A new study of over 50,000 children in the US found that spending four or more hours a day on screens is associated with a higher prevalence of mental health problems. This association is mediated by reduced physical activity and disrupted sleep routines.

UFFP editor Mrs Feriel Berraies Guigny in collaboration with Flow Neuroscience

 A new Nature Portfolio study reveals that excessive screen time in children is associated with significantly detrimental mental health outcomes across several disorders: ADHD, anxiety, behavioural problems and even depression.

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According to clinicians from Flow Neuroscience, a company behind the first FDA-approved non-drug, non-invasive depression treatment, the issue is even bigger than the study reveals, as these children are often overprescribed antidepressants and have limited treatment alternatives due to their age.

Based on data from over 50,000 US children aged 6-17, the study revealed that excessive screen time, categorized as four or more hours per day, is associated with increased odds of mental health issues, raising the likelihood of depression by 61%, anxiety by 45%, behavioural or conduct problems by 24% and ADHD by 21%.

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“What is most concerning about these results is the high probability of depression,” says Dr. Hannah Nearney, M.D., clinical psychiatrist and UK Medical Director at Flow Neuroscience. “While there are effective treatments for depression, treatment from a young age can present challenges that may further negatively impact a patient’s life, partly due to the side effects associated with antidepressant use. Unfortunately, non-drug alternatives are often limited to talking therapy, leaving a gap in the provision of services and exposing vulnerable children to increased risk.”

According to the study, physical activity emerges as the most influential protective factor between screen time and mental health problems, accounting for up to 39% of that relationship.

In comparison, irregular bedtimes are culpable for up to 23,9%, and short sleep duration explains around 7,24% of the relationship between screen time and mental health issues.

“What’s most important is that we now know the main determinants and protective factors regarding a range of mental health issues in children. The odds can be significantly reduced with adjustments in behaviours such as physical activity, and expanding the tools we can use to combat these illnesses,” highlighted Dr. Nearney.

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The data from the study also indicated that this problem will escalate, as nearly one in every three children spends too much of their time in front of screens, suggesting the behaviour is normalized.

Meeting guidelines for physical activity (which is more than 60 minutes per day) is already low, with only one out of five children achieving this standard. And just one out of four children maintains a consistent weekday bedtime routine.

Given the limitations and risks associated with prescribing SSRIs to children, including a small but measurable increase in suicidality, there is a growing need to explore alternative, non-pharmacological treatments.

In this context, the first FDA-approved non-drug treatment, based on transcranial direct current stimulation (tDCS), is expected to become available in the US later this year. However, it is not approved for children under 18.

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“Due to long waiting times, not enough attention is given to children and adolescents with mental health problems such as depression. Too often, they’re pushed into the trial-and-error pathways with antidepressants, even at a young age. We hope that such tools as brain stimulation will become available for these young people too, but what we can do in the meantime is to follow the suggestion of studies like the latter one, and not only avoid screen time, but also regulate our sleep schedules, add physical activity to children’s daily lives, and explore other similar options,” highlighted Dr. Nearney.

Even though currently, children don’t have non-drug, at-home, FDA-approved tools for depression treatment, an increasing amount of research supports that such technologies as tDCS are safe for pediatric use.

In the meantime, this Nature study reframes youth mental health as largely a preventable behavioural challenge and shows that many risks stem from modifiable habits like screen use, physical activity, and sleep.

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About Flow Neuroscience

Flow Neuroscience is a healthcare company that focuses on tDCS therapies and devices. In 2016, it was co-founded in Sweden by Daniel Mansson, a clinical psychologist, and Erik Rehn, an engineer. Erin Lee joined as CEO in 2022, having previously worked at Google, Uber, and Babylon, and the company is now based in the UK. Flow is the only at-home medical tDCS device with clinically proven effectiveness in treating depression, approved in all major markets: by the American Food and Drug Administration (FDA), the UK’s National Health Service (NHS), the Australian Therapeutic Goods Administration (TGA), and having passed regulations in Europe, Norway, Switzerland, and Hong Kong.