ASSOCIAÇÃO ENTRE USO EXCESSIVO DE REDES SOCIAIS E TRANSTORNO DEPRESSIVO MAIOR EM ADOLESCENTES: UMA REVISÃO SISTEMÁTICA E META-ANÁLISE EM REDE

ABSTRACT – Objective: To assess the association between excessive social media use and major depressive disorder in adolescents, considering protective factors, mediating mechanisms, and cultural differences., Methods: Systematic review and network meta-analysis conducted under PRISMA 2020 guidelines, with searches in eight international and regional databases. Included observational and experimental studies (2015–2025) involving adolescents (ages 10–19). Analyses included non-linear dose response models, multiple mediation, and subgroup analyses by age, culture, and platform. Results: Sixty seven studies (n = 284,567) revealed a significant association between social media use and depressive symptoms (r = 0.15; 95%CI 0.12–0.18), with an inflection point at 3.2 daily hours. Individualistic societies showed higher vulnerability (r = 0.28), especially among adolescents aged 14–16. Protective factors such as strong family support (RR = 0.67), adequate digital literacy (RR = 0.74), and active use for social connection (RR = 0.82) showed substantial effects. Instagram was associated with the highest risk (SUCRA = 0.85), and WhatsApp with the most protection (SUCRA = 0.12). Sleep disruption, social comparison, FOMO, and physical inactivity accounted for over 90% of the observed association. Conclusion: The relationship between social media use and adolescent depression is significant, culturally mediated, and explained by modifiable mechanisms. Evidence-based interventions should prioritize family support, critical digital literacy, and adaptive usage strategies.