Associations of Passive and Active Screen Time With Psychosomatic Complaints of Adolescents

Introduction Increased screen time is a ubiquitous part of adolescent life and is adversely associated with their well-being. However, it remains unclear whether different types of screen time have equivalent associations, or if relationships are dose-dependent. Methods The data were from 2 nationally representative Health Behaviour in School-aged Children (2010, 2014) surveys across 44 European and North American countries. Psychosomatic health was assessed using 8 complaints and dichotomized as high or low. Discretionary time spent on passive (e.g., TV) and mentally active (e.g., electronic games, computer use) screen-based activities was categorized into 3 groups. Data were analyzed in 2021. Results The study included 414,489 adolescents (average age, 13.6 [SD=1.63] years; 51.1% girls). Multilevel modeling showed that psychosomatic complaints increased monotonically once all forms of screen time exceeded 2 hours/day. Adolescents reporting high (>4 hours/day) TV time, compared with those reporting low (≤2 hours/day), had higher odds of reporting psychosomatic complaints with 67% higher odds (OR=1.67, 95% CI=1.62, 1.72) in boys and 71% (OR=1.71, 95% CI=1.66, 1.75) in girls. High electronic game use was associated with psychosomatic complaints, with odds being 78% higher in boys (OR=1.78, 95% CI=1.73, 1.84) and 88% higher in girls (OR=1.88, 95% CI=1.82, 1.94). Similar associations were found between computer use and psychosomatic complaints. Conclusions Passive and mentally active screen time are adversely associated with psychosomatic complaints in a dose-dependent manner, with associations slightly stronger for active than passive screen time. This study supports limiting any type of screen time, either passive or active, to 2 hours/day to foster well-being.