Impact of excessive social media use on adolescent depression and its consequences in France: An individual-based microsimulation model.

Abstract

Social media (SM) platforms have become increasingly prevalent in adolescents' lives, and concerns have arisen regarding their potential contribution to depression. This study examined whether excessive SM use contributes to rising adolescent depression rates and evaluated potential mitigation strategies. We developed an individual-based microsimulation model of 18.6 million French adolescents born 1990-2012, tracking depression outcomes from 2000-2022 (analyses conducted August 2024-July 2025). The model incorporated 95 parameters, including demographics, SM use patterns, and established depression risk factors (childhood adversities, chronic physical conditions, physical inactivity, obesity, substance use). The main outcome was cumulative depression cases, and secondary outcomes were suicide deaths, health-adjusted life expectancy (HALE) loss, and associated costs. The model was well-calibrated and validated adequately against US-specific data. It showed that excessive SM use likely played an important role in the recent increase in rates of adolescent depression. Among French adolescents, simulations indicated that excessive SM use was associated with an additional cumulative lifetime 590,000 depression cases (95%CI [400,000, 760,000]), 799 suicide deaths (95%CI [547, 1,028]), 137,000 (95%CI [94,000, 176,000]) HALE loss years, and 3.94 (95%CI [2.70, 5.07]) billion euros, compared to scenarios without SM platforms. Key limitations are that microsimulation modeling cannot establish causality from observational data and the reliance on duration-based exposure measures without capturing content type or engagement quality. In this study, we estimated that limiting SM use to 1 h per day for all adolescents, replacing 30 min of SM use with 30 min of physical activity, or stopping its use for adolescents most at-risk for depression, would be associated with a reduction in cumulative lifetime prevalence of depression by 14.7%, 12.9%, and 12.0%, respectively, and diminished associated costs. Targeted SM interventions could potentially reduce adolescent depression burden, though real-world implementation and effectiveness require validation.