Threat of coronavirus and depressive symptoms in adolescents: do 24-hour movement behaviors mediate this relationship?

Abstract

Background: The COVID-19 pandemic has disrupted the lives of adolescents worldwide, increasing their risk of mental health issues such as anxiety and depression. Daily behaviors like physical activity, screen use, and sleep are thought to influence emotional well-being, but it remains unclear how they interact with pandemic-related stressors. This study investigated whether these 24-hour movement behaviors help explain the link between adolescents’ perceived threat of the coronavirus and symptoms of depression.

Methods: We conducted a cross-sectional survey with 1,303 adolescents (50.96% female; average age = 16.32 years, SD = 1.10) in Northeast Brazil between August and October 2021. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Structural equation modeling was used to test whether physical activity, recreational screen time, and sleep duration mediated the association between perceived coronavirus threat and depressive symptoms.

Results: The perceived threat of the coronavirus was directly associated with higher depressive symptoms (ß: 0.163; p value < 0.001). Additionally, each movement behavior showed a significant association with depression: more physical activity (ß: -0.084; p value < 0.01) and longer sleep (ß: -0.167; p value < 0.001) were linked to fewer symptoms, while greater recreational screen time was related to more (ß: 0.130; p value < 0.001). However, none of these behaviors explained the pathway between perceived threat and depressive symptoms, suggesting that other factors—such as emotional regulation, social support, or family dynamics—may better account for this link.

Conclusion: While the movement behaviors did not mediate the effect of the perceived coronavirus threat on depression, they were still independently related to mental health. These findings support the value of promoting healthy daily routines among adolescents during pandemics and as part of broader mental health strategies. Public health interventions should consider these behaviors as protective factors that may help reduce the burden of depression in future crises.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12889-025-24591-2.

Keywords: Adolescence; COVID-19 pandemic; Mental health; Physical activity; Screen time; Sleep.

Fig. 1

Structural equation model using the total sample showing the direct and mediated effects of the perceived threat of coronavirus on 24-hour movement behaviors and depressive symptoms. Structural equation model examining the associations between perceived coronavirus threat and depressive symptoms score, with potential mediation by 24-hour movement behaviors assessed in August, September, and October of 2021: moderate to vigorous physical activity, recreational screen time, and sleep time (hours/day). Paths labeled a1, a2, and a3 represent the effects of perceived threat on each behavioral mediator; paths b1, b2, and b3 represent the effects of each mediator on depressive symptoms; and path c represents the direct effect of perceived threat on depressive symptoms. Straight lines indicate statistically significant paths; dashed lines indicate nonsignificant paths. All coefficients are standardized. The model was adjusted for age, sex, head of household education level, and BMI. **p < 0.001, *p = 0.001