The association between physical activity and symptoms of depression in different contexts - a cross-sectional study of Norwegian adolescents

Child health prioritisation in national adaptation policies on climate change: a policy document analysis across 160 countries

Integration of child-specific adaptation measures into health policies is imperative given children's heightened susceptibility to the health impacts of climate change. Using a document analysis method, we examined 160 national adaptation policies for inclusion of child-relevant measures and identified 19 child health-related adaptation domains. 44 (28%) of 160 countries' policies that were analysed failed to include any domains, 49 (31%) included at least one child-related domain, 62 (39%) included between two and six domains, and five (3%) included at least seven domains. Predominant domains among child-specific adaptation measures included education and awareness raising, followed by community engagement and nutrition. No country addressed children's direct needs in the domain of mental health. National adaptation policies tend towards overly simple conceptualisations of children across four major lenses: age, social role, gender, and agency. Limited inclusion of child-specific measures in national adaptation policies suggests insufficient recognition of and action on children's susceptibility to climate change effects.

Association between physical activity duration and depressive symptoms in adolescents: A longitudinal study in a rural city in Japan

In Japan, physical activity duration in junior high schools is substantially higher than that in elementary schools. Using longitudinal data, this study examined the association between changes in physical activity duration and depressive symptoms in 1225 adolescents without depressive symptoms at baseline (51.2% female) from a rural city in Japan. Adolescents in the group that changed from "Active" (physical activity duration ≥7 h /week) in the fifth-grade of elementary school (age 11 years) to "Inactive" in the second-grade of junior high school (age 14 years) had a higher odds ratio of being rated as having depressive tendencies at age 14 years than adolescents in the Active-Active group. Additionally, the results of the cross-lagged effects model analysis suggested that depressive symptoms may be a factor in the reduced physical activity duration.

Assessing the impact of physical activity on reducing depressive symptoms: a rapid review

CONTEXT

The prevalence of depression among teenagers is a significant issue worldwide, which calls for a thorough investigation of non-drug treatments. This expedited evaluation examines 24 specifically chosen studies to clarify the correlation between physical activity depression symptoms in teenagers, undertaken following PRISMA principles.

METHODS

A wide range of research methods, including longitudinal studies, surveys, and cross-sectional analyses, were used in different nations to understand the intricate relationship between physical activity, sedentary behaviours, and depression symptoms. The data-gathering methods included standardised questionnaires, accelerometer measurements, and self-report instruments.

FINDINGS

The review highlights the crucial significance of engaging in physical activity to alleviate depression symptoms. Improved self-esteem consistently acts as a crucial intermediary between participation in physical activity and decreased rates of depression. Engaging in physical activity is a safeguard, particularly for individuals with restricted access to physical activity. In contrast, a sedentary lifestyle greatly increases the probability of developing moderate to severe symptoms of depression. Gender differences are apparent, with females being disproportionately impacted by depression. There are strong connections between engaging in physical activity and reducing symptoms of depression, which can be observed in various situations, such as participating in team sports or engaging in leisure activities.

CONCLUSION

This study provides insight into the potential of physical activity as a non-pharmacological approach to address adolescent depression. This highlights the significant impact of physical activity, which has important implications for public health programs aimed at improving the mental well-being of adolescents by promoting physical activity. It is crucial to do additional research that considers gender-specific variations and various physical activity circumstances to enhance our comprehension of this important matter.

Physical activity and depressive symptoms during the fifth wave of COVID-19 pandemic: Implication for public policy and administrators

Depression is a public mental health problem that can progress to suicidal ideation, literature suggests regular physical activity may ameliorate it. The study assessed the link between physical activity and depression symptoms during the fifth wave of the COVID-19 pandemic and the Academic Staff Union (ASU) strike among undergraduates. Four hundred and eighteen undergraduates were recruited and participated in the study. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. The result on PA showed that about one-third of the participants were inactive, above half were moderately active, while a few achieved high PA levels. Above one-fifth of the participants experienced minimal or no depression while a good percent had mild, moderate, moderately severe, and severe depression. Non-parametric tests between PA total score and depression total score with demographic variables were not significant. Spearman's correlation showed a strong negative relationship between PHQ-9 scores and IPAQ-SF scores. This suggests that a high PA level is associated with lower depression symptoms. The COVID-19 pandemic and the ASU strike experiences resulted in increased depression among undergraduates. The university administration needs to formulate an urgent policy to promote PA among undergraduates and provide treatment for the affected students.

Playing for more than winning: Exploring sports participation, physical activity, and belongingness and their relationship with patterns of adolescent substance use and mental health

BACKGROUND

Promoting adolescent sports participation and physical activity may be effective low-barrier prevention strategies for co-occurring adolescent substance use (SU) and mental health symptoms (MH). The objectives of this study were to: 1) explore associations between profiles of SU/MH and sports participation; and 2) determine whether physical activity and belongingness account for these associations.

METHODS

Data came from a representative sample of 11,994 grade 9-12 Ontarian students (ages ~14-18) previously grouped into five SU/MH profiles based on patterns of use and symptoms. A series of multinomial logistic regressions, adjusted for socio-demographics and school clustering, were used to predict the risks of students belonging to SU/MH profiles based on: 1) school sports participation (>=weekly), 2) sports and physical activity (>=60minutes; 0-7 days), and 3) sports, physical activity, and school belongingness.

RESULTS

Greater school sports participation, physical activity, and belongingness were each associated with reduced risks of belonging to most profiles with elevations in SU and/or MH symptoms relative to the low SU/MH profile (Relative Risk Ratios: sports=0.62-0.87, physical activity=0.78-0.98, belonging=0.75-0.83). Frequency of physical activity accounted for ~32-60% of the associations between sports and SU/MH profiles, while school belongingness accounted for the remaining associations. Physical activity and belongingness remained independently associated with SU/MH profiles.

CONCLUSIONS

Findings suggest possible indirect associations between school sports participation and SU/MH profiles through physical activity and school belongingness, which may be promising prevention targets that have independent associations over and above sports. School sports participation may be one of a number of ways to achieve these goals.

Physical activity, physical frailty and depressive symptoms among Chinese male and female older adults: do different indicators make a difference?

Objectives

Older adults become more inactive and frailer with aging. Physical status is closely linked to mental health, but it is unclear which physical indicator is more strongly associated with depressive symptoms in older adults. The present study aimed to compare relationships between self-reported physical activity, physical frailty (muscle mass, muscle strength, and gait ability) and depressive symptoms in community male and female older adults.

Methods

A total of 1,180 adults aged 60 years and older were recruited to participate in this study from a Chinese community receiving annual check-up service from September 2018 to May 2019. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). The Bio-electrical Impedance Analyzer was used to determine the muscle mass. As the indicators of muscle function, grip strength and gait ability were assessed by the dynamometer and Timed Up and Go Test (TUGT), respectively. The 15-item version of Geriatric Depression Scale (GDS-15) was used to examine depressive symptoms. Demographic variables, health status and sleep quality were collected using questionnaire.

Results

11.8% men and 11.9% women reported depressive symptoms. Logistic regression showed that depressive symptoms was associated with low grip strength (OR = 2.42, 95% CI: 1.04-5.63), slow gait ability (OR = 3.60, 95% CI: 1.28-10.13) in older males, and associated with low level of self-reported physical activity (OR = 3.85, 95% CI: 2.00-7.42) in older females. No significant association was found between muscle mass and depressive symptoms.

Conclusion

There were gender differences in the relationship between physical activity, physical frailty, and depressive symptoms. Grip strength and gait ability may be a better indicator of frailty for predicting depressive symptoms in older men while physical activity may be useful in predicting depressive symptoms in older women.

The association of adolescents' smoking with the physical activity levels of their friends

BACKGROUND

Smoking is inversely related to people's Physical Activity Level (PAL). As the behavior of friends may affect the choices and behavior of adolescents, having friends with a high PAL may potentially protect against adolescent smoking. This study aims to assess whether adolescents' smoking is associated with the PAL of their friends.

METHODS

SILNE-R survey data of 11.918 adolescents from 55 different schools in 7 European cities was used to determine weekly smoking, individual PAL, PAL of friends, school PAL, and smoking of friends. Multilevel, multivariable logistic regression analysis were used to assess the association between the PAL of friends and weekly smoking. Several socio-demographic variables were included as covariates in the analysis.

RESULTS

Our results indicated that 10.8% of the respondents was smoking weekly. Weekly smoking was most common among adolescents whose friends had a PAL of 0-42.0 min per day (14.5%). Respondents were significantly more likely to be smoking weekly if their friends were on average 0-42 min vs. 80-180 min physically active (OR 1.27 [95% CI 1.04-1.55]). This association existed independently of the individual PAL of respondents. Stratification for smoking of friends yielded equal results, although the association appeared to be somewhat stronger for those with smoking friends (OR 1.38 [95% CI 1.06-1.82]).

CONCLUSION

Adolescents are less likely to smoke weekly if they associate with friends who spend >80 min per day on physical activity. Initiatives aimed at the prevention of smoking among adolescents may benefit from organizing group-based physical activity programs.

Dissecting the causal association between social or physical inactivity and depression: a bidirectional two-sample Mendelian Randomization study

A growing body of research suggests that social or physical activity can affect the risk of Major depressive disorder (MDD). However, the bidirectional relationship between them remains to be clarified further, especially between inactivity and MDD. Here, we performed a two-sample Mendelian Randomization analysis using genetic variants associated with social/physical activities and MDD, and assessed the mediating effect of obesity-related measures and brain imaging phenotypes. The dataset on MDD, social activities, and physical activities included 500,199; 461,369; 460,376 individuals, respectively. Information regarding body mass index (BMI), body fat percentage (BFP), IDPs for 454,633; 461,460; 8,428 participants, respectively. We identified bidirectional causal relationships between sport clubs or gyms, strenuous sports, heavy do-it-youself, other exercises and MDD. We also observed that leisure/social inactivity (odds ratio [OR] = 1.64; P = 5.14 × 10-5) or physical inactivity (OR = 3.67; P = 1.99 × 10-5) caused an increased risk of MDD, which were partially mediated by BMI or BFP and masked by the weighted-mean orientation dispersion index of left acoustic radiation or volume of right caudate. Furthermore, we discovered that MDD increased the risk of leisure/social inactivity (OR = 1.03; P = 9.89 × 10-4) or physical inactivity (OR = 1.01; P = 7.96 × 10-4). In conclusions, we found that social/physical activities reduced the risk of MDD, while MDD in turn hindered social/physical activities. Inactivity may increase the risk of MDD, which was mediated or masked by brain imaging phenotypes. These results help to understand the manifestations of MDD and provide evidence and direction for the advancement of intervention and prevention.

Motivations and barriers towards optimal physical activity level: A community-based assessment of 28 EU countries

Regular physical activity (PA) is one of the most important determinants of a healthy lifestyle and improved physical and mental well-being. Despite the health benefits of regular PA, the studies show low levels of PA among European adolescents and adults. An increase in physical inactivity has been associated with different personal and environmental factors. This study aimed to investigate positive motivation and barriers to community-based PA. Face-to-face interviews were conducted to collect data on PA, positive motivation and barriers to PA, demographic, and socioeconomic factors. Moderate and vigorous levels of PA were assessed. Regression analysis was applied to estimate the associations for positive and negative reasons for meeting PA recommendations. Data were available for 28,031 adults with a mean age of 48.3 (SD = 18.8) and 51.8% women. Significant variations in individual characteristics were seen between different types of communities. The percentage of participants who reported achieving recommended levels of PA was the lowest in rural areas (44.3%). Regression models showed that most motivational factors had a strong positive association with meeting PA recommendations. We observed the effects of interactions between making acquaintances, having fun and the type of community on meeting PA recommendations. The effects of interactions between the type of community and barriers to PA such as price, risk of injury, disability / illness, and a lack of motivation on PA recommendations were observed. In conclusion, the motivational factors and barriers to PA are associated with the physical environment, and community-based programs and policies for encouraging PA participation are needed.

Associations between Mental Health, Lifestyle Factors and Worries about Climate Change in Norwegian Adolescents

Climate change is a serious global health threat that has an impact on young people's lives and may influence their mental health. Since the global climate strike movement, many adolescents have expressed worries about climate change. Thus, the aim of this study is to examine the prevalence of worries about climate change, and factors associated with worries about climate change, in a representative sample of Norwegian adolescents. Data were retrieved from Ungdata, an annual nationwide online youth survey. Adolescents (n = 128,484) from lower and upper secondary school participated in the study. Data were analysed descriptively and with logistic regression. Most of the adolescents were not worried or a little worried about climate change. Girls, pupils who had at least one parent with higher education and pupils from urban areas were more inclined to worry about the climate. Adolescents who worried about the climate had more symptoms of depression than those who were less worried. While worry about climate change may constitute an additional burden for adolescents experiencing depressive symptoms, such worry can also be seen to reflect climate-friendly values.

Leisure-Time Activities in Different Contexts and Depressive Symptoms in Norwegian Adolescents: A Cross-Sectional Study

The purpose of this study was to examine the association between physical activity organised in sports clubs, non-organised physical activity, other organised leisure-time activities, and depressive symptoms among adolescents. This study was based on cross-sectional data from the Ungdata survey conducted between 2017 and 2019. The sample comprised 7656 adolescents (aged 13-16 years). Binominal logistic regression was used to analyse the association between the three different leisure-time activities and depressive symptoms. All models were adjusted for gender, family economy, parents' higher education, having friends, alcohol intoxication, and smoking. The odds for symptoms of depression were higher for those who were less physically active in a sports club (OR: 1.34, 95% CI: 1.15-1.57) and in non-organised physical activities (OR: 1.50, 95% CI: 1.29-1.74) and lower for those who participated less in other organised leisure-time activities (OR: 0.79, 95% CI: 0.68-0.92) compared with those who were physically active (sports club and non-organised) and those who participated in other organised leisure-time activities. Our findings suggested that being physically active, both in a sports club and in non-organised activities, was associated with lower odds of depressive symptoms among adolescents. Additional research is needed to confirm a possible causal relationship.

Cross-sectional associations between physical activity pattern, sports participation, screen time and mental health in Swedish adolescents

OBJECTIVES

To investigate the associations between physical activity pattern, sports participation, screen time and mental health in Swedish adolescents.

DESIGN, SETTING AND PARTICIPANTS

A total of 1139 Swedish adolescents (mean age 13.4) from 34 schools participated in the cross-sectional study 'Physical Activity for Healthy Brain Functions in School Youth' in 2019.

METHODS

Time spent sedentary and in moderate-to-vigorous physical activity (MVPA) was measured using accelerometers for seven consecutive days. Screen time and sports participation were self-reported. Anxiety and health-related quality of life (HRQoL) were assessed using a Short version of the Spence Children's Anxiety Scale and Kidscreen-10.

RESULTS

MVPA was positively associated (95% CI 0.01 to 0.05 in girls and 0.02 to 0.07 in boys) whereas screen time on weekdays was inversely associated with HRQoL (-4.79 to -2.22 in girls and -2.66 to -0.41 in boys). The largest effect sizes were observed between the high/low MVPA group in boys (Cohen's d=0.51) and screen time groups in girls (Cohen's d=0.59 on weekdays). With regards to anxiety, high compared with lower time spent in MVPA during leisure time on weekdays was associated with lower anxiety scores (95% CI -0.13 to -0.05 in girls and -0.07 to -0.01 in boys). Gender differences were observed, boys who participated in organised sports had low anxiety scores (95% CI -3.49 to -0.13) whereas girls who reported 5 hours or more of screen time had high scores (95% CI 1.94 to 6.18 on weekdays and 1.39 to 5.29 on weekend days).

CONCLUSIONS

This study showed that MVPA was associated with better mental health, whereas the opposite was seen for screen time. These associations were not consistently significant throughout all time domains, between the genders and mental health outcomes. Our results could create a paradigm for future studies to decide which types of PA patterns and time domains to target in intervention studies with the aim improve mental health among adolescents.

Participation in Higher Intensity Physical Activity Predicts Lower Depressive Symptom Incidence in College Students

The prevalence of depression and insufficient physical activity (PA) continue to rise in the United States, particularly among college students. PA is typically associated with decreased levels of depressive symptoms; however, the association between different intensities of PA and depressive symptoms is unclear among college students. The aim of this study was to examine how well weekly moderate PA (MPA), vigorous PA (VPA) and strength training (ST) volumes predicted depressive symptoms in college students. Students self-reported weekly MPA, VPA, ST, depressive symptoms (CESD-7), restful nights of sleep, grade point average (GPA) and socio-demographic characteristics. Four individual linear regression models were performed to examine how MPA, VPA, and ST predicted depressive symptoms. Covariates controlled for socio-demographic characteristics (gender, race/ethnicity, and sexual orientation) and other variables (GPA and sleep) that could influence depressive symptoms. Data suggested that higher volumes of VPA (β = -0.11; R² = 0.157) and higher days of ST (β = -0.11; R ² = 0.157) significantly predicted (p < 0.001) lower depressive symptoms. While MPA volume (β = -0.01; R ² = 0.147) did not significantly predict depressive symptoms. Higher volumes of VPA and more days of ST participation predicts lower depressive symptoms in college students. High intensity exercise programs should be promoted at universities and throughout the young adult population. Exercise prescription may be useful and successful for students at risk of depression. Emphasis placed on these intensities will attempt to decrease depressive symptoms in students.

School educational models and child mental health among K-12 students: a scoping review

BACKGROUND

The promotion of mental health among children and adolescents is a public health imperative worldwide, and schools have been proposed as the primary and targeted settings for mental health promotion for students in grades K-12. This review sought to provide a comprehensive understanding of key factors involved in models of school education contributing to student mental health development, interrelationships among these factors and the cross-cultural differences across nations and societies.

METHODS

This scoping review followed the framework of Arksey and O'Malley and holistically reviewed the current evidence on the potential impacts of school-related factors or school-based interventions on student mental health in recent 5 years based on the PubMed, Web of Science, Embase and PsycExtra databases.

RESULTS/FINDINGS

After screening 558 full-texts, this review contained a total of 197 original articles on school education and student mental health. Based on the five key factors (including curriculum, homework and tests, physical activities, interpersonal relationships and after-school activities) identified in student mental development according to thematic analyses, a multi-component school educational model integrating academic, social and physical factors was proposed so as to conceptualize the five school-based dimensions for K-12 students to promote student mental health development.

CONCLUSIONS

The lessons learned from previous studies indicate that developing multi-component school strategies to promote student mental health remains a major challenge. This review may help establish appropriate school educational models and call for a greater emphasis on advancement of student mental health in the K-12 school context among different nations or societies.

Assessment of Subjective Well-Being in a Cohort of University Students and Staff Members: Association with Physical Activity and Outdoor Leisure Time during the COVID-19 Pandemic

Time spent outdoors and physical activity (PA) promote mental health. To confirm this relationship in the aftermath of COVID-19 lockdowns, we explored individual levels of anxiety, depression, stress and subjective well-being (SWB) in a cohort of academic students and staff members and tested their association with sport practice, PA at leisure time and time spent outdoors. Our cross-sectional study collected data during the COVID-19 outbreak (April−May 2021) on 939 students and on 238 employees, who completed an online survey on sociodemographic and lifestyle features, depression, anxiety, stress, and SWB. Results showed that the students exhibited higher levels of anxiety, depression, and stress, and lower levels of SWB (p < 0.001 for all domains) compared to the staff members. Correlation analysis confirmed that PA and time spent in nature were associated to high mental health scores among staff and, more consistently, among students. Finally, mediation analyses indicated that the time spent in nature, social relationships, and levels of energy play a mediator role in the relationship between sport practice and SWB. Our evidence reinforces the protective role of time spent in nature in improving mental health, and provides support for policymakers to make appropriate choices for a better management of COVID-19 pandemic consequences.

Influence of External Natural Environment Including Sunshine Exposure on Public Mental Health: A Systematic Review

The COVID-19 pandemic has been raging around the world and public health measures such as lockdowns have forced people to go out less often, reducing sunlight exposure time, green space use, and physical activity. It is well known that exercise has a positive impact on mental health, but the impact of external environmental factors such as sunlight exposure and green space use on mental health has not been systematically reviewed. In this review, we categorized the major factors that may affect people’s mental health into (1) external environmental factors such as exposure to sunlight and green spaces, (2) internal life factors such as physical activity and lifestyle, and (3) mixed external and internal factors, and systematically examined the relationship between each factor and people’s mental health. The results showed that exposure to sunlight, spending leisure time in green spaces, and physical activity each had a positive impact on people’s mental health, including depression, anxiety, and stress states. Specifically, moderate physical activity in an external environment with sunlight exposure or green space was found to be an important factor. The study found that exposure to the natural environment through sunbathing and exercise is important for people’s mental health.

Adolescents' Long-Term Experiences of Manageability, Comprehensibility, and Meaningfulness of a Group-Based Exercise Intervention for Depression

Physical exercise is a potentially effective treatment for adolescents with mild to moderate depression. However, there is a lack of long-term follow-ups to reveal adolescents’ experiences of exercise as a treatment for depression. The salutogenic concept of sense of coherence (SOC), comprising the domains manageability, comprehensibility, and meaningfulness is important to understand behaviour change. This study aimed to describe adolescents’ long-term experiences of manageability, comprehensibility, and meaningfulness of a group-based exercise intervention for depression. Fourteen adolescents with persistent depression were recruited from a psychiatric outpatient clinic and interviewed one year after participating in a 14-week moderate to vigorous exercise intervention for depression. An abductive qualitative content analysis was conducted, based on the three SOC domains manageability, comprehensibility, and meaningfulness. The results revealed that participation in the intervention was made manageable by a supportive environment, including: the intervention design, togetherness with peer group, and encouragement from adults. The comprehensibility of the intervention emerged through the insights regarding health benefits of exercise and the aim of the intervention. Meaningfulness was achieved through improved health behaviour, well-being and self-esteem, along with strengthened belief in the future and increased commitment to everyday life. The group-based exercise intervention was experienced as manageable, comprehensible, and meaningful.

Linking Leeds: A Social Prescribing Service for Children and Young People

The use of social prescribing interventions for common mental health issues is expanding as clinicians seek to diverge from the traditional medical model of treatment. This intervention allows for the referral of patients to a nonclinical social activity via a link worker. Evidence for the benefits of social prescribing is growing. Most evidence is based on adults; however, a smaller number of studies involving children and young people have produced encouraging results. This evaluation reports on data routinely collected by the Linking Leeds service between 9 January 2019–11 January 2020. Linking Leeds provides Social Prescribing for people aged 16 years and above; however, the current paper focuses on service users aged between 16 and 25. Their aim is to connect people to services and activities in their community in order to benefit overall health and mental wellbeing. This evaluation of the Linking Leeds program supports the growing body of evidence to support the benefits social prescribing can have on young people’s mental health. Two main mechanisms were identified which underpin social prescribing in young people: social connectedness and behavioural activation.

Absenteeism and associated labour costs according to depressive symptom severity in the German general population: why preventive strategies matter

Purpose

Depression is a highly prevalent mental health condition with substantial individual, societal and economic consequences. This study focussed on the association of depressive symptom severity with absenteeism duration and employer labour costs.

Methods

Using cross-sectional data from the German Health Update 2014/2015, multivariable zero-inflated Poisson regression (ZIP) models explored the association of depressive symptom severity (8-item depression patient health questionnaire—PHQ-8), with absenteeism weeks during 12 months in men and women working full- or part-time. The predicted sick leave weeks were multiplied by mean average labour costs.

Results

The sample consisted of 12,405 persons with an average sick leave of 1.89 weeks (SD 4.26). Fifty-four % were women and 57% were between 40 and 59 years of age. In men and women, mild, moderate, moderately severe and severe depressive symptoms were associated with a significant factor increase in sick leave weeks compared to persons with no or minimal symptoms. Labour costs increased with increasing symptom severity from € 1468.22 for men with no or minimal depressive symptoms to € 7190.25 for men with severe depressive symptoms and from € 1045.82 to € 4306.30 in women, respectively.

Conclusion

The present results indicate that increasing depressive symptom severity is associated with increasing absenteeism and employer costs. They emphasize the need for implementation, realignment or extension of professional work-site health promotion programmes aiming at the improvement and maintenance of employee health and the reduction of labour costs associated with depression-related sick leave.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01788-7.

Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study

OBJECTIVE

The aim of this research was to examine the bidirectional association between self-reported symptoms of mental disorder and physical activity among a large sample of Canadian secondary school students over time.

METHODS

Linked survey data were obtained from 28,567 grade 9 to 12 students across Canada participating in two waves of the COMPASS Study (2017-18; 2018-19). Autoregressive cross-lagged models were run to examine the reciprocal relationships between self-reported moderate-to-vigorous physical activity (MVPA) and symptoms of depression (CESD-10) and anxiety (GAD-7). Models were stratified by gender, and accounted for grade, ethno-racial identity, and school-level clustering.

RESULTS

Autoregressive associations show that neither symptoms of anxiety nor depression, at baseline, were predictive of mean MVPA at follow-up - consistent for the full sample and among both males and females. Higher MVPA among males at baseline was associated with lower symptoms of both anxiety (β = - 0.03, p = 0.002) and depression (β = - 0.05, p < 0.001) at follow-up. However, among females, higher MVPA at baseline was associated with greater symptoms of anxiety (β = 0.03, p < 0.001), but not symptoms of depression (β = 0.01, p = 0.073), at follow-up.

CONCLUSION

In our large sample of Canadian secondary school students, associations between physical activity and symptoms of mental disorder were not bi-directional, and these relationships differed in males and females. This study illustrates the complex nature of the relationship between physical activity and symptoms of mental disorder among youth. While results support the benefits of promoting physical activity among males to prevent or manage internalizing symptoms, the relationship among females warrants further investigation.

Depressive Symptom and Associated Factors Among School Adolescents of Urban, Semi-Urban and Rural Areas in Bangladesh: A Scenario Prior to COVID-19

Background: The purpose of this study was to investigate the prevalence of depressive symptom and the factors associated with this condition among urban, semi-urban and rural adolescents in the Dhaka district of Bangladesh. Methods: A cross sectional study using two stage cluster sampling procedure was performed. A self-administered questionnaire was conveyed to 2,355 adolescents from nine secondary schools of Dhaka district of Bangladesh. Of the respondents, 2,313 completed the nine item Patient Health Questionnaire (PHQ-9). Besides, sociodemographic information, self-reported body image as well as modification of Leisure Time Exercise Questionnaire (LTEQ) and WHO Global PA Questionnaire (GPAQ) were used to determine the sociodemographic and lifestyle factors associated with depressive symptom among adolescents. Results: A total of 30.1% adolescents were found to be suffering from moderate to severely severe depressive symptom. Females (60.8%) were found suffering significantly more than males (39.2%). Sociodemographic factors, for example, residential setting and family size were found significantly associated with depressive symptom among adolescents. Adjusted estimate of logistic regression shows that physical inactivity (AOR: 1.44; 95% CI: 1.14-1.84), >2 h/day screen time (AOR: 1.68; 95% CI: 1.39-2.03), sleep dissatisfaction (AOR: 3.23; 95% CI: 2.64-3.96), and underweight body image perception (AOR: 2.30; 95% CI: 1.70-3.13) were significantly associated with depressive symptom among adolescents. Conclusions: Among urban, semi-urban and rural school adolescents in Dhaka, Bangladesh, depressive symptom is quite prevalent. To lessen the spread of depressive symptom among Bangladeshi adolescents, urgent steps should therefore be taken.

The behavioral, psychological, and social impacts of team sports: a systematic review and meta-analysis

Objectives: To assess the association between team sport participation and behavioral, psychological, and social health outcomes in young athletes.Methods: A systematic review and meta-analysis were undertaken to identify studies published between 01/01/1950-05/01/2020 investigating the association between team sport participation and health outcomes in young athletes (<25 years). Included studies compared team sport participants to controls or themselves, assessed health outcomes, and had a sample size >50. Prospective and retrospective studies were included; non-primary literature was excluded. Health outcomes were categorized as: 1) behavioral, 2) psychological, or 3) social. Data were extracted to form 2 × 2 tables for each study to calculate odds ratios (OR) and 95% confidence intervals (CI).Results: Of 371 queried articles, 34 studies from 10 countries across 4 continents were included, with 9 reporting homogenous outcomes for meta-analysis.Behavioral: Fifteen studies evaluated behavioral health outcomes of alcohol and/or drug use, fitness, and diet. Quantitatively, team sport participation was found to decrease rates of cigarette/tobacco use across 5 studies (OR 0.72, 95% CI 0.69-0.76) and alcohol/drug use across 7 studies (OR 0.73, 95% CI 0.69-0.77). Qualitatively, 12/15 (80%) of studies confirmed improved behavioral health outcomes with team sport participation.Psychological: Nineteen studies evaluated psychological health outcomes including anorexia, anxiety, depression, self-esteem, and suicidal ideation. Quantitatively, team sport participation was associated with decreased depression/anxiety rates across 5 studies (OR 0.59, 95%CI 0.54-0.64). Qualitatively, 14/19 (74%) of studies confirmed improved psychological health.Social: Ten studies evaluated social health outcomes including academic performance, commitment, psychosocial health, social behavior/identity, and delinquency/high-risk activity. Qualitatively, 7/10 (70%) of studies confirmed improved social health outcomes with team sport participation.Conclusion: Team sport participation was associated with decreased odds of smoking/tobacco use, alcohol/drug use, and depression/anxiety. Though few studies mentioned potential negative effects of team sport participation, the majority reported improved behavioral, psychological, and social health outcomes in youth athletes worldwide.

Associations between Self-Esteem, Psychological Stress, and the Risk of Exercise Dependence

Body concerns and stress-related disorders are increasing in the younger population in a wide range of nations. Studies find links between both self-worth, exercise dependence, and self-esteem in relation to stress, but few have considered all three variables in relation to one another. The present study explored whether the co-appearance of high levels of psychological distress, and low levels of self-esteem may be a vulnerability factor for developing exercise dependence by studying the links between self-esteem, psychological stress, and exercise dependence. A standardized cross-sectional questionnaire was completed by 203 regular exercisers attending two gyms (mean age: 35.9 years). The variables self-esteem, psychological distress, and exercise dependence were all significantly correlated with each other, even after weekly exercise amount, age, and gender had been accounted for. Those who exercised for more than 9 h per week had a significantly higher score on stress and exercise dependence symptoms, and a lower score on self-esteem compared with the remaining groups. One could hypothesize that low self-esteem is a vulnerability factor and high psychological stress a maintenance factor for an exercise-dependent person. It is argued that more focus should be directed toward the negative consequences of excessive exercise.

Neck and shoulder pain in adolescents seldom occur alone: Results from the Norwegian Ungdata Survey

BACKGROUND

No previous studies have investigated the prevalence of co-occurring neck/shoulder pain, other musculoskeletal pain, headache and depressive symptoms in adolescents. This study aimed to describe the prevalence of isolated neck/shoulder pain and the co-occurrence of neck/shoulder pain with other musculoskeletal pain, headache and depressive symptoms in Norwegian adolescents.

METHODS

This is a cross-sectional study using data from the Norwegian Ungdata survey (2017-2019). Adolescents from almost all municipalities in Norway answered a comprehensive questionnaire, including physical complaints. We investigated the prevalence of self-reported neck/shoulder pain in isolation and neck/shoulder pain in combination with other musculoskeletal pain, headache and depressive symptoms. The results were presented with per cent and stratified by school level and sex.

RESULTS

In total, 253,968 adolescents (50% girls) participated in the study, of which 56.5% were from lower secondary school. The total prevalence of neck/shoulder pain was 24%, but only 5% reported isolated neck/shoulder pain. Among students reporting neck/shoulder pain, half of them also reported other musculoskeletal pain, and 50% of the boys and 70% of the girls reported co-occurring headache. Depressive symptoms were reported in 28% of the boys and 45% of the girls with neck/shoulder pain.

CONCLUSION

Neck/shoulder pain in adolescents is seldom isolated, but seems to co-occur with headache, other musculoskeletal pain and depressive symptoms. Researchers and clinicians should keep a broader health perspective in mind when approaching adolescents with neck/shoulder pain.

SIGNIFICANCE

One in five adolescents reported neck/shoulder pain in this large population-based study of Norwegian adolescents. A majority of adolescents reported neck/shoulder pain in co-occurrence with other musculoskeletal pain, headache and depression. Researchers and clinicians should assess these comorbidities when assessing adolescents with neck/shoulder pain.

The Effect of College Students' Physical Activity Level on Depression and Personal Relationships

Background: Physical activity greatly affects human physical and mental health. This study investigated the effect of college students’ physical activity levels on depression and personal relationships. Methods: Participants were 525 college students from five Korean cities. The International Physical Activity Questionnaire, Beck’s Depression Inventory, and Leary’s interpersonal orientation paper test measured physical activity volume, depression, and interpersonal relationships, respectively. Data were analyzed using descriptive statistics, reliability analysis, one-way analysis of variance (ANOVA), and Pearson’s correlation analysis. Results: The results revealed significant differences among emotional, cognitive, and synchronous symptoms of depression across activity level groups. Regarding interpersonal relationships according to physical activity, for the sociometric disposition, there were differences between groups in the sympathetic-acceptable and sociable-friendliness factors and, for the expressive disposition, in the competitive-aggressive and rebellious-distrustful factors. Conclusions: There were statistical correlations between the physical activity volume and depression and the physical activity and interpersonal relationships. Subsequent research should examine college students’ physical activities and causal relationships among various psychological variables.

Lifestyle habits and depressive symptoms in Norwegian adolescents: a national cross-sectional study

Background

This study’s purpose was to examine the association between a broad range of lifestyle habits and depressive symptoms in Norwegian adolescents.

Methods

This study was based on national, self-reported, cross-sectional data from the Ungdata Surveys, conducted in 2017–2019. The target group comprised 244,250 adolescents (ages 13–19). Binominal logistic regression was used to analyse the association between lifestyle habits (physical activity, social media use, gaming, dietary habits, smoking, smokeless tobacco, alcohol intoxication) and depressive symptoms. The outcome measure was defined as a high level of depressive symptoms (≥80th percentile). Separate analyses were performed for boys and girls, and all models were adjusted for perceived family economy, parental higher education and age.

Results

The odds of having depressive symptoms were significantly lower among those who reported being physically active at least 3 times per week (OR; boys: 0.81, girls: 0.83), used social media ≤3 h per day (OR; boys: 0.65, girls: 0.70), engaged in gaming ≤3 h per day (OR; boys: 0.72, girls: 0.77), were non-smokers (OR; boys: 0.74, girls: 0.72) and had not experienced alcohol intoxication during the previous 12 months (OR; boys: 0.66, girls: 0.67). Furthermore, the results indicated a significant inverse association between depressive symptoms and high consumption of a range of healthy food items and low consumption of unhealthy food and beverages among girls. Similar tendencies were found among boys (OR; 0.77–0.91). Finally, higher adherence to healthy lifestyle habits was associated significantly with lower odds of having depressive symptoms among both genders (OR; boys: 0.40, girls: 0.52).

Conclusions

A healthier lifestyle was associated with lower odds of having depressive symptoms. Additional research is needed to confirm a possible causal relationship.

Does Vigorous Physical Activity Contribute to Adolescent Life Satisfaction?

Background: Physical and mental health are the basis of life satisfaction (LS), even during adolescence. The aim of this study was to identify the associations between LS and types of physical activity (PA) in Czech and Polish boys and girls. Methods: The research involved 933 girls and 663 boys aged 15–19 years. LS was diagnosed using the Bern Subjective Well-Being Questionnaire and the WHO-5 Well-Being Index. The International Physical Activity Questionnaire-long form (IPAQ-LF) questionnaire was used to identify the types of weekly PA. Results: Adolescents with the highest LS had more recreational, moderate, vigorous, and total weekly PA. The strongest associations between LS and PA were in the Czech and Polish boys and girls who participated in vigorous PA (VPA). The recommendations for VPA were fulfilled by 45% of Czech and 46% of Polish boys and 40% of Czech and 50% of Polish girls, with the highest LS. The most significant positive moderator between LS and PA was participation in organized PA. Boys with the highest LS were 1.94 times more likely to meet the weekly recommendation of VPA than boys with the lowest LS. Similarly, girls with the highest LS were 1.77 times more likely to meet these recommendations. Conclusions: Promoting both current subjective well-being and organized PA, with an emphasis on achieving the VPA recommendations, may support general LS and a healthy lifestyle in adolescents.

Mental Health Problems and the Associated Family and School Factors in Adolescents: A Multilevel Analysis

Objective: Mental health is one of the most important issues in adolescents’ life. Adolescents’ health is highly important, because of their role in the future. This study was conducted using multilevel analysis to investigate the risk factors at student and school levels.

Method: This was a cross sectional study for which 1740 students and 53 schools were selected between February and March 2018 in Qazvin, Iran. Multistage stratified cluster sampling was used for data collection. Mental health problems were measured by the Strengths and Difficulties Questionnaire (SDQ). Emotional symptom, conduct problem, hyperactivity, peer relationship problem, and prosocial behavior were the subscales. This study used multilevel analysis to determine the association between each of the questionnaire scales and students and schools variables. Results: The prevalence of the mental health problems was 16.2%. Conduct problem was more prevalent than others (21.1%). Overall, the score of mental health problems was significantly lower in boys’ schools, in adolescents with physical activity, and in families with high socioeconomic status. Hyperactivity and emotional symptoms were significantly higher in girls’ schools. While prosocial behavior and peer relationship problems were significantly higher in boys’ schools. The association between variables and the scales of mental health problems was different.Conclusion: Results indicated desirable physical activity and socioeconomic status are effective components in the adolescents’ mental health, and, mostly girls’ schools were more vulnerable than boys’ schools. Therefore, the educational authorities and health policymakers should consider this diversity to design interventional programs and pay more attention to the high-risk adolescents in different schools.

Differences in objectively measured daily physical activity patterns related to depressive symptoms in community dwelling women - mPED trial

Physical activity (PA) is an effective depression treatment. However, knowledge on how variation in day-to-day PA relates to depression in women is lacking. The purposes of this study were to 1) compare overall objectively measured baseline daily steps and duration of moderate to vigorous PA (MVPA) and 2) examine differences in steps and MVPA on days of the week between women aged 25–65 years, who were physically inactive, with high and low depressive symptoms, enrolled in a run-in period of the mobile phone based physical activity education (mPED) trial. The Center for Epidemiological Studies Depression Scale was used to categorize low/high depressive symptom groups. We used linear mixed-effects models to examine the associations between steps and MVPA and depression-status overall and by day of the week, adjusting for selected demographic variables and their interactions with day of the week. 274 women were included in the final analysis, of which 58 had high depressive symptoms. Overall physical activity levels did not differ. However, day of the week modified the associations of depression with MVPA (p = 0.015) and daily steps (p = 0.08). Women with high depression were characterized by reduced activity at the end of the week (Posthoc: Friday: 791 fewer steps, 95% CI: 73–1509, p = 0.03; 8.8 lower MVPA, 95% CI: 2.16–15.5, p = 0.0098) compared to women with low depression, who showed increased activity. Day of the week might be an important target for personalization of physical activity interventions. Future work should evaluate potential causes of daily activity alterations in depression in women.

Trends in the utilization of youth primary healthcare services and psychological distress

Background

Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.

Methods

This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13–19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time.

Results

We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16 and 66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.

Conclusions

Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06124-w.

Low sports participation is associated with withdrawn and depressed symptoms in urban, school-age children

BACKGROUND

The association between sports participation and mental health has not been studied in primary care samples of school-age children, nor in underrepresented minority children. We assessed the relationship between number of sports played and psychiatric symptoms in children ages 6-11 at well-child visits in an urban clinic.

METHODS

Guardians of 206 children (85% Latinx) ages 6-11 completed Child Behavior Checklists (CBCL) in Spanish (66.5%) or English at well-child visits at an urban community health center. We performed linear regression between number of sports played and individual CBCL syndrome scores, and multiple logistic regression with normal (T-score <60) vs. elevated (T-score ≥60) CBCL syndrome scale score as the outcome. We conducted bivariate, multiple logistic regression, and linear regression analyses between low (1 or fewer) vs. high (2 or more) sports participators and subscales of interest.

RESULTS

Fewer sports played was associated with higher Withdrawn/Depressed CBCL syndrome scale T-scores (p = 0.019), but not with other CBCL syndrome scale scores nor number of syndrome scale elevations (p = 0.638). Low participators had higher odds of an elevated Withdrawn/Depressed T-score (p = 0.033) than high participators.

LIMITATIONS

Our dataset did not contain certain details about sports played, nor information about income and insurance, and our results may not generalize to other populations.

CONCLUSIONS

Playing fewer sports is associated with higher withdrawn/depressed symptoms in urban, predominantly Latinx, school-age children. Therefore, urban school-age children with low sports participation may be at risk for depression, and sports participation might protect against depressive symptoms in childhood.

Physical Activity and Mental Health: A Cross-sectional Study of Canadian Youth

OBJECTIVE

Our objective was to examine the associations between recreational and non-recreational physical activity with mental health outcomes among Canadian youth aged 12-17.

METHODS

Cross-sectional data from the 2015/2016 Canadian Community Health Survey was used for analysis. Physical activity was classified as either recreational or non-recreational. Both types of physical activity were categorized using the Canadian Physical Activity Guidelines. Mental health outcomes included the Patient Health Questionnaire-9 (PHQ-9) scale dichotomized with 5+ and 10+ cut-offs, self-perceived mental health, and self-reported professionally diagnosed mood and anxiety disorders. Descriptive statistics (proportions with 95% confidence intervals), and multivariable logistic regression were used in the analysis.

RESULTS

It was found 21.20% of youth were not participating in recreational physical activity and 40.97% were engaging in below guideline recreational physical activity. No activity, or below guideline recreational physical activity was associated with negative mental health. Non-recreational physical activity models were generally non-significant. Additionally, it was determined that associations between recreational physical activity and PHQ-9 score were only evident in males. For the no activity and below guideline activity levels the odds ratios (ORs)=2.57 and 3.19 for males and OR=0.95 and 0.96 for females, respectively.

CONCLUSIONS

Recreational physical activity is associated with youth mental health (particularly in males), but non-recreational physical activity is not consistently associated. While the data are cross-sectional and cannot support causal inference, these results highlight the potential importance of accessible recreational physical activity programs. Further, these results may inform guidelines about types of youth physical activity and their apparent mental health benefits.

Exercise Interventions as the Primary Treatment for Depression: Evidence from a Narrative Review

There is an increasing evidence supporting the efficacy of exercise interventions in the treatment of depression, which is a growing global health concern. However, data on the efficacy of exercise as the primary treatment for depression are scarce. This narrative review explored the efficacy of exercise interventions as the primary treatment for depressive disorders. A comprehensive search for English-language literature published between January 1965 and November 2019 was conducted via PubMed, Google Scholar, Scopus, Web of Science, PsycINFO, EMBASE, Cochrane database and Medline. Thirteen randomised control trials (RCTs) were included in the final analysis. Their results indicated that supervised aerobic exercise and high-intensity progressive resistance training (PRT) were effective in ameliorating depressive symptoms as the primary treatment compared with control groups, but they were not superior to other active treatments, such as antidepressants and cognitive behavioural therapy. Aerobic exercise and high-intensity PRT may be a promising primary treatment for depression as they may induce biopsychosocial effects (effects on neurotrophic factor, pro-inflammatory cytokines, monoamine, the hypothalamic-pituitary-adrenal axis, self-efficacy, mastery experience, adaptive coping and social interaction), which may ameliorate the severity of depressive symptoms. However, future RCTs with more comprehensive and well-designed methodologies are warranted to confirm our findings.

Physical Activity of Secondary School Adolescents at Risk of Depressive Symptoms

BACKGROUND

The aim of the study is to analyze the associations between depressive symptoms (DS), well-being and different types of physical activity (PA) in adolescents.

METHODS

Overall, 368 girls and 228 boys aged 15-19 years were involved in the research. To explore the composition of weekly PA, we used the IPAQ-Long questionnaire, and a pedometer was used to monitor weekly PA. The prevalence of DS was diagnosed by the Bern Subjective Well-Being Questionnaire and the WHO-5 Well-Being Index.

RESULTS

The girls and boys who reported the most DS and the lowest level of well-being had significantly less weekly recreational PA. The girls who reported the fewest DS had a 2.12 times greater odds of meeting the 11,000 steps/day recommendation than did the girls with the most DS, whereas we did not detect statistically significant differences in rates of meeting the recommendation in the boys with distinct levels of DS.

CONCLUSIONS

The study confirms the stronger negative associations between DS and PA, especially among girls. The greatest opportunities for behavioral change in adolescents at the highest risk of DS are in the promotion of recreational PA.

The moderating effect of physical activity in the relation between problematic mobile phone use and depression among university students

AIM

To examine the moderating effect of physical activity (PA) between problematic mobile phone use (PMPU) and depression in university students.

METHODS

The sample consisted of 4624 students (55.5% females and 44.5% males) aged 17-25 years old (M=19.91, SD=1.27). Patient Health Questionnaire (PHQ-9) and Center for Epidemiologic Studies Depression Scale (CES-D) were applied to evaluate the state of depression in all participants. The data of PMPU and PA were collected by standardized questionnaires named Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and International physical activity Questionnaire-Short Form (IPAQ-SF). Chi-square tests and multivariate logistic regressions were applied to examine the associations of PMPU and depression, as well as the moderating effects of PA.

RESULTS

The prevalence of PMPU and depression were 27.5%, 6.1% (PHQ-9 at clinical level) and 25.1% (CES-D≥20), respectively. The relationships between PMPU and depression have been shown in our study. The rates of depression were higher among students with PMPU or low PA. Hierarchical analysis indicated that moderate or high PA was related to a greater decrease in the risk of depression for students with PMPU.

CONCLUSIONS

The findings indicate that PA moderates the association between PMPU and depression. Future researches with longitudinal design are warranted. The intervention programs of depression should consider individuals' health behaviors.

Leisure time physical activity and depressive symptoms among adolescents in Sweden

Background

Mental health problems have increased noticeably among adolescents. Physical activity has been identified as an important factor in the promotion of mental health. The purpose of this study was to explore how leisure time physical activity was associated with depressive symptoms among adolescents in Sweden.

Methods

Using binary logistic regression we analyzed Swedish data collected as part of the Children of Immigrants: Longitudinal Survey in Four European Countries. The complete sample used for analysis consisted of 3787 adolescents (including 1855 boys and 1932 girls).

Results

Adolescents who participated in physical activity during their leisure time on a daily, weekly, or monthly basis had substantially lower odds of often feeling depressed than those who were physically inactive. This pattern applied to both boys and girls. Relative to boys, girls had significantly higher odds of often feeling depressed.

Conclusions

The findings of this study suggested that participation in physical activity regularly during leisure time was associated with a lower level of depressive symptoms among adolescents in Sweden. Because of the cross-sectional study design conclusions about causality cannot be drawn. Future research based on longitudinal data is needed to further explore the mechanisms behind the association. This study calls for recognition of the value of physical activity in promoting mental health among adolescents.

Association between Active Travel to School and Depressive Symptoms among Early Adolescents

Background: Although much evidence has demonstrated the positive relationship of active school travel (AST) and physical health, little is known about the relationship of AST and mental health indicators among early adolescents, especially in Chinese populations. Thus, this study aimed to investigate the relationship of AST with depressive symptoms and its sex as well as age difference among early adolescents from Shanghai urban areas, China. Methods: 6478 adolescents (mean age = 13.6) in urban area were recruited, of whom boys accounted for 46.2%. A self-reported questionnaire in Chinese was used to collect data on AST and depressive symptoms, and other control variables. Multivariable logistic regression analyses were used to explore the relationships of AST with depressive symptoms. Results: Of all included participants, 53.2% of adolescents reported being active in AST without sex difference. The prevalence of depressive symptoms was 19.2% without sex difference. AST was associated with reporting no depressive symptoms in adolescents (adjusted OR = 1.20, 95%CI: 1.06–1.36). However, the relationship was significant in boys (adjusted OR = 1.34, 95%CI: 1.11–1.60), in those who were grade 8 (adjusted OR = 1.25, 95%CI: 1.01–1.55) and 9 (adjusted OR = 1.29, 95%CI: 1.01–1.65) adolescents. Conclusions: AST may play an important role in preventing depressive symptoms among early adolescents. However, the relationship of AST with depressive symptoms differed by sex and age. More research is encouraged to explore the mechanism linking AST and depressive symptoms among adolescents, especially in different contexts.

Association between Physical Activity, Food Consumption and Depressive Symptoms Among Young Adults in Spain: Findings of a National Survey

Young adults have a significant prevalence of mental disorders, which could lead to dysfunctional quality of life. Records of 1,645 Spanish adolescents were examined and multiple logistic regressions were performed. Being a woman, being older and having a sedentary life were all associated with a higher psychological vulnerability, whereas a low frequency of fresh fruit and bread/cereals consumption, as well as regular intense physical activity, were considered protective against such susceptibility. Regular physical activity and a diet with a high consumption of fruit and cereals may help reduce depressive symptoms, but sociodemographic features are as much as important as lifestyle habits.

Impact of problematic mobile phone use and insufficient physical activity on depression symptoms: a college-based follow-up study

Background

Insufficient physical activity (IPA) and mobile phone dependence are common coexisting behaviors among college students. However, the impact of the synergies between the two behaviors on depression has yet to be validated. Therefore, this study evaluated independent and interactive associations of problematic mobile phone use (PMPU) and IPA with depression symptoms and increased depressive symptoms among Chinese college students.

Methods

In total, 2134 college students participated in this follow-up study, which was conducted between June 2014 (wave 1) and December 2014 (wave 2) at Anhui Medical University. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use and the Center for Epidemiologic Studies Depression Scale were used to assess PMPU and depression symptoms, respectively. Physical activity (PA) was assessed with a reliable question from the Youth Risk Behavior Survey. Joint effects of PMPU and PA were calculated, and increased depressive symptoms were assessed. We used multivariable-adjusted odds ratios (OR) with 95% confidence intervals (CI) to evaluate associations between depression symptoms and PMPU, IPA, and the PMPU/IPA joint effect, estimated by binary logistic regression models.

Results

PMPU and high PMPU/IPA joint effect scores were significantly associated with depression symptoms in waves 1 (OR 7.36, 95% CI: 5.09, 10.66) and 2 (OR 3.74, 95% CI: 2.56, 5.48). IPA was significantly associated with depression symptoms in wave 1 (OR 1.40, 95% CI: 1.09, 1.79) but not wave 2 (OR 1.24, 95% CI: 0.95, 1.62). PMPU and high PMPU/IPA joint effect scores were also significantly associated with increased depressive symptoms (OR 2.36, 95% CI: 1.55, 3.60).

Conclusions

These results suggest that PMPU is an important factor for depression in college students, and IPA may be a synergistic factor.

The association between health literacy and psychosomatic symptoms of adolescents in China: a cross-sectional study

Background

Lower health literacy (HL) has been known to be involved in a range of common mental and physical disorders among adolescent students. Ample studies indicated low HL is associated with a series of chronic diseases even psychological diseases, nevertheless, little is known about this relationship among adolescents. In this context, the study aimed to examine associations between psychosomatic symptoms (physical and psychological symptoms) and HL in junior and senior high school students in China, and to provide guidance for improving the physical and mental health in Chinese adolescents.

Methods

A total of 22,628 junior and high school students in China were enrolled in this study. HL and psychosomatic symptoms were measured by self-report validated questionnaires. Multiple linear regression analyses were conducted to examine the associations between six sub-scales of HL and physical / psychological symptoms.

Results

Multiple linear regression analysis demonstrated that the sub-scales of HL showed a significantly negative association with physical symptoms and psychological symptoms (P <  0.05 for each). Physical symptoms was most strongly associated with IR (β = − 0.134), followed by SM (β = − 0.093), DB (β = − 0.059), SA (β = − 0.058) and PA (β = − 0.054). No statistically significant difference was found between HA and physical symptoms (P > 0.05). Meanwhile, psychological symptoms were most strongly associated with IR (β = − 0.160), followed by SA (β = − 0.129), SM (β = − 0.069), DB (β = − 0.031), HA (β = − 0.026) and PA (β = − 0.021).

Conclusion

These results indicated the importance of identifying the association of HL with physical and psychological symptoms, and provided the evidence that lower HL may serve as a critical and independent risk factor for poor health outcomes. Meanwhile, to maintain students’ desirable healthy status public health efforts for enhancing their HL level are urgently needed in adolescents.

Change in physical activity is not associated with change in mental distress among adolescents: the Tromsø study: Fit Futures

Background

Previous research shows that physical activity has a protective effect on mental distress in adults, but the relationship is less researched and seems more ambiguous for adolescents. Studies in this field have typically been cross-sectional by design and based on self-reported physical activity measures, which are known to be vulnerable to response bias. The aim of this study was to investigate the relationship between change in objectively assessed physical activity as measured by accelerometer and change in mental distress among adolescents using longitudinal data from The Tromsø Study: Fit Futures.

Method

This study was based on data from 676 upper-secondary school students (mean age 16.23 years at baseline, 45.26% boys) from The Tromsø Study: Fit Futures. Physical activity, mental distress and covariates were measured at baseline (T1) and follow-up (T2) 2 years later. Physical activity was objectively measured with an ActiGraph GT3X accelerometer over 7 days. Mental distress was measured with the Hopkins Symptom Checklist-10 (HSCL-10). Change score variables were computed as the difference between T1 and T2 in number of steps, number of minutes of moderate to vigorous physical activity (MVPA) and mental distress between T1 and T2, and analyzed using linear regression analysis.

Results

Changes in steps per day were not associated with changes in mental distress in neither the crude, partially, nor fully adjusted model. Neither was changes in minutes of MVPA per day. Interaction effects between change in both steps per day and minutes of MVPA and gender were also not statistically significant, nor was the interaction effects between baseline levels of mental distress and physical activity.

Conclusion

The results of our study indicate that for adolescents in the sample, change in physical activity is unrelated to change in mental distress over a two-year period.

Unhealthy eating and weight dissatisfaction in adolescents who never, occasionally, or regularly use smokeless tobacco (Swedish snus)

OBJECTIVE

Although cigarette smoking has been linked to weight-related concerns and unhealthy weight control practices, little is known about weight dissatisfaction and eating among adolescents who use smokeless tobacco (SLT) products. The use of Swedish moist snuff (snus) has increased dramatically over recent years, surpassing cigarette smoking among young people in several countries. This study investigated differences in unhealthy eating behaviors and weight dissatisfaction in male and female adolescents who never, occasionally, or regularly use snus.

METHOD

Adolescents aged 16-19 years enrolled in high school (11th, 12th, and 13th grades) completed a cross-sectional, online survey of adolescent health and well-being. Meal skipping and snus use frequency were assessed in the total sample (N = 23,622), and items assessing weight dissatisfaction (n = 4,195) and eating-related pathology (n = 3,563) were administered to subsamples. Analyses were adjusted for cigarette smoking, parental education, and socioeconomic status.

RESULTS

Adolescents who used snus, especially on a daily basis, reported less regular breakfast, lunch, and dinner consumption. Females who used snus on an occasional basis reported significantly more disturbed eating pathology. Snus use was associated with weight dissatisfaction in males and females, manifesting differentially according to gender and snus use frequency.

DISCUSSION

Unhealthy eating behaviors and weight dissatisfaction were significantly elevated among snus users aged 16-19 years. An increased awareness that occasional snus use may signal disturbed eating pathology among adolescent females is important for detection and prevention efforts. Parents, schools, and health professionals should be vigilant for possible snus use among weight-dissatisfied adolescents.