ANXIETY DISORDERS RELATED TO SCREEN USE IN CHILDHOOD AND ADOLESCENCE

Abstract

Technological advances and the widespread availability of digital devices have profoundly transformed the daily lives of children and adolescents. However, prolonged screen use has been associated with negative repercussions on mental health, notably an increase in the prevalence of anxiety disorders in this age group. Overexposure to digital content, reduced face-to-face social interactions, and sensory overload can affect neurodevelopment, emotional regulation, and behavior, posing a growing challenge to public health and interdisciplinary care practices. This study aims to analyze the relationship between excessive screen use and the occurrence of anxiety disorders in children and adolescents, considering clinical, diagnostic, and psychosocial aspects, as well as emerging preventive and therapeutic strategies. This is a qualitative, descriptive, and analytical literature review based on national and international publications between 2019 and 2024, obtained from the SciELO, LILACS, PubMed, Scopus, and Web of Science databases. Priority was given to peer-reviewed articles relevant to pediatric, psychiatric, and interdisciplinary clinical practice, including systematic reviews, longitudinal studies, and meta-analyses. Recent evidence suggests that excessive screen time, especially on social media, online games, and streaming platforms, is associated with symptoms of generalized anxiety, panic attacks, and increased irritability in children and adolescents. Neurobiological mechanisms include hyperactivation of the hypothalamic-pituitary-adrenal axis, dopaminergic dysregulation, and impaired sleep patterns due to exposure to blue light and nocturnal cognitive hyperstimulation. In addition, constant social comparison and exposure to cyberbullying increase the risk of low self-esteem and social anxiety, potentially perpetuating pre-existing anxiety conditions. Longitudinal studies suggest a dose-response relationship, in which daily use exceeding 3-4 hours correlates with a higher prevalence of anxiety symptoms, especially when use occurs at night or replaces protective activities such as sports, face-to-face play, and family interactions. The COVID-19 pandemic has intensified this scenario, as remote learning and social isolation have dramatically increased digital dependence, favoring the growth of anxiety, depression, and post-traumatic stress in young populations. On the other hand, mediating factors such as the quality of content consumed, the presence of positive social interactions, and parental support can mitigate the risks. Promising interventions include digital literacy programs, limiting screen time as recommended by the World Health Organization (WHO), encouraging physical activity, and implementing cognitive-behavioral therapies adapted to the digital environment. Recent research also explores digital screening tools and mindfulness apps as complementary strategies for managing anxiety in adolescents. From a clinical point of view, early identification is essential. Pediatricians, psychiatrists, and school teams should integrate screening for digital habits into mental health assessments, allowing for early and interdisciplinary interventions, with family involvement and, when necessary, pharmacological support. Excessive screen use in childhood and adolescence is strongly associated with an increase in the prevalence and severity of anxiety disorders, mediated by neurobiological, behavioral, and psychosocial factors. Mitigating these impacts requires a multifactorial approach, combining digital education, public policies, family guidance, and evidence-based therapeutic interventions. Establishing healthy limits and promoting protective activities emerge as essential strategies for reducing risks and promoting balanced emotional development in the digital age.