Physical activity correlates among 24,230 people with depression across 46 low- and middle-income countries

Preferences of patients with depression for exercises: a discrete choice experiment

BACKGROUND

Exercise brings great benefits to patients with depression and is recommended as adjunct treatment for depressive disorder. The low compliance to exercise makes the effective management of depression a serious challenge. Preferences for exercise are important for promoting intrinsic motivation, enjoyment, and behavior maintenance. This study quantified the exercise preferences of patients with depression by a discrete choice experiment (DCE), which provided references for the development of intervention programs, so as to improve the physical activity level of patients with depression and promote the effective management of depressive symptoms.

METHODS

The six attributes (Professional guidance, Interestingness, Type, Special venue, Frequency, and Safety) and their levels were developed through a literature review, in-depth interviews, and focus group discussions. The software Ngene 1.2 was used to generate 36 choice sets, which were divided into 4 blocks. A survey instrument was developed adhering to the design-principles of DCE. A mixed logit model was used to estimate the preferences of patients with depression. The choice probability of exercise scenarios were predicted.

RESULTS

The preferences of 323 depressed patients were analyzed. High level of interestingness was the most important attribute level (coefficient = 0.84, P < 0.01), followed by high safety (coefficient = 0.79, P < 0.01). There is a gender-based and daily steps-based difference in preference. The optimal exercise strategy should be fun and safe, exercise 3-4 times a week, venue without restrictions, professional guidance, and a combination of teams and individuals.

CONCLUSION

Based on the findings, patients with depression in this target population prefer exercises with attributes such as intrerestingness, safety, while considering gender-based and daily steps-based deference in preferences.

Global research trends in the effects of exercise on depression: A bibliometric study over the past two decades

Introduction

With depression's growing global prevalence and substantial impact, effective prevention and management strategies are imperative. Our study aims to perform a thorough bibliometric analysis of existing research on the impact of exercise on depression.

Methods

A comprehensive analysis of Web of Science Core Collection publications from 2000 to 2020 was performed, highlighting trends, themes, and influential authors. The study focused on subject categories, source journals, countries/regions, institutions, and prolific authors. Co-citation and keyword analyses revealed key themes, hotspots and the thematic evolution.

Results

The multidisciplinary nature of this research is evident across psychiatry, psychology, neuroscience, and sports science. Specific populations such as women, the elderly, and those with chronic illnesses were targeted. Mind-body exercises like yoga and tai chi gained prominence. Co-citation clusters showcased the evolution from early investigations on exercise's impact to recent dose-response and protocol studies.

Conclusions

This bibliometric analysis provides insights into the dynamic field of exercise interventions for depression. It underscores the importance of individual differences, calls for guidelines considering comorbidities, and points towards future directions such as exploring mind-body exercise mechanisms and well-designed clinical trials. This study contributes to a comprehensive understanding of the research landscape and informs future endeavors aimed at refining depression treatment through exercise interventions.

Network Analysis of Health-related Behaviors, Insomnia, and Depression Among Urban Left-behind Adolescents in China

Mental health of urban left-behind adolescents (LBA) is a public issue of growing concern. This study aims to examine the symptom level associations among multiple health-related behaviors, insomnia, and depression in urban LBA. Data on a sample of urban LBA aged 11-19 (N = 3,601) from the Adolescent Mental Health Survey in Shenzhen, China, were used. Health-related behaviors (i.e., Internet use, physical inactivity, social jetlag, smoking, and alcohol consumption), insomnia, and depressive symptoms were assessed using a self-administered questionnaire. Graphical Gaussian Model (GGM) was used to describe key bridging nodes in an undirected network. Directed Acyclic Graph (DAG) was used to construct a directed network and estimate the most likely causal associations among behaviors/symptoms. In the undirected network, Internet use was identified as the key bridging node most strongly associated with insomnia and depression. Two other key bridging nodes include difficulty initiating sleep and appetite change. In the directed network, anhedonia emerged as the most pivotal symptom, which could cause insomnia symptoms and behavioral changes, either directly, or through triggering other depressive symptoms, such as low energy and appetite change. These findings have implications for understanding the occurrence and maintenance process of health-related behaviors, insomnia, and depression in urban LBA. In practice, Internet use should be considered a priority in targeting multiple health behavior interventions. Meanwhile, early screening and treatment for anhedonia are of great significance as well.

Subthreshold depression - concept, operationalisation and epidemiological data. A scoping review

PURPOSE

In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in recent years. The purpose of the present paper was to review, based on a scoping review, the relevant papers in this field published between October 2011 and September 2020.

MATERIALS AND METHODS

Of the 1,160 papers identified, 64 records could be included in further analysis. The scoping review was conducted using both electronic and manual methods.

RESULTS

The main result of the analysis is that the operationalisation criteria used are highly heterogeneous, which also leads to very heterogenous epidemiological data.

CONCLUSIONS

Clear conclusions are not possible scrutinising the reported results. Most definitions seem to be arbitrary, with considerable overlap (e.g., between SD and minor depression). The review also revealed that the impact of SD on quality of life and related parameters appear to be in the range of the respective impact of major depression (MD) and therapeutic approaches might be helpful for SD and also for the prevention of conversion from SD to MD. Keeping the presented difficulties in mind, a proposal for the definition of SD is made in the present paper in order to facilitate the discussion leading to more homogeneous criteria.

Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women

BACKGROUND

Relationships between mental health and multiple health behaviours have not been explored in young South African women experiencing social constraints. The aim of this study was to identify associations between mental health indicators and risk factors with physical activity, sedentary behaviour, and sleep, amongst young women living in Soweto, a predominantly low-income, urban South African setting.

METHODS

For this cross-sectional study, baseline measurements for participants (n = 1719, 18.0-25.9 years old) recruited for the Healthy Life Trajectories Initiative were used including: physical activity, sedentary behaviour (sitting, screen and television time), sleep (duration and quality), depression and anxiety indicators, emotional health, adverse childhood experiences, alcohol-use risk; social vulnerability, self-efficacy, and social support.

RESULTS

Multiple regression analyses showed that depression (β = 0.161, p < 0.001), anxiety (β = 0.126, p = 0.001), adverse childhood experiences (β = 0.076, p = 0.014), and alcohol-use risk (β = 0.089, p = 0.002) were associated with poor quality sleep. Alcohol-use risk was associated with more screen time (β = 0.105, p < 0.001) and television time (β = 0.075, p < 0.016). Social vulnerability was associated with lower sitting time (β = - 0.187, p < 0001) and screen time (β = - 0.014, p < 0.001). Higher self-efficacy was associated with more moderate- to vigorous-intensity physical activity (β = 0.07, p = 0.036), better-quality sleep (β = - 0.069, p = 0.020) and less television time (β = - 0.079, p = 0.012). Having no family support was associated with more sitting time (β = 0.075, p = 0.022). Binomial logistic regression analyses supported these findings regarding sleep quality, with anxiety and depression risk doubling the risk of poor-quality sleep (OR = 2.425, p < 0.001, OR = 2.036, p = 0.003 respectively).

CONCLUSIONS

These findings contribute to our understanding of how mental health indicators and risk factors can be barriers to health behaviours of young women in Soweto, and that self-efficacy and social support can be protective for certain of these behaviours for these women. Our results highlight the uniqueness of this setting regarding associations between mental health and behaviours associated with non-communicable diseases risk.

Effects of Mood Regulation on Sociodemographic Status, Exercise Pattern, and Physical Conditions of Chinese Adults and the Elderly

Objective

This study focused on mood regulations and their association with sociodemographic status, exercise pattern, and physical conditions of adults and older adults in China who did not undergo interventions.

Method

Data were based on the 2016 to 2018 Guangdong National Physique Monitoring data, in which 5242 participants aged 20-69 years were recruited. Multiple statistical analysis methods, such as descriptive and logistic regression analyses, were used to study each exercise motivation and its association with influencing factors, including sociodemographic characteristics, exercise measurements, and physical conditions. An exercise index for mental health was also used to investigate the number and types of people who were more likely to meet the index.

Results

We observed that 44.9% (2355/5242) of participants did not engage in physical exercise in this study. Only older participants (40 to 69 years old) and those with an average level of education (high school/technical secondary school) showed a significant association with exercising for mood regulation. Few people met the index that is good for mental health (16.64% [872/5242] met index 1, and 2.84% (149/5242) met index 2), and higher education showed a significant association with a reduction in the mental health burden and the prevention of depression.

Conclusion

This study found that motivating people to be more active and educating them on the potential mental health benefits of exercise could help them to exercise more.

Assessment of Bidirectional Relationships between Leisure Sedentary Behaviors and Neuropsychiatric Disorders: A Two-Sample Mendelian Randomization Study

(1) Background: Increasing evidence shows that sedentary behaviors are associated with neuropsychiatric disorders (NPDs) and thus may be a modifiable factor to target for the prevention of NPDs. However, the direction and causality for the relationship remain unknown; sedentary behaviors could increase or decrease the risk of NPDs, and/or NPDs may increase or decrease engagement in sedentary behaviors. (2) Methods: This Mendelian randomization (MR) study with two samples included independent genetic variants related to sedentary behaviors (n = 408,815), Alzheimer's disease (AD; n = 63,926), schizophrenia (SCZ; n = 105,318), and major depressive disorder (MDD; n = 500,199), which were extracted from several of the largest non-overlapping genome-wide association studies (GWASs), as instrumental variables. The summarized MR effect sizes from each instrumental variable were combined in an IVW (inverse-variance-weighted) approach, with various approaches (e.g., MR-Egger, weighted median, MR-pleiotropy residual sum and outlier), and sensitivity analyses were performed to identify and remove outliers and assess the horizontal pleiotropy. (3) Results: The MR evidence and linkage disequilibrium score regression revealed a consistent directional association between television watching and MDD (odds ratio (OR), 1.13 for MDD per one standard deviation (SD) increase in mean television watching time; 95% CI, 1.06-1.20; p = 6.80 × 10^-5) and a consistent relationship between computer use and a decrease in the risk of AD (OR, 0.52 for AD per one SD increase in mean computer use time; 95% CI, 0.32-0.84; p = 8.20 × 10^-3). In the reverse direction, MR showed a causal association between a reduced risk of SCZ and an increase in driving time (β, -0.016; 95% CI, -0.027--0.004; p = 8.30 × 10^-3). (4) Conclusions: Using genetic instrumental variables identified from large-scale GWASs, we found robust evidence for a causal relationship between long computer use time and a reduced risk of AD, and for a causal relationship between long television watching time and an increased risk of MDD. In reverse analyses, we found that SCZ was causally associated with reduced driving time. These findings fit in with our observations and prior knowledge as well as emphasizing the importance of distinguishing between different domains of sedentary behaviors in epidemiologic studies of NPDs.

Association Between Physical Activity Intensity and the Risk for Depression Among Adults From the National Health and Nutrition Examination Survey 2007–2018

Objective

Whether vigorous physical activities (VPA) bring additional benefits to depression prevention in comparison with moderate physical activity (MPA) remains unclear. The aim of this study was to find the correlation between the proportion of VPA to moderate-to-VPA (MVPA) (a combination of VPA and MPA) and the risk for depression, as well as to explore whether correlations differ among subgroups separated by age and sex.

Methods

The data originating from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 were applied. The total amount of PA per week was obtained by multiplying frequency and duration. The proportion of VPA to MVPA was obtained among the participants who performed any MVPA. Depression was set for those who scored 10 and above in the Patient Health Questionnaire-9 (PHQ-9). The odds ratios (ORs) and 95% confidence intervals (95% CIs) for depression were evaluated using logistic regression.

Results

Among 26,849 participants of this study, only 12,939 adults were found with any MVPA, in which 748 participants with depression were detected. Logistic regression was conducted among 12,939 participants. The participants with higher than 66.7–100% of MVPA as VPA were inversely correlated with a 30% (OR = 0.70, 95% CI = 0.50, 0.99) lower risk for depression. The subgroup analyses revealed that significant correlations were only found in men and those aged 45 years and above.

Conclusion

This study suggested that a higher proportion of VPA to MVPA might be correlated with a lower risk for depression in men and those aged 45 years and above. Besides the recommendation, adults should perform 150 min MVPA per week, more time should be spent in performing VPA in MVPA among men and older adults.

Physical activity, physical fitness and quality of life in outpatients with major depressive disorder versus matched healthy controls: Data from a low-income country

BACKGROUND

There is an urgent need to increase awareness that people with major depressive disorder (MDD) in low-income countries do also have a compromised physical health. We compared physical fitness and physical activity levels in outpatients with MDD with healthy matched controls in Uganda and explored whether the variance in quality of life (QoL) can be explained by the variance in physical fitness and physical activity levels.

METHODS

Fifty outpatients (35 men, median age = 29 years, interquartile range = 14 years) and 50 age, gender and body mass index matched controls performed a 6-minute walk test (6MWT), the World Health Organization Quality of Life short-version (WHOQoLBref), Simple Physical Activity Questionnaire (SIMPAQ), and Brief Symptoms Inventory-18 (BSI-18). Differences between groups were assessed with a Mann Whitney U test and backward stepwise multivariable regression analysis was performed to evaluate independent variables explaining the variance in WHOQoLBref scores.

RESULTS

Outpatients with MDD have significantly lower 6MWT, SIMPAQ walking, SIMPAQ incidental physical activity, physical and psychological WHOQoLBref scores, and significantly higher BSI-18 depression and anxiety scores. BSI-18 depression was the only significant independent predictor of the WHQoLBref physical score explaining 39.7% of the variance, while the 6MWT score remained the only significant independent predictor of the WHQoLBref psychological score explaining 31.7% of the variance.

CONCLUSIONS

Our data demonstrate that outpatients with MDD in a low-income country are significantly less physically fit and less physically active than the general population. Lower physical fitness levels are also associated with lower QoL levels.

Effects of a Physical Exercise Program on Physiological, Psychological, and Physical Function of Older Adults in Rural Areas

With the increase in the older population, there is a concern for health in older adults. This study aimed to develop a physical exercise program that combined walking and gymnastics for older adults residing in rural areas and to evaluate its effect on their physiological and psychological health and physical function. A quasi-experimental design was adopted. Participants were aged 65 years or older, with 94 and 130 participants in the experimental and control group, respectively. The program was implemented for seven months, from April–October 2016. Walking and gymnastics were performed once a week each, for about 60 and 50 min, respectively. Data were analyzed using the Chi-squared test, Fisher’s exact test, independent t-test, or Mann–Whitney U test. Results revealed that the experimental group participants displayed improved waist circumference (t = 1.70, p = 0.045), body mass index (U = 4691.00, p = 0.002), depressive symptoms (t = −2.94, p = 0.002), upper limb strength (t = 2.27, p = 0.012), and lower limb strength (t = 3.86, p < 0.001). Therefore, it can be presumed that the physical exercise program was effective and beneficial for older adults living in rural areas. This program is expected to contribute to maintaining and improving their health if implemented regularly in the future.

Cross-sectional associations of leisure and transport related physical activity with depression and anxiety

BACKGROUND

Previous evidence supports the notion that the physical activity (PA) domain (leisure-time or transport), and the amount of time spent in PA, influence the association of PA with depressive and anxiety symptoms. However, no study evaluated the associations of different volumes of leisure-time PA (LTPA) and transport PA (TPA) with prevalent depression, anxiety, and co-occurring depression and anxiety (D&A) disorders.

AIM

To investigate the associations between different volumes of LTPA and TPA with prevalent depression, anxiety, and D&A.

METHODS

Cross-sectional study using baseline data of the ELSA-Brasil cohort. The International Physical Activity Questionnaire (IPAQ) long-form was used to assess PA levels in each domain. The Clinical Interview Scheduled Revised (CIS-R) was used to diagnose prevalent depressive, anxiety, and D&A disorders. Logistic regressions, adjusting for confounding factors, were employed. Results are expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).

RESULTS

A total of 14,381 adults (54.5% female, 67.5% aged 45-64 years) were assessed. T^{ime spent in LTPA was associated with a lower prevalence of depression in low, and high volumes (}60-89min/week^{aOR = 0.47, 95%CI = 0.29-0.76, p = 0.002,} >300min/week^{aOR = 0.43, 95%CI = 0.31-0.59,} p < 0.001). High volumes of LTPA were associated with a lower prevalence ^{D&A (}270-299min/week^{aOR = 0.55, 95%CI 0.38-0.79, p = 0.001}; >300 minutes^{aOR = 0.63, 95%CI 0.54-0.74, p < 0.001). Low (}60-89min/week^{aOR = 0.56,95%CI = 0.40-0.79, p = 0.001)} volumes of TPA were associated with lower prevalence of depression.

LIMITATIONS

Cross-sectional design and self-reported PA. Lack of assessment of sedentary behaviour or occupational PA.

CONCLUSIONS

The present study highlights the importance of contextual factors in the association between PA and mental health, particularly at higher levels.

The impact of physical activity rate on subjective well-being among North-Western Italian population during COVID-19 nationwide lockdown

BACKGROUND

Several factors influence subjective well-being, and one of them is the rate of physical activity. However, the possibilities to perform physical activity are compromised by the running COVID-19 pandemic. Thus, the present study aimed to explore the relationship between self-reported physical activity levels during COVID-19 and subjective well-being. Furthermore, our secondary aim was to investigate whether personal well-being was different between men and women and between people with different self-reported physical activity levels.

METHODS

Physical activity rate and subjective well-being were assessed using specific online surveys. Well-being was investigated using the 5-item World Health Organization Well-being Index while physical activity rates using the official Italian short form of IPAQ. Participation was voluntary, and people could fill the questionnaire simply by clicking on a specific link reachable via Social Networks or by email.

RESULTS

The final sample size was 595 Italian responders. Male and female were equally distributed (50,3% male and 49,7% female). The multiple regression indicated that the model was a significant predictor of subjective well-being (R2 =,070,F (3,59) = 14,68, p< 0.0001). The univariate ANOVA detected a statistically significant difference in subjective well-being perception between gender (p<0,05; ƞ²= ,01) and among physical activity rates ((whole sample: p<0,0001, ƞ²=0,03); Males: F(2,296)=4,364, p<0,01, ƞ²=0,03; Females: F(2,293)=5,256, p<0,001, ƞ²=0,04)). Tuckey's post hoc identified a difference between Low active and moderate active males (p< 0,01) and low active and very active females (p< 0,01).

CONCLUSIONS

More vigorous activities are necessary for women to reach the goal of feeling good and satisfied with life than men. Therefore, women should be encouraged to spend more time practising physical activity at a more vigorous rate. This outcome might help practitioners set specific home training programs to be advised during periods of social life restrictions as the running COVID-19 pandemic.

Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders

PURPOSE

This study aimed to examine the effect of high-intensity interval training (HIIT) on both sleep and cardiorespiratory fitness in patients with depression.

METHODS

Using a single pre- and post-test study design with no control group, 82 patients diagnosed with depressive disorders underwent HIIT comprising a total of 24 15-min sessions, three times per week for 8 weeks. Depressive symptoms, sleep quality, and cardiorespiratory fitness were evaluated using the Beck depression inventory-II, the Pittsburgh sleep quality index (PSQI), and cardiopulmonary exercise testing (CPET) in the form of maximum oxygen uptake (VO₂ max), respectively.

RESULTS

All 82 patients completed the intervention. HIIT training was associated with significant improvements in BDI-II score (diff =  - 1.57 [95% CI - 2.40 to - 0.73], P = 0.001), PSQI score (diff =  - 1.20 [95% CI - 2.10 to - 0.32], P = 0.008), and CPET VO₂ max (diff = 0.95 [95% CI 0.62-1.28], P = 0.001). Effect size calculations revealed that the greatest improvement occurred in CPET VO₂ max (Cohen's d = 0.64) and that improvements in the BDI-II and PSQI scores were somewhat smaller in magnitude (Cohen's d =  - 0.41 and - 0.30, respectively). Sleep quality improvements were observed in sleep latency, habitual sleep efficiency, and the use of sleep-promoting medications (Cohen's d = 0.18, 0.19, and 0.25, respectively). Change in cardiorespiratory fitness successfully predicted change in sleep quality but not in depressive symptoms. Adverse effects were limited to minor injuries which did not interfere with completion of training.

CONCLUSIONS

HIIT training delivered over 8 weeks was associated with improvements in depression symptoms, sleep quality, and cardiorespiratory fitness in patients with depressive disorders.

Prevalence, clustering and combined effects of lifestyle behaviours and their association with health after retirement age in a prospective cohort study, the Nord-Trøndelag Health Study, Norway

Background

Lifestyle behaviours are potential risk factors for disease and mortality, but less is known about the association with health in retirement age. The aim of this paper was to study the prevalence, clustering and combined effects of lifestyle behaviours and their association with health outcomes in the first decade after retirement in a Norwegian cohort.

Methods

Participants were 55–64-year-olds at baseline in the Nord-Trøndelag Health Survey 2 (HUNT2, 1995–97) who also participated in HUNT3 (2006–08). Logistic regression analyses were used to investigate the association of daily smoking, physical inactivity, risky alcohol consumption, disturbed sleep duration, excessive sitting time and low social participation before retirement with self-rated health (n = 4022), life satisfaction (n = 5134), anxiety (n = 4461) and depression (n = 5083) after retirement, 11 years later.

Results

Low social participation and physical inactivity were the most prevalent lifestyle behaviours (41.1 and 40.6%). Risky alcohol consumption and disturbed sleep were the lifestyle behaviours most strongly associated with poor self-rated health, poor life satisfaction and anxiety after retirement (OR’s = 1.39–1.92). Physical inactivity was additionally associated with depression (OR = 1.44 (1.12–1.85)). Physical inactivity had the largest population attributable fractions for reducing poor self-rated health and depression (14.9 and 8.8%). An increasing number of lifestyle risk behaviours incrementally increased the risk for the adverse health outcomes.

Conclusions

Risky alcohol consumption and disturbed sleep duration were most strongly associated with poor health outcomes after retirement age. On a population level, increased physical activity before retirement had the largest potential for reducing adverse health outcomes after retirement age.

Employers With Metabolic Syndrome and Increased Depression/Anxiety Severity Profit Most From Structured Exercise Intervention for Work Ability and Quality of Life

BACKGROUND

Major depressive disorder and anxiety disorders are associated with less productivity, earlier retirement, and more sick-days at the workplace. These associations also exist for patients with metabolic syndrome. For both, exercise is a generally recommended part of multimodal treatments. However, for individuals with metabolic syndrome, in which depression and anxiety is more prevalent and severe, evidence for the efficacy of exercise interventions is limited.

METHODS

Company employees with diagnosed metabolic syndrome (n=314, age: 48 ± 8 yrs) were randomized to a 6-month exercise intervention (150 min per week) or wait-list control. Participants received individual recommendations for exercise activities by personal meetings, telephone, or via a smartphone app. Physical activities were supervised and adapted using activity monitor data transferred to a central database. Work ability (work ability index), depression severity and anxiety severity [hospital anxiety and depression scale (HADS)], and health-related quality of live [short form 36 (SF-36)] were assessed.

RESULTS

We included 314 subjects from which 287 finished the intervention. Total work ability, depression- and anxiety severity, and the mental component score of the SF-36 improved after 6 months exercise compared to controls. After baseline stratification for normal (HADS scores 0-7) and increased depression- and anxiety scores (HADS scores 8-21) individuals with increased severity scores had similar age, body composition, blood lipids, and cardiorespiratory fitness compared to those with normal scores, but lower total work ability and component sum scores of health-related quality of life. After 6 months total work ability increased in the exercise group compared to controls with the magnitude of the observed increase being significantly greater for subjects with increased depression- and anxiety severity at baseline compared to those with normal severity scores.

CONCLUSIONS

A 6-month exercise intervention for company employees with metabolic syndrome showed strongest effects on self-perceived work ability in individuals with mild to severe depression- and anxiety severity. This suggests exercise programs offered to workers with metabolic syndrome not only reduces individual disease risk but may also reduce healthcare and employers costs arising from metabolic syndrome and mental disease conditions.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier NCT03293264.

Intensity, frequency, duration, and volume of physical activity and its association with risk of depression in middle- and older-aged Chinese: Evidence from the China Health and Retirement Longitudinal Study, 2015

Background

The general benefit of physical activity (PA) to one’s mental health has been widely acknowledged. Nevertheless, the specific type and amount of PA that associates with lower risk of depression in China awaits further investigation. The present study was conducted on middle- and older-aged Chinese population with two objectives: 1) to understand the patterns of PA; 2) to measure the associations between depression and PA at different levels from various aspects.

Methods

Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2015), we selected 9118 community residents aged 45 years and older. Depressive symptoms were measured by 10-item Center for Epidemiologic Studies (CES-D 10). Multivariate logistic regression model was performed to examine the association between risk of depression and PA from four aspects including intensity, frequency, duration, and volume.

Results

Spending 1–2 days/week (OR = 0.58, 95% CI: 0.36, 0.91), less than 30 minutes each time (OR = 0.66, 95% CI: 0.42, 1.03) or 150–299 min/week (OR = 0.49, 95% CI: 0.28, 0.87) on Moderate Physical Activity (MPA) was associated with lower odds of depression in women. Spending 3–5 days/week (OR = 1.98, 95% CI: 1.29, 3.05) or 6–7 days/week (OR = 1.50, 95% CI: 1.07, 2.11), 4 hours and longer each time (OR = 1.65, 95% CI: 1.18, 2.32), 300 min/week or longer (OR = 1.65, 95% CI: 1.22, 2.24) on Vigorous Physical Activity (VPA) in total, or 2250 Metabolic Equivalent of Task (OR = 1.73, 95% CI: 1.26, 2.38) on Moderate-to-Vigorous PA was associated with higher risk of depression in men.

Conclusions

The association between depression and PA depended largely on intensity and gender. Lower frequency, shorter duration, and moderate amount of MPA was associated with lower risk of depression in women. Risk of depression was higher in men who spent higher frequency, longer duration, and overlong time on VPA.

Increasing physical activity and healthy diet in outpatients with mental disorders: a randomized-controlled evaluation of two psychological interventions

INTRODUCTION

While physical activity (PA) can play an important role in the treatment of mental disorders (MD), large proportions of patients with MD do not meet PA recommendations. The aim of this trial was to evaluate whether structured psychological intervention (MoVo-LISA) is effective in helping outpatients with MD to increase their level of PA. As active control group (CG) we modified MoVo-LISA to target healthy diet behavior.

METHODS

N = 83 outpatients with MD (F1-F4) were randomized to the two conditions. PA (self-report and accelerometry), dietary behavior, social-cognitive determinants of health behavior change, psychiatric symptoms and health-related quality of life were assessed at baseline, 1 and 12 weeks after the intervention.

RESULTS

Significant time*group interaction effects for objectively measured PA, dietary behavior and fruit and vegetable consumption indicated differential effects of the interventions on these outcomes. PA increased in the MoVo-LISA group (IG) from baseline to follow-up while it decreased in CG. IG showed a significant higher level of objectively measured PA at follow-up compared to CG. Dietary behavior and fruit and vegetable consumption significantly increased from baseline to follow-up in CG, but not IG. IG showed a significant increase in some, but not all social cognitive determinants of health behavior change.

CONCLUSIONS

MoVo-LISA is effective in helping outpatients with MD to increase their level of PA in short- and mid-term. The used intervention strategies are effective for the promotion of healthy diet in patients with MD as well.

Correlates of physical activity and sedentary behaviour in the Thai population: a systematic review

BACKGROUND

Given the importance of knowing the potential impediments and enablers for physical activity (PA) and sedentary behaviour (SB) in a specific population, the aim of this study was to systematically review and summarise evidence on individual, social, environmental, and policy correlates of PA and SB in the Thai population.

METHODS

A systematic review of articles written in Thai and English was conducted. Studies that reported at least one correlate for PA and/or SB in a healthy Thai population were selected independently by two authors. Data on 21 variables were extracted. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale.

RESULTS

A total of 25,007 records were screened and 167 studies were included. The studies reported associations with PA for a total of 261 variables, mostly for adults and older adults. For most of the variables, evidence was available from a limited number of studies. Consistent evidence was found for individual-level and social correlates of PA in children/adolescents and adults and for individual-level correlates of PA in older adults. Self-efficacy and perceived barriers were consistently associated with PA in all age groups. Other consistently identified individual-level correlates in adults and older adults included self-rated general health, mental health, perceived benefits, and attitudes towards PA. Consistent evidence was also found for social correlates of PA in adults, including social support, interpersonal influences, parent/family influences, and information support. The influence of friendship/companionship was identified as a correlate of PA only in children/adolescents. A limited number of studies examined SB correlates, especially in older adults. The studies reported associations with SB for a total of 41 variables. Consistent evidence of association with SB was only found for obesity in adults. Some evidence suggests that male adults engage more in SB than females.

CONCLUSIONS

More Thai studies are needed on (i) PA correlates, particularly among children/adolescents, and that focus on environment- and policy-related factors and (ii) SB correlates, particularly among older adults. Researchers are also encouraged to conduct longitudinal studies to provide evidence on prospective and causal relationships, and subject to feasibility, use device-based measures of PA and SB.

Physical effort exertion and pain: Links with trait-based risk for psychopathology

People with serious mental illness (SMI) are at an increased risk for physical health complications, such as cardiovascular disease and obesity. Low levels of physical activity is a major contributor to these health complications. One factor associated with limited physical activity in the broader sedentary population is pain. While preliminary findings suggest an association between lack of physical activity and pain in SMI, conclusions are still unclear. Thus, the goal of this correlational study was to examine associations between trait-based risk for psychopathology (hypomanic personality, schizotypy, and anhedonic depression) and the experience of pain following a physical endurance/effort task. Healthy participants (N = 43; 18 females) completed self-report measures of trait-based risk for psychopathology. They also reported on the experience of pain before and after the Time To Exhaustion (TTE) test. Findings revealed that risk for psychosis and anhedonic depression were associated with increases in pain following the TTE test, accounting for other key variables, such as age and self-reported physical exercise. Risk for mania was unrelated to changes in pain. These results suggest that the experience of pain in relation to physical endurance/effort may contribute to diminished physical activity among people at risk for SMI.

Physical Activity Patterns and Risk of Type 2 Diabetes and Metabolic Syndrome in Middle-Aged and Elderly Northern Chinese Adults

The main aim of this study is to quantitatively describe the status of physical activity and evaluate its levels in a rural population and to investigate the association between the quantifiable physical activity and type 2 diabetes and metabolic syndrome. In total, 2076 participants aged over 40 years were included in a cross-sectional analysis. Physical activity status and the contributions of different types of activity were evaluated. The association between social behaviors and physical activities was analyzed. In addition, the impact of physical activities on type 2 diabetes mellitus and metabolic syndrome was also analyzed by logistic regression. Approximately half of the total activity in rural areas consisted of work-related activity (49.3%) followed by commuting (30.2%) and recreational activity (20.5%). In rural areas, the prevalence of physical activity levels was 28.6% for low levels, 47.3% for moderate levels, and 24.1% for high levels. Educational level showed a significant negative association with the physical activity level. Lower physical activity shows a strong and significant association with type 2 diabetes and metabolic syndrome. In conclusion, insufficient physical activity among rural people over 40 years old increases the risk of type 2 diabetes and metabolic syndrome. Population-wide and individualized guidelines for physical activities especially recreational physical activities should be developed.