Abstract
BACKGROUND: Depression is a prevalent mental health disorder affecting millions of people worldwide, imposing a significant economic burden on society. Despite the progress in treatment, many individuals with depression still face challenges in accessing appropriate care. Therefore, effectively preventing depression has become an area of focus. The purpose of this study is to explore the impact of sedentary behaviour and varying dose-response relationships on the risk of depression. METHODS: A systematic search of relevant studies published up to 15 August 2024 was performed using the PubMed, Embase, and Web of Science databases. We selected original studies that reported a relationship between sedentary behaviour and the risk of depression. Two authors used pre-filled forms to independently extract the trial characteristics and intervention details. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and a random effects analysis was conducted. Clinical outcomes were assessed according to odds ratios (ORs) and 95% confidence intervals (CIs). The quality of the included studies was evaluated using the Eight-component Rating scale and the Cochrane Risk of Bias tool. RESULTS: Twenty-five studies involving 252,503 participants were included. Compared with participants with less sedentary behaviour, those with more sedentary behaviour had a significantly increased risk of depression (OR 1.35 [95% CI 1.20–1.52], p < 0.001; I(2) = 83.3%, p < 0.001). Furthermore, we found that among participants with sedentary behaviour, those aged 16–20 had the highest risk of depression (OR 1.69, p < 0.001), followed by those under the age of 16 (OR 1.43, p < 0.001) and those aged 20–40 (OR 1.05, p = 0.032). In contrast, participants > 40 years showed no significant difference (OR 1.14, p = 0.073). Participants from developed countries had a lower risk of depression than the risk in those from developing countries. Lastly, sedentary behaviour of varying intensities was associated with a higher risk of depression. CONCLUSIONS: Sedentary behaviour greatly increases the risk of depression. Participants under the age of 20 were at a higher risk of developing depression owing to sedentary behaviour. Appropriate exercise can be effective for preventing depression. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-23418-4.