Depression precedes problematic video streaming in adolescents: Prevalence trends and cross-lagged associations from a four-wave population-based study

Background: In the age of TikTok, YouTube, and Netflix, video streaming (VS) is highly popular among adolescents. Yet, risky to addiction-like viewing patterns (i.e., problematic (P)VS) may adversely affect well-being. Prevalence estimates based on established criteria and etiological understanding of this phenomenon remain scarce. It is associated with de-pression, a major issue within the youth mental health crisis. However, causality remains unclear. This study investigated prevalence trends of adolescent PVS and its temporal rela-tionship with depression. Methods: Population-based data were drawn from four annual waves (2022-2025) of a rep-resentative online survey among 3,477 German adolescents (aged 10-17 years). Weighted annual PVS prevalence estimates were calculated based on standardized measures applying ICD-11 criteria of behavioural addictions distinguishing pathological from hazardous behav-ioural patterns. A cross-lagged panel analysis examined the reciprocal relationship between PVS and depression over four years. Results: Prevalence of pathological VS ranged between 2 to 4% across waves. Hazardous VS prevalence was 13-14% from 2022 to 2024, before increasing to 25% in 2025. Up to 81% of adolescents with pathological VS (21% with hazardous VS) showed clinically relevant symptoms of depression, versus 8-9% of non-affected adolescents. Depression significantly predicted PVS in two of three lags ({beta}W1-W2=0.233, {beta}W2-W3=0.155), but not vice versa. Conclusions: Prevalence rates and their divergent associations with depression support dis-tinguishing hazardous from pathological VS and underline the clinical relevance of PVS. Depression preceded PVS, pointing to the role of maladaptive coping. This has direct impli-cations for effective intervention measures. Future research should clarify the mechanisms underlying this relationship.