title: Computer use and stress, sleep disturbances, and symptoms of depression among young adults--a prospective cohort study.
abstract: BACKGROUND
  We have previously studied prospective associations between computer use and mental health symptoms in a selected young adult population. The purpose of this study was to investigate if high computer use is a prospective risk factor for developing mental health symptoms in a population-based sample of young adults.
  
  
  METHODS
  The study group was a cohort of young adults (n = 4163), 20-24 years old, who responded to a questionnaire at baseline and 1-year follow-up. Exposure variables included time spent on computer use (CU) in general, email/chat use, computer gaming, CU without breaks, and CU at night causing lost sleep. Mental health outcomes included perceived stress, sleep disturbances, symptoms of depression, and reduced performance due to stress, depressed mood, or tiredness. Prevalence ratios (PRs) were calculated for prospective associations between exposure variables at baseline and mental health outcomes (new cases) at 1-year follow-up for the men and women separately.
  
  
  RESULTS
  Both high and medium computer use compared to low computer use at baseline were associated with sleep disturbances in the men at follow-up. High email/chat use was negatively associated with perceived stress, but positively associated with reported sleep disturbances for the men. For the women, high email/chat use was (positively) associated with several mental health outcomes, while medium computer gaming was associated with symptoms of depression, and CU without breaks with most mental health outcomes. CU causing lost sleep was associated with mental health outcomes for both men and women.
  
  
  CONCLUSIONS
  Time spent on general computer use was prospectively associated with sleep disturbances and reduced performance for the men. For the women, using the computer without breaks was a risk factor for several mental health outcomes. Some associations were enhanced in interaction with mobile phone use. Using the computer at night and consequently losing sleep was associated with most mental health outcomes for both men and women. Further studies should focus on mechanisms relating information and communication technology (ICT) use to sleep disturbances.
authors.affiliation: Occupational and Environmental Medicine, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden. sara.thomee@amm.gu.se
authors.forename: Sara
authors.initials: S
authors.lastname: Thomée
authors.forename: Annika
authors.initials: A
authors.lastname: Härenstam
authors.forename: Mats
authors.initials: M
authors.lastname: Hagberg
mesh_terms: D015331:Cohort Studies; D003201:Computers / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult