Depression is the most prevalent mental health disorder and among the leading causes of death among children and adolescents. This disorder is a major health concern due to its high prevalence, early-onset, and devastating consequences on children, families, and society [1-3]. Depression is associated with biopsychosocial characteristics; some studies have linked media exposure to the generation of depression in children and adolescents [11]. Using electronic media is common worldwide, especially among children and adolescents [18]. Additionally, global statistics indicate that adolescents use electronic media for about 8 hours a day. Furthermore, evidence suggests that such measures can be a potential risk factor for depression [6]. However, the results of available research are contradictory in this respect. Whether the increase in psychological problems, especially depression in childhood and adolescence, is related to activity on the internet and social networks remains undiscovered.

This systematic review and meta-analysis study was conducted based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines (2009). To obtain related citations, the appropriate keywords were identified and searched in databases between 2005 and June 2019. Then, with matching articles, overlapping, duplicate, and irrelevant studies were removed. These articles were reviewed and evaluated according to the inclusion criteria and by removing the articles that did not meet the inclusion criteria. Eventually, 15 English articles were included in the research and their results were extracted. Furthermore, the results of 3 Iran-based conference papers were mentioned; however, due to not meeting the eligibility criteria, they were excluded from the meta-analysis.
 After performing a systematic review, to analyze the initial research, using CMA software, the effect size was separately calculated per research; the effect size of the fixed effect model and the random effects model, funnel diagram, Q test, and Egger regression method.

Of the 15 English articles, 10 and 5 were cross-sectional and longitudinal studies, respectively. In total, 10621 subjects were surveyed in the articles; of them, approximately 52% and 48% were females and males, in sequence, ranging in age from 10 to 18 years.
 After performing a systematic review, the information of 15 English articles was entered in CMA-2. The calculated effect sizes presented a distribution from -0.090 to 0.970; accordingly, 14 effect sizes were significant and only one effect size related to the research of Selfoot et al. (2009) was not significant (Figure 1).



To determine the meta-analysis model, the homogeneity of the studies was assessed using the Q test (Table 1).



The obtained data indicated that the average effect of social networks (random-effects model) on depression was equal to 0.18 in the sample. The estimated effect size was significant; therefore, there was a significant correlation between social network use and depression in the explored children and adolescents. Based on Cohen’s interpretive criteria, the collected effect size (0.18) was low.
Moreover, the studies included in this meta-analysis applied cross-sectional and longitudinal research design which might have attributed to the data heterogeneity. Therefore, the effect sizes are separately listed concerning the research design in Table 2.



As per Table 2, the effect size of longitudinal and cross-sectional research was medium (0.47) and low (0.17), respectively. However, for more accurate inferences, further longitudinal research is required. In other words, social network use, in longitudinal studies, moderately influenced depression, while this effect was small in cross-sectional studies.

This article examined the impact of social media use on depression by reviewing the relevant research in adolescents in the last 15 years (2005 to June 2019). The present research results indicated the effect of social network use on depression (this effect was small but significant).
 In this study, of 15 articles, 5 were conducted longitudinally. These articles examined a short time, with 12 months as the longest interval between assessments. Due to the widespread use of social networks, there is no control group naturally, which complicates the analysis of longitudinal data. Furthermore, based on evidence from cross-sectional research (10 studies), it is impossible to conclude whether the use of social media causes depression and other mental health issues, or whether depressed individuals spend more time in such platforms, generate addictive and problematic behaviors and invest in the social media.
Additionally, certain attitudes or behaviors, such as social comparison and motives for using social media, may provide a greater impact on depressive symptoms than the number of times social media is used or the number of virtual friends; further research is suggested in this respect.
 Overall, this systematic and meta-analysis review revealed the overall impact of social media use on depression. This is a simple expression of a complex relationship; limited research has examined the effect of moderating or mediating variables. Therefore, mediator and moderator variables should be examined. Most of the studies were cross-sectional; thus, a causal relationship between social media use and depression cannot be inferred. Given that research conducted in Iran has only examined internet addiction, future research is necessary in this area.

This article is a meta-analysis without any human or animal sample.

This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Conceptualization, methodology, and analysis: Mina Vesal; Data collection, extracting findings, writing drafts, editing, and finalizing: Both authors.

The authors declared no conflicts of interest.

 

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