Screen Use and Mental Health in Children and Adolescents
A secondary analysis of an RCT study was recently published in JAMA Network Open, which evaluated the effect of leisure-time screen media use when reduced to ≤ 3 hours per week for a period of 2 weeks in a population of children and adolescents from Denmark (n=181, ages 4-17 years).
- Smartphones and tablets were handed over for the time of the intervention by all children and ≥ 1 adult in each participating household, and a non-smartphone provided as a replacement for calls and text messages. Participants were allowed up to three hours of leisure-time screen media use (e.g., television, computer) per week. They were also allowed up to 30 minutes per day of “necessary” screen media use (to coordinate appointments, submit schoolwork, etc.). Tracking was used to monitor screen use.
- The intervention group mean age was 8.6 years, and the control group mean age was 9.5 years.
- The RCT excluded participants who had a neuropsychiatric, developmental, or sleep disorder, and those unable to participate in regular physical activity in their daily lives.
Findings
The change in total behavioural difficulties was evaluated by the Strengths and Difficulties Questionnaire at the point of follow-up. A statistically significant and clinically meaningful difference was found between the groups in the mean score, supporting the intervention. Largest improvements were reported for internalizing symptoms (reduced emotional symptoms and peer problems) along with prosocial behaviour (enhanced positive social interactions).
Bottom Line
There appears to be a connection between a reduction in leisure-time use of screen media in the short-term and improved psychological symptoms in children and adolescents.
- This research relates to content in the 2018 module Anxiety in Children and Adolescents (info point 8) which reported study data associating duration of screen time with symptoms of anxiety in adolescents. Additionally, the 2020 module Behavioural Challenges in Parenting (info point 22) refers to a systematic review of reviews which reported an association between longer screen time use and more depressive symptoms. Guidelines suggest no more than 2 hours of screen time per day for children aged 5 and up.
Brief Updates
Heart Failure and Sodium Restriction
- A 2024 Tools for Practice article Sodium Restriction in Health Failure concluded that in cases of chronic heart failure, the restriction of dietary sodium to < 2 g/day does not reduce hospitalization or death when compared to 2-3 g/day. The evidence included data from 5 systematic reviews.
- This is in alignment with the recommendation included in the 2019 Heart Failure module and the suggested salt consumption level included in the patient handout.
Acute Diverticulitis and Antibiotic Use
- The 2024 Tools for Practice article Antibiotics or no antibiotics for acute diverticulitis, that is the question! states that in cases of acute uncomplicated diverticulitis in non-septic immunocompetent patients, antibiotic use does not change rates of early complication or recurrence. The evidence included data from a systematic review and 3 RCTs.
- This supports the 2021 Gastroenterology Snapshots module (info point 37) which stated that most major guidelines recommend antibiotic use on a case-by-case basis only (e.g., in immunosuppressed patients).