Association between screen time and cumulating school, behavior, and mental health difficulties in early adolescents: A population-based study.

Early adolescents may daily spend excessive screen-time (with television viewing, computer/console gaming, discussion forums/chatting online, internet surfing, doing homework, and electronic mails) while its association with cumulating several school-behavior-mental-health difficulties (SBMDs) (poor-academic-performance, being obese, alcohol/tobacco/cannabis/other-illicit-drugs use, suffered violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms, and suicide attempt) is poorly addressed. We investigated this association among 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed a questionnaire including socioeconomic features, daily screen-time for various screen-based activities (coded 1=<2/2=2-4/3=≥5 h; daily-total-screen-time level DSAtotal was defined as their sum and categorized into 4 levels: 6-7/8-9/10-12/≥13), various SBMDs and the time of their onset during the life course (their cumulated number SBMDscore was categorized into 5 levels: 0/1/2/3-4/≥5). Logistic regression modeling showed that the DSAtotal was strongly associated with all SBMDs (gender-age-adjusted odds ratio reaching 8.28, p < 0.001) and SBMDscore (gender-age-adjusted relative risk reaching 11.60, p < 0.001, pseudo R2 = 0.039). These associations remained strongly significant when controlling for socioeconomic adversities (contributions 20-38%). The proportion of subjects without each SBMD steadily decreased with age according to DSAtotal levels. These findings help to understand the impacts of high DSAtotal on SBMDs in early adolescents and identify at-risk adolescents for prevention and care.