{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:00:33Z","timestamp":1790834433606,"version":"4.1.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021171","name":"Basic and Applied Basic Research Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2026A1515011154"],"award-info":[{"award-number":["2026A1515011154"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescents globally exhibit growing engagement with discretionary screen time, but its association with depressive symptoms remains unclear in developing economies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the relationship between discretionary screen time and depressive symptoms among Chinese adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study of 4,706 adolescents in Maoming City, Guangdong Province, China. Participants were stratified into four discretionary screen time categories: &amp;lt;1\u2005h (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,372), 1\u20132\u2005h (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,277), 2\u20134\u2005h (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,032), and \u22654\u2005h (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,025). Depressive symptoms were assessed using the validated CESD-9, with a cutoff score of \u226510. The primary analysis was a multilevel logistic regression model with random intercepts for school and class, adjusted for all measured covariates except BMI, anxiety and insomnia; a model additionally adjusted for BMI, anxiety and insomnia served as a sensitivity analysis. Subgroup analyses evaluated potential effect modification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of depressive symptoms was 29.7% (1,398\/4,706). In the primary multilevel model (random intercepts for school and class; adjusted for sociodemographic, socioeconomic and lifestyle factors, without BMI, anxiety and insomnia), compared with the &amp;lt;1\u2005h reference group, the odds ratios were 1.21 (95% CI: 0.98\u20131.49;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.082) for 1\u20132\u2005h, 1.88 (95% CI: 1.52\u20132.33;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) for 2\u20134\u2005h, and 2.54 (95% CI: 2.04\u20133.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) for \u22654\u2005h; each screen-time category increment was associated with 39% higher odds of depressive symptoms (OR\u2009=\u20091.39, 95% CI: 1.29\u20131.49;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). When additionally adjusted for BMI, anxiety and insomnia (sensitivity analysis, Model 4), the associations were attenuated but remained statistically significant for the higher categories (\u22654\u2005h: OR\u2009=\u20091.69, 95% CI: 1.28\u20132.22; per-category OR\u2009=\u20091.19, 95% CI: 1.09\u20131.29). Subgroup analyses revealed no statistically significant evidence of effect modification (all\n                      <jats:italic>p<\/jats:italic>\n                      -interaction &amp;gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prolonged discretionary screen time is significantly associated with higher odds of depressive symptoms among Chinese adolescents, indicating a graded association that strengthens with increasing screen time. These findings are relevant to public-health monitoring of discretionary screen use in adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1957282","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:42:22Z","timestamp":1790833342000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between discretionary screen time and depressive symptoms in Chinese adolescents: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhi","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Neurosis and Psychosomatic Diseases, The Third Hospital of Quzhou","place":["Quzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuye","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Binzhou People\u2019s Hospital","place":["Binzhou, Shandong, 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