Background Secondary school students are at a special growth period, and tend to become addicted because of excessive or improper use of the internet, thus affecting their physical and mental health.
Objective This study aims to understand the correlations between depressive symptoms and internet use among secondary school students in Hongkou District, Shanghai, and to provide evidence for intervening mental health problems among adolescents.
Methods Two high schools, two middle schools, and one vocational school were randomly selected in Hongkou District of Shanghai by multi-stage stratified cluster sampling method in September 2019. Two to three classes were randomly selected from each grade (Grade 7 to 12) from each school. All the students of the selected classes were included in the study. A cross-sectional questionnaire survey was conducted to investigate the general information, depressive symptoms, internet addiction, and screen-watching time of the students. Of the 1 275 questionnaires recovered, 23 unqualified questionnaires were excluded, and finally a total of 1 252 questionnaires were included, corresponding to a valid return rate of 98%.
Results The detection rate of internet addiction symptoms among the students was 2.9% (36/1 252), and the detection rate of depressive symptoms was 21.0% (263/1 252). Multiple logistic regression analysis results showed that key stage, whether you have symptoms of internet addiction, and the time spent on mobile devices every day in the past week were the influencing factors of students' depressive symptoms. The risks of middle school students' and high school students' depressive symptoms were both higher than that of vocational school students', and corresponding ORs (95% CIs) were 1.619 (1.036-2.530) and 2.141 (1.419-3.230) respectively. Those with internet addiction related behaviors had a higher risk of depressive symptoms than those without, and OR (95% CI) was 3.437 (1.685-7.010). Compared with the students who did not use mobile devices, those who spent 4 h and above had a higher risk of developing depressive symptoms, and OR (95%CI) was 2.337 (1.138-4.799).
Conclusion Internet addiction and excessive screen-watching time on mobile devices are risk factors for depressive symptoms in secondary school students in Hongkou District. Middle and high school students are also key populations at higher risks of developing depressive symptoms. Avoiding excessive screen-watching time and internet addiction through home-school linkage could prevent students' depressive symptoms.
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