Moreover, close global cooperation among countries forms a stable cooperative network, as depicted in Figure 3A, B.

Table 1.

Top 10 countries/regions ranked by publication number and centrality.

Rank Countries Count Countries Centrality
1 USA 817 USA 0.18
2 Australia 486 Germany 0.16
3 England 467 Italy 0.13
4 Canada 312 England 0.1
5 People’s Republic of China 252 Spain 0.1
6 Spain 251 India 0.08
7 Brazil 200 Netherlands 0.05
8 Netherlands 164 France 0.05
9 Germany 138 Denmark 0.05
10 Belgium 133 South Africa 0.05
Open in a new tab

Figure 3.

Figure 3.

Open in a new tab

The visualization of countries/regions, institutions and authors. (A) Country collaboration map. (B) Visualization map of countries. (C) Visualization map of institutions. (D) Visualization map of authors.

3.4. Analysis of research institutions

Research in this field involves 606 institutions. The highest-producing institution is Kings College London, contributing 111 publications to this field, followed by University College London (UCL, n = 80), University of Queensland (n = 79), Deakin University (n = 73), and Karolinska Institute (n = 72). Among the top 10 highest-producing institutions, UCL has the highest centrality at 0.09, and the same centrality is observed for Karolinska Institute, indicating that these institutions hold a central position in research cooperation, as shown in Figure 3C and Table 2.

Table 2.

Top 10 institutions ranked by publication number and centrality.

Rank Institutions Count Institutions Centrality
1 Kings Coll London 111 UCL 0.09
2 UCL 80 Karolinska Inst 0.09
3 Univ Queensland 79 Univ Queensland 0.07
4 Deakin Univ 73 Univ Sydney 0.07
5 Karolinska Inst 72 Harvard Med Sch 0.07
6 Univ Sydney 69 Deakin Univ 0.06
7 South London & Maudsley NHS Fdn Trust 68 Univ Melbourne 0.06
8 Katholieke Univ Leuven 63 Univ Toronto 0.05
9 Anglia Ruskin Univ 61 Univ Ghent 0.05
10 Univ Toronto 61 Columbia Univ 0.05
Open in a new tab

UCL = University College London.

3.5. Analysis of research authors

Research in this field involves 14,881 authors. The most prolific author is Brendon Stubbs, contributing 96 publications, followed by Vancampfort D (n = 76), Smith L (n = 49), Koyanagi A (n = 45), Firth J (n = 41), Rosenbaum S (n = 40), Hallgren M (n = 36), Hamer M (n = 29), Owen N (n = 26), and Werneck AO (n = 26). In terms of citation count, Vancampfort D has the highest citation frequency (284), followed by Tremblay Ms (274), World Health Organization (266), and Stubbs B (213), with citation frequencies exceeding 200. In terms of influence, Stubbs B has the highest h-index (h_index = 31), followed by Vancampfort D (29), Firth J (23), Hallgren M (20), and Rosenbaum S (20), as shown in Figure 3D and Table 3.

Table 3.

Top 10 productive authors, co-cited author and influential authors.

Rank Authors Record count % of 3092 Co-cited author Count Element h_index
1 Stubbs B 96 3.105 Vancampfort D 284 Stubbs B 31
2 Vancampfort D 76 2.458 Tremblay MS 274 Vancampfort D 29
3 Smith L 49 1.585 World Health Organization 266 Firth J 23
4 Koyanagi A 45 1.455 Stubbs B 213 Hallgren M 20
5 Firth J 41 1.326 Ekelund U 189 Rosenbaum S 20
6 Rosenbaum S 40 1.294 Schuch FB 185 Smith L 19
7 Hallgren M 36 1.164 Teychenne M 142 Koyanagi A 18
8 Hamer M 29 0.938 Biddle SJH 128 Owen N 17
9 Owen N 26 0.841 Hamer M 127 Biddle SJH 16
10 Werneck AO 26 0.841 Firth J 125 Hamer M 16
Open in a new tab

3.6. Analysis of published journals

Research in this field involves 795 journals. The most prolific journal is the International Journal of Environmental Research and Public Health (n = 226), followed by BMC Public Health (n = 160) and PLOS ONE (n = 108), all of which have published over 100 articles. In terms of citation count, the most cited journal in Medicine & Science in Sports & Exercise (n = 1617), followed by PLOS ONE (n = 1450), International Journal of Behavioral Nutrition and Physical Activity (n = 1249), Preventive Medicine (n = 1193), BMC Public Health (n = 1172), Lancet (n = 1133), and American Journal of Preventive Medicine (n = 1044). These journals have citation frequencies exceeding 1000, as shown in Table 4.

Table 4.

Top 10 productive journals and cited journals.

Rank Journal Count % of 3092 Cited Journal Count
1 International Journal of Environmental Research and Public Health 226 7.309 Med Sci Sport Exer 1617
2 BMC Public Health 160 5.175 PLOS ONE 1450
3 PLOS ONE 108 3.493 Int J Behav Nutr Phy 1249
4 International Journal of Behavioral Nutrition and Physical Activity 71 2.296 Prev Med 1193
5 Journal of Affective Disorders 71 2.296 BMC Public Health 1172
6 Preventive Medicine 58 1.876 Lancet 1133
7 BMJ Open 56 1.811 Am J Prev Med 1044
8 Frontiers in Public Health 55 1.779 Brit J Sport Med 996
9 Frontiers in Psychiatry 31 1.003 JAMA – J Am Med Assoc 933
10 Nutrients 29 0.938 Int J Env Res Pub He 849
Open in a new tab

3.7. Analysis of highly cited articles

Among the 3092 publications, we selected the top 10 highly cited articles for analysis. The most cited article is “Lack of exercise is a major cause of chronic diseases” published in 2012,[21] with 1364 citations. This article examines the impact of physical inactivity on chronic diseases. The remaining 3 articles with over 1000 citations are “Systematic review of sedentary behavior and health indicators in school-aged children and youth,” published in 2011 with 1286 citations[22]; “Physical activity and mental health in children and adolescents: a review of reviews,” published in 2011 with 1266 citations[23]; and “Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth,” published in 2016 with 1156 citations.[24] The article with the highest impact factor among the cited papers is “City planning and population health: a global challenge,”[25] with an impact factor of 168.9, published in Lancet. The next highest impact factor is for “Physical activity and mental health in children and adolescents: a review of reviews,” published in the British Journal of Sports Medicine, with an impact factor of 18.6. The impact factors of the remaining articles are below 10. Additionally, we observed that 3 of the top 10 articles are from Canada, 3 are from England, 2 are from Australia, and 2 are from the USA, indicating that these 3 countries are core contributors to publications in this field (see Table 5).

Table 5.

Top 10 highly cited articles.

Rank Year Title First author/Country Journal Journal IF Citations
1 2012 Lack of exercise is a major cause of chronic diseases Booth, Frank W./USA Comprehensive Physiology 5.8 1364
2 2011 Systematic review of sedentary behavior and health indicators in school-aged children and youth Tremblay, Mark S./Canada International Journal of Behavioral Nutrition and Physical Activity 8.7 1286
3 2011 Physical activity and mental health in children and adolescents: a review of reviews Biddle, Stuart J. H./England British Journal of Sports Medicine 18.6 1266
4 2016 Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth Poitras, Veronica Joan/Canada Applied Physiology Nutrition and Metabolism 3.4 1156
5 2010 Fundamental movement skills in children and adolescents review of associated health benefits Lubans, David R./Australia Sports Medicine 9.8 903
6 2018 Physical activity and incident depression: a meta-analysis of prospective cohort studies Schuch, Felipe B./Brazil American Journal of Psychiatry 17.7 705
7 2016 City planning and population health: a global challenge Giles-Corti, Billie./Australia Lancet 168.9 608
8 2006 Adolescent physical activity and health – a systematic review Hallal, Pedro C./Brazil Sports Medicine 9.8 586
9 2004 Health-enhancing physical activity and sedentary behavior in children and adolescents Biddle, SJH/Leics Journal of Sports Sciences 3.4 574
10 2014 The effects of stress on physical activity and exercise Stults-Kolehmainen, Matthew A./USA Sports Medicine 9.8 569
Open in a new tab

3.8. Analysis of co-cited references

In the literature co-citation network generated by CiteSpace, the size of nodes is proportional to the number of citations received by the papers. Larger nodes indicate higher citation counts for the corresponding papers. Among the top 10 co-cited papers, the most co-cited paper is “Sedentary Behavior Research Network (SBRN) – Terminology Consensus Project process and outcome,”[26] followed by “Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis,”[27] which is also the paper with the highest centrality. Other important publications with co-citation frequencies exceeding 100 include “Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis,”[28] “Physical activity and incident depression: a meta-analysis of prospective cohort studies,”[29] and “Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonized meta-analysis of data from more than 1 million men and women.”[30] These papers hold significant positions in research in this field (see Table 6 and Fig. 4A).

Table 6.

Top 10 co-cited reference.

Rank Count Centrality Year Author Journal Title
1 151 0.05 2017 Tremblay MS Int J Behav Nutr Phy Sedentary Behavior Research Network (SBRN) – Terminology Consensus Project process and outcome
2 108 0.16 2015 Biswas A Ann Intern Med Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults a systematic review and meta-analysis
3 103 0.01 2017 Vancampfort D World Psychiatry Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder, and major depressive disorder: a global systematic review and meta-analysis
4 102 0.03 2018 Schuch FB Am J Psychiat Physical activity and incident depression: a meta-analysis of prospective cohort studies
5 100 0.06 2016 Ekelund U Lancet Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonized meta-analysis of data from more than 1 million men and women
6 93 0.01 2017 Schuch F J Affect Disorders Physical activity and sedentary behavior in people with major depressive disorder: a systematic review and meta-analysis
7 91 0.01 2020 Bull FC Brit J Sport Med World Health Organization 2020 guidelines on physical activity and sedentary behavior
8 77 0.01 2018 Guthold R Lancet Glob Health Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants
9 74 0.04 2015 Zhai L Brit J Sport Med Sedentary behavior and the risk of depression: a meta-analysis
10 70 0.03 2016 Hoare E Int J Behav Nutr Phy The associations between sedentary behavior and mental health among adolescents: a systematic review
Open in a new tab

Figure 4.

Figure 4.

Open in a new tab

Visualization map of co-cited references (A) and co-occurrence keywords network (B).

3.9. Keyword analysis

Keywords are highly condensed and summarized representations of the core content of an article, reflecting its main ideas and themes. Keywords can effectively reflect the research hotspots and trends in different periods of a field, fully embodying the articles’ themes and core research content. Excluding “sedentary behavior,” “mental health,” and “health,” the top 10 co-occurring keywords are “physical activity,” “exercise,” “association,” “depression,” “risk,” “adult,” and “quality of life.” In terms of centrality, the top 10 keywords are “physical activity” (centrality = 0.07), “aerobic exercise” (centrality = 0.07), “behavior” (centrality = 0.06), “blood pressure” (centrality = 0.06), “health promotion” (centrality = 0.05), “brain” (centrality = 0.05), “exercise” (centrality = 0.04), “adult” (centrality = 0.04), and “children” (centrality = 0.04), as shown in Table 7 and Figure 4B.

Table 7.

Top 10 keywords from counts and centrality.

Rank Keywords Counts Keywords Centrality
1 Physical activity 1528 Physical activity 0.07
2 Sedentary behavior 969 Aerobic exercise 0.07
3 Exercise 561 Behavior 0.06
4 Association 510 Blood pressure 0.06
5 Mental health 508 Health promotion 0.05
6 Health 478 Brain 0.05
7 Depression 437 Exercise 0.04
8 Risk 408 Adult 0.04
9 Adult 332 Children 0.04
10 Quality of life 312 Older adult 0.04
Open in a new tab

Analyzing burst keywords can provide researchers with a clearer and more intuitive understanding of the hotspots and trends in the development of a field. We discovered 96 burst keywords, indicating that early research in the field, around 2004, focused on issues related to energy surplus and weight caused by prolonged sitting. From 2020 to the present, there has been increased focus on topics such as “sleep,” “COVID-19 pandemic,” “university student,” “health indicator,” and “circadian rhythm,” as shown in Figure 5.

Figure 5.

Figure 5.

Open in a new tab

Top 96 keywords with strongest citation bursts.

4. Discussion

4.1. Research status

Long-term SB, frequent late nights, and lack of exercise are 3 common unhealthy habits among young people.[31] The impact of SB on mental health is particularly prominent in today’s society. Therefore, we conducted a bibliometric analysis to examine the development of this field from the perspective of publications and obtained 3092 publications from 2004 to 2024. The total number of publications on “sedentary behavior and mental health” has been increasing from 2004 to 2024. The number of publications increased annually from 2004 to 2021, peaking in 2021, and has decreased annually since 2022 but still maintains a relatively high level, indicating that the field’s popularity has not waned. Moreover, the sharp increase in publications around 2021 may be significantly associated with the COVID-19 pandemic. Under the influence of the COVID-19 pandemic, sedentary time has increased, leading to an increase in psychological problems such as depression and anxiety, severely affecting the quality of life across all age groups and posing a threat to public health.[32–35]

Looking at the scientific collaboration in this field, the disciplinary development is driven by 102 countries/regions, 606 research institutions, and 14,881 authors. The United States and the United Kingdom contribute the most and hold core positions in the national cooperation network. Cooperation among countries in this field is relatively frequent, with the United States, Germany, Italy, England, and Spain forming the initial research core. Regarding institutional collaboration, the institution with the highest output is King’s College London, ranked in the top 10 universities in the UK (QS World Rankings 2021) and based in the heart of London. In institutional collaboration, the final node occupying a core position is UCL, which is consistently ranked as one of the top 10 universities in the world (QS World University Rankings 2010–2022). Institutions in England have made significant contributions to the study of the relationship between SB and mental health, reflecting the importance attached to research in this field by the institutions above.

Upon analyzing relevant authors, we found that among the 14,881 authors, the most prolific is Brendon Stubbs, who works at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London. Brendon Stubbs also holds the highest h-index in this field. In his latest research, based on Mendelian randomization analysis, he proposed an association between SB and conditions such as schizophrenia, suggesting that PA can mitigate the risk of mental health and medication use disorders, recommending PA as a treatment modality for severe mental illness.[36,37] Additionally, Davy Vancampfort from the Catholic University of Leuven has also made outstanding contributions in this field. His latest study, through a systematic review, explores the correlates of SB in people with fibromyalgia. It suggests that clinicians should consider physical and psychological barriers when reducing or interrupting SB in individuals with fibromyalgia.[9]

Additionally, we also examined the publication status of journals in this field. Three journals that have contributed more than 100 publications to this field are the International Journal of Environmental Research and Public Health (n = 226), BMC Public Health (n = 160), and PLOS ONE (n = 108). The International Journal of Environmental Research and Public Health and BMC Public Health focus on public health, with impact factors around 4, which although not high, still receive attention from researchers in this field. PLOS ONE, as a comprehensive journal, stands out in both publication volume and citation frequency, becoming a major journal in this field. The most cited articles published in PLOS ONE are “The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: a systematic review.”[38] The article suggests that “higher levels of physical activity are associated with better health-related quality of life in children and adolescents, while increased sedentary behavior is associated with lower health-related quality of life.” We also found that Medicine & Science in Sports & Exercise, focusing on sports medicine and exercise science, has the highest citation frequency among published articles, forming the main source of research foundation in this field.

4.2. Research hotspots and trends

Based on the analysis of co-cited references and keywords, the research hotspots and trends in the field of “sedentary behavior and mental health” can be summarized as follows. It was found that current researchers are focusing on topics such as “the association between sedentary behavior and physical activity with health,” “sedentary behavior and its association with depression, anxiety, and risk factors,” and “the association between sedentary behavior and obesity, cardiovascular mortality risk, and other related diseases in children and the elderly.”

Systematic reviews involving children and adults demonstrate a dose-response relationship between PA, SB, and health-related quality of life. This suggests that the higher the frequency of PA or the shorter the sedentary time, the better the health-related quality of life.[38] Long-term SB is associated with a range of negative health outcomes for older adults, from poorer cardiometabolic health to impaired physical function and higher mortality risk.[39] A bidirectional Mendelian randomization study indicates that PA and sedentary time have bidirectional effects on mental health outcomes.[40] Further investigations, such as those conducted in Polish children and adolescents,[41] are focused on explaining these associations, which essentially clarify the significant impact of SB on health.

Some researchers are also focusing on explaining the relationship between SB and current diseases, such as the impact of low-intensity PA and SB on cardiopulmonary health,[42] as well as the effects of PA and SB on weight management.[43] Regarding emotional impact, anxiety, and depression have always been hot topics of research. With prolonged sedentary time, the level of stress, anxiety, and depression among university students has significantly increased.[44] Furthermore, SB shows a dose–response positive correlation with anxiety, depression, and suicidal behavior, highlighting the enormous harm of suicidal behavior to overall health.[45,46] Research on these topics is ongoing and continues to be a sustained focus.

However, future research trends may focus on SB patterns during the COVID-19 pandemic, its impact on student sleep, and changes in related health indicators. For example, during the COVID-19 pandemic, quarantine measures have led to restricted activity, reduced PA, and increased SB among children, adolescents, and adults.[35] Additionally, longitudinal Mendelian randomization studies suggest that prolonged sedentary time adversely affects COVID-19 recovery.[46] Exploratory studies in 2023 further indicate that individuals with an active lifestyle and avoidance of prolonged sitting habits have a higher quality of life during the outbreak of COVID-19, suggesting that avoiding SB and adopting an active lifestyle are the best strategies in facing unpredictable pandemics.[47] Moreover, a survey in Thailand revealed that 75.8% of the population experienced prolonged sitting during COVID-19, particularly those with higher education and income levels. Targeted interventions to break SB are beneficial for maintaining health.[48] Additionally, numerous studies on SB and depression are currently being published, indicating that research in this area will continue for some time to come.

Certainly, with increased emphasis on health and well-being, sleep quality has received particular attention. Many studies have shown a deep connection between SB and sleep disturbances. For instance, the National Health and Nutrition Examination Survey of 22,599 participants indicated that SB is a risk factor for sleep disorders.[8] Moreover, research from various perspectives indicates a relationship between SB and sleep quality. Increased PA and reduced SB are positively correlated with sleep quality.[49] When considering BMI, prolonged SB (such as screen time, smartphone use, and computer usage) and higher BMI may lead to shortened sleep duration and decreased sleep efficiency in young adults in China.[50] There will be more research conducted in this area in the future.

5. Conclusion

Over the past 2 decades, research on SB and mental health has received widespread attention, becoming a hot topic in public health. However, there has been a slight decline in publication growth after 2022. There is close collaboration among countries, institutions, and authors, with the United States, Kings College London, UCL, as well as Stubbs B and Vancampfort D, occupying core positions in this research field. Journals focusing on public health are the main sources of publications. Future research hotspots include investigating the relationship between the COVID-19 pandemic and patterns of SB, as well as the impact of SB on sleep and specific psychological disorders.

5.1. Relevance for clinical practice

In recent years, SB, mainly based on TV viewing time and screen time, has become increasingly common. SB mainly refers to low energy consumption behavior in which the body maintains a sitting or lying position while in a clear state. This behavior is not conducive to physical health and is considered a precursor factor affecting the body’s physical and mental health. SB can cause the occurrence and development of emotional disorders such as anxiety and depression. However, the current research status in this field is not clear. This study will help to clarify the impact of SB on mental health and provide reference for the prevention and treatment of diseases such as depression in clinical practice.

5.2. Limitations

This study has limitations to note. We mainly used the WOS core database, which may miss some research from other databases or gray literature. The bibliometric method, focusing on quantitative analysis, cannot fully capture qualitative details like specific contexts of how SB affects mental health. Despite these, the study provides key value. By visualizing a knowledge map, it offers a broad view of 2 decades of research trends. Identifying hotspots and future directions can guide researchers to focus on emerging areas, enhance global collaboration, and develop targeted solutions for mental health issues related to SB.

Author contributions

Data curation: Yi Liu, Zhen Zhang.

Formal analysis: Yi Liu.

Investigation: Yi Liu, Sisheng Tian.

Methodology: Yi Liu, Sisheng Tian.

Project administration: Hao Zhang, Sisheng Tian.

Resources: Zhen Zhang, Hao Zhang, Sisheng Tian.

Software: Yi Liu.

Abbreviations:

COVID-19
coronavirus disease 2019
PA
physical activity
SB
sedentary behavior
UCL
University College London
WOS
Web of Science

This study was sponsored by the National Natural Science Foundation of China (No. 82204958, 82305065), Natural Science Foundation of Shandong Province (No. ZR2020ZD17), The 18th Special Support of China Postdoctoral Science Foundation (No. 2025T181085), and Shandong Provincial Higher Education Institutions Youth Innovation Team Program (No. 2023KJ191 and 2024KJJ061).

The authors declare that they have no conflicts of interest.

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

How to cite this article: Liu Y, Zhang Z, Zhang H, Tian S. Knowledge mapping analysis of sedentary behavior and mental health research: A bibliometric analysis from 2004 to 2024. Medicine 2025;104:37(e44275).

Contributor Information

Yi Liu, Email: zjxsnh2018@163.com.

Zhen Zhang, Email: zhanghaojune@126.com.

Hao Zhang, Email: zhanghaojune@126.com.

References

  • [1].Paudel S, Owen AJ, Smith B. Socio-ecological influences of leisure-time physical activity among Nepalese adults: a qualitative study. BMC Public Health. 2021;21:1443. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [2].Yang D, Haixia S, Li Y. Analysis of the current situation and influencing factors of sedentary behavior among Chinese adults during leisure time. Mod Prev Med. 2022;49:2808–2813 + 2820. [Google Scholar]
  • [3].Yang Y, Shin JC, Li D, An R. Sedentary behavior and sleep problems: a systematic review and meta-analysis. Int J Behav Med. 2017;24:481–92. [DOI] [PubMed] [Google Scholar]
  • [4].Zhao Q, Chen C, Zhang J, Ye Y, Fan X. Sedentary behavior and health outcomes in patients with heart failure: a systematic review and meta-analysis. Heart Fail Rev. 2022;27:1017–28. [DOI] [PubMed] [Google Scholar]
  • [5].Duran AT, Romero E, Diaz KM. Is sedentary behavior a novel risk factor for cardiovascular disease? Curr Cardiol Rep. 2022;24:393–403. [DOI] [PubMed] [Google Scholar]
  • [6].Lynch BM. Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer Epidemiol Biomarkers Prev. 2010. 19(11):2691–2709. [DOI] [PubMed] [Google Scholar]
  • [7].Agbaje AO, Perng W, Tuomainen TP. Effects of accelerometer-based sedentary time and physical activity on DEXA-measured fat mass in 6059 children. Nat Commun. 2023;14:8232. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [8].You YW, Chen Y, Fang W, et al. The association between sedentary behavior, exercise, and sleep disturbance: a mediation analysis of inflammatory biomarkers. Front Immunol. 2023;13:1080782. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [9].Vancampfort D, Brunner E, McGrath RL, Hemmings L, Van Damme T. Correlates of sedentary behavior in people with fibromyalgia: a systematic review. Int J Rheum Dis. 2023;26:841–9. [DOI] [PubMed] [Google Scholar]
  • [10].Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. J Sport Health Sci. 2024;13:472–83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [11].de Rezende LFM, Rodrigues Lopes M, Rey-López JP, Matsudo VKR, Luiz OC. Sedentary behavior and health outcomes: an overview of systematic reviews. PLoS One. 2014;9:e105620. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [12].Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, et al. Role of physical activity and sedentary behavior in the mental health of preschoolers, children and adolescents: a systematic review and meta-analysis. Sports Med. 2019;49:1383–410. [DOI] [PubMed] [Google Scholar]
  • [13].Wang M, Association Study on Sedentary Behavior and Anxiety and Depression Symptoms among Adolescents in Low - and Middle Income Countries 2022, Wuhan University [Google Scholar]
  • [14].Liu Y, et al. The combined effect of sedentary behavior and physical exercise behavior on anxiety tendencies in occupational populations. J Peking Univ (Medical Edition). 2022;54:490–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [15].Ninkov A, Frank JR, Maggio LA. Bibliometrics: Methods for studying academic publishing. Perspect Med Educ. 2022;11:173–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [16].Chen CM, Dubin R, Kim MC. Emerging trends and new developments in regenerative medicine: a scientometric update (2000–2014). Expert Opin Biol Ther. 2014;14:1295–317. [DOI] [PubMed] [Google Scholar]
  • [17].Sabe M, Pillinger T, Kaiser S, et al. Half a century of research on antipsychotics and schizophrenia: a scientometric study of hotspots, nodes, bursts, and trends. Neurosci Biobehav Rev. 2022;136:104608. [DOI] [PubMed] [Google Scholar]
  • [18].Zhou R, Lin X, Xu J, Lin X, Wu Z. Knowledge mapping analysis of mental health research on COVID-19. Front Psychiatry. 2022;13:931575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [19].Zhou J, Song D, Ma J, et al. Research trends in the mental health and multimorbidity of older people from 2002 to 2022: a bibliometric analysis via CiteSpace. Front Psychiatry. 2023;14:1117554. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [20].Yang Z, Chen S, Bao R, et al. Public health concern on sedentary behavior and cardiovascular disease: a bibliometric analysis of literature from 1990 to 2022. Medicina (Kaunas). 2022;58:1764. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [21].Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2:1143–211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [22].Tremblay MS, LeBlanc AG, Kho ME, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act. 2011;8:98. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [23].Biddle SJH, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011;45:886–95. [DOI] [PubMed] [Google Scholar]
  • [24].Poitras VJ, Gray CE, Borghese MM, et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41:S197–239. [DOI] [PubMed] [Google Scholar]
  • [25].Giles-Corti B, Vernez-Moudon A, Reis R, et al. City planning and population health: a global challenge. Lancet. 2016;388:2912–24. [DOI] [PubMed] [Google Scholar]
  • [26].Tremblay MS, Aubert S, Barnes JD, et al. Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act. 2017;14:75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [27].Biswas A, Oh PI, Faulkner GE, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162:123–32. [DOI] [PubMed] [Google Scholar]
  • [28].Vancampfort D, Firth J, Schuch FB, et al. Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis. World Psychiatry. 2017;16:308–15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [29].Schuch FB, Vancampfort D, Firth J, et al. Physical activity and incident depression: a meta-analysis of prospective cohort studies. Am J Psychiatry. 2018;175:631–48. [DOI] [PubMed] [Google Scholar]
  • [30].Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388:1302–10. [DOI] [PubMed] [Google Scholar]
  • [31].Yuanchun D, Huang Z. The three major unhealthy behaviors among young people: prolonged sitting, staying up late, and lack of exercise. China Youth Daily; 2023;12:3. [Google Scholar]
  • [32].Runacres A, Mackintosh KA, Knight RL, et al. Impact of the COVID-19 Pandemic on sedentary time and behaviour in children and adults: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18:11286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [33].Sepúlveda-Loyola W, Rodríguez-Sánchez I, Pérez-Rodríguez P, et al. Impact of social isolation due to COVID-19 on health in older people: mental and physical effects and recommendations. J Nutr Health Aging. 2020;24:938–47. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [34].Pfefferbaum B, Van Horn RL. Physical activity and sedentary behavior in children during the COVID-19 pandemic: implications for mental health. Curr Psychiatry Rep. 2022;24:493–501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [35].Evenson KR, Alothman SA, Moore CC, et al. A scoping review on the impact of the COVID-19 pandemic on physical activity and sedentary behavior in Saudi Arabia. BMC Public Health. 2023;23:572. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [36].Machaczek KK, Firth J, Tew GA, Stubbs B, Jones G, Peckham EJ. Towards the standardization of physical activity programs for severe mental ill health: a survey of current practice across 54 mental health trusts in England. Psychiatry Res. 2023;330:115602. [DOI] [PubMed] [Google Scholar]
  • [37].Iob E, Pingault J-B, Munafò MR, et al. Testing the causal relationships of physical activity and sedentary behaviour with mental health and substance use disorders: a Mendelian randomisation study. Mol Psychiatry. 2023;28:3429–43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [38].Wu XY, Han LH, Zhang JH, Luo S, Hu JW, Sun K. The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: a systematic review. PLoS One. 2017;12:e0187668. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [39].Fanning J, Nicklas BJ, Rejeski WJ. Intervening on physical activity and sedentary behavior in older adults. Exp Gerontol. 2022;157:111634. [DOI] [PubMed] [Google Scholar]
  • [40].Casanova F, O'Loughlin J, Karageorgiou V, et al. Effects of physical activity and sedentary time on depression, anxiety and well-being: a bidirectional Mendelian randomisation study. BMC Med. 2023;21:501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [41].Górna S, Pazdro-Zastawny K, Basiak-Rasała A, et al. Physical activity and sedentary behaviors in Polish children and adolescents. Arch Pediatr. 2023;30:42–7. [DOI] [PubMed] [Google Scholar]
  • [42].Greenwalt D, Phillips S, Ozemek C, Arena R, Sabbahi A. The impact of light physical activity, sedentary behavior and cardiorespiratory fitness in extending lifespan and healthspan outcomes: how little is still significant? A narrative review. Curr Probl Cardiol. 2023;48:101871. [DOI] [PubMed] [Google Scholar]
  • [43].Bryan AD, Jakicic JM, Hunter CM, Evans ME, Yanovski SZ, Epstein LH. Behavioral and psychological phenotyping of physical activity and sedentary behavior: implications for weight management. Obesity (Silver Spring, Md.). 2017;25:1653–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [44].Lee E, Kim Y. Effect of university students’ sedentary behavior on stress, anxiety, and depression. Perspect Psychiatr Care. 2019;55:164–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [45].Jiang LY, Cao Y, Ni S, et al. Association of sedentary behavior with anxiety, depression, and suicide ideation in college students. Front Psychiatry. 2020;11:566098. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [46].Chen X, Hong X, Gao W, et al. Causal relationship between physical activity, leisure sedentary behaviors and COVID-19 risk: a Mendelian randomization study. J Transl Med. 2022;20:216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [47].Huang CY, Huang WH, Yen HY. An exploration of sedentary behavior, physical activity, and quality of life during the COVID-19 outbreak. Int J Public Health. 2023;68:1605585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [48].Topothai T, Tangcharoensathien V, Suphanchaimat R, Petrunoff NA, Chandrasiri O, Müller-Riemenschneider F. Patterns of physical activity and sedentary behavior during the COVID-19 pandemic in the Thai 2021 National Health Survey. J Phys Act Health. 2023;20:364–73. [DOI] [PubMed] [Google Scholar]
  • [49].Koohsari MJ, Yasunaga A, McCormack GR, et al. Sedentary behaviour and sleep quality. Sci Rep. 2023;13:1180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [50].Liu W, Yuan Q, Zeng N, et al. Relationships between college students’ sedentary behavior, sleep quality, and body mass index. Int J Environ Res Public Health. 2021;18:3946. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Medicine are provided here courtesy of Wolters Kluwer Health

RESOURCES