ArticleBMC public health2025
Internet addiction and anxiety-depressive comorbidity among chinese adolescents: the mitigating effects of physical activity in a large-scale cross-sectional study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The relationship between perceived stress and mobile phone addiction in adolescents: a meta-analysis.BMC psychology · 2025Pooled it
- Mental health literacy mediates associations of self rated health and chronic disease status with anxiety and depression in Chinese residents.Scientific reports · 2026Article
- Longitudinal trends and sociodemographic inequalities in comorbid insufficient physical activity and depressive symptoms among Chinese adolescents and young adults, 2016-2022.Scientific reports · 2026Article
- Internet Addiction and Its Association with Depression, Anxiety and Quality of Life Among School-going Adolescents: A Cross-sectional Study.Annals of neurosciences · 2026Article
- Network analysis of comorbid internet addiction, anxiety, and depression symptoms among Chinese junior high school students.Frontiers in public health · 2026Article
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Abstract
objectiveThis study aimed to examine the associations between internet addiction (IA), physical activity (PA), and mental health comorbidities (depression, anxiety, and their co-occurrence) among Chinese adolescents, and assess the mediating role of PA in the IA-mental health relationship.
methodsA cross-sectional analysis was conducted using data from the 2024 National Student Common Diseases and Risk Factors Surveillance (NSCDRFS) in Tianjin, China, involving 20,692 adolescents aged 12-19 years. IA was assessed via a DSM-5-derived 9-item scale (cutoff ≥ 5). PA levels were categorized as insufficient (≤ 2 days/week of moderate-to-vigorous activity). Mental health outcomes included depressive symptoms (CES-D ≥ 16), anxiety symptoms (GAD-7 ≥ 10), and anxiety-depression comorbidity (ADC), defined as meeting both depression (CES-D ≥ 16) and anxiety (GAD-7 ≥ 10) diagnostic criteria. Multivariable logistic regression and mediation analyses were performed to evaluate direct and indirect pathways.
resultsAdolescents with IA exhibited significantly higher risks of anxiety (OR = 1.80, 95% CI: 1.68-1.91), depression (OR = 1.99, 95% CI: 1.88-2.11), and ADC (OR = 2.12, 95% CI: 2.00-2.25) compared to non-IA peers (all P < 0.001). Insufficient PA independently increased risks of anxiety (OR = 1.17), depression (OR = 1.27), and ADC (OR = 1.23). Mediation analysis revealed that PA accounted for only 3.5-4.3% of the total effects of IA on mental health outcomes, with direct effects remaining predominant (95.7-96.5%). Subgroup analyses highlighted stronger IA-mental health associations in younger adolescents (12-15 years), non-boarding students, and junior high school cohorts.
conclusionIA is an independent risk factor for mental health comorbidities in Chinese adolescents, with PA serving as a minor yet significant mediator. Targeted interventions should integrate IA screening, culturally adapted PA promotion, and digital literacy education to address this triad. Future longitudinal studies are needed to elucidate causal pathways and neurodevelopmental mechanisms.
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