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      The association between leisure time physical activity in adolescence and poor mental health in early adulthood: a prospective cohort study

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          Abstract

          Background

          The incidence of poor mental health (MH) is increasing in Denmark and worldwide, especially among 16–24 year olds. Low physical activity (PA) during adolescence seems to be a risk factor for poor MH in early adulthood. Among adults, it appears that a high level of PA may be protective against poor MH.

          We aimed to examine whether high levels of leisure time physical activity (LTPA) during adolescence reduced the risk of poor MH at age 20/21.

          Methods

          Prospective cohort study with data collected during 2004–2010 in the western part of Denmark. The study population was 3031 young people (age 14/15 in 2004). LTPA was the exposure variable and originates from questionnaires in 2004/2007. MH was the outcome variable and was measured at age 20/21 in 2010. MH was evaluated using a short version of the CES-DC. Logistic regression was used to analyse the associations between levels of LTPA and MH. All analyses were stratified by gender.

          Results

          1,589 adolescents were included in the final analyses. Girls at 14/15 years of age with a low level of LTPA had an Adjusted Odds Ratio(AOR) of 1.63 (95 % CI = 1.23–2.17) for poor MH as 20/21 year olds, compared to girls with a high level of LTPA. Among boys, the corresponding AOR = 1.19 (95 % CI = 0.85–1.66). We found an exposure-response relationship between levels of LTPA and MH among girls, but not among boys. Girls with a reduction/persistent low level of LTPA between the ages of 15–18 had an increased risk for poor MH at age 20/21 compared to the reference group.

          Conclusions

          Among girls, we found an association between a low level of LTPA among 14/15 year olds as well as a reduction/persistent low level of LTPA over time with poor MH at 20/21 years. We found no association between low levels of LTPA and poor MH among 14/15 year olds boys however it appears that a reduction/persistent low level of LTPA over time may have some influence on the risk of poor MH at 20/21 years. It is important to address the change in habits of LTPA during adolescence to prevent poor MH.

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          Most cited references32

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          Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children.

          The utility of the Center for Epidemiologic Studies Depression Scale for Children (CES-DC), a modified version of the Center for Epidemiologic Studies Depression Scale, was explored in a sample of children, adolescents, and young adults at high or low risk for depression according to their parents' diagnosis. Proband parents were participants in the Yale Family Study of Major Depression who had children between the ages of 6 and 23 years. Diagnostic and self-report information on offspring was collected over two waves, spaced 2 years apart, from 1982 to 1986. Support was obtained for the reliability and validity of the CES-DC as a measure of depressive symptoms, especially for girls and for children and adolescents aged 12-18 years. Children with major depressive disorder or dysthymia, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), had elevated scores in comparison with all other respondents. The CES-DC lacked diagnostic specificity; children with a range of current DSM-III diagnoses had elevated scores on the measure. A cutoff point of 15 and above for screening children and adolescents for current major depressive disorder or dysthymia may be optimal. Depressed respondents scoring below this cutoff point (false negatives) showed better social adjustment than true positives; nondepressed respondents scoring above this cutoff point (false positives) showed worse adjustment than true negatives. Factor analysis was used to construct an abbreviated, four-item version of the scale. The abbreviated scale was shown to be useful as a screen.
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            Physical activity, leisure-time screen use and depression among children and young adolescents.

            Adolescent mental disorders remain a relatively neglected area of research, despite evidence that these conditions affect youth disproportionately. We examined associations between physical activity, leisure-time screen use and depressive symptoms among Australian children and adolescents. Large cross-sectional observational study. Self-reported physical activity and leisure-time screen behaviours, and depressive symptoms using the Short Mood and Feeling Questionnaire were assessed in 8256 students aged 10-16 years (mean age=11.5 years, SD=0.8). Thirty three percent of the sample reported moderate to high depressive symptoms, with rates higher among females (OR=1.18; 95% CI: 1.02, 1.36; p=0.001). Increased opportunities to be active at school outside class (OR=0.70; 0.58, 0.85; p<0.001), being active in physical education classes (OR=0.77; 0.69, 0.86; p<0.001), greater involvement in sports teams at school (OR=0.77; 0.67, 0.88; p<0.001) and outside of school (OR=0.84; 0.73, 0.96; p=0.01) were all independently associated with lower odds for depressive symptoms. Meeting recommended guidelines for physical activity (OR=0.62; 0.44, 0.88; p=0.007) and, for 12-14 year olds, leisure-time screen use (OR=0.77; 0.59, 0.99; p=0.04) were also independently associated with lower odds for depressive symptoms. Higher levels of physical activity among children and young adolescents, and lower levels of leisure-time screen use among young adolescents, are associated with lower depressive symptoms. Longitudinal studies are needed to understand the causal relationships between these variables. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
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              A prospective study of leisure-time physical activity and mental health in Swedish health care workers and social insurance officers.

              This study analyzes longitudinal associations between self-reported leisure-time physical activity (PA) and perceived stress, burnout and symptoms of depression and anxiety. Cohort data collected in 2004 and 2006 from health care and social insurance workers in western Sweden (2694 women; 420 men) were analyzed. Cox regression was conducted to examine associations between baseline levels of PA and mental health (MH) problems 2 years later. Cross-sectional analysis show that individuals reporting either light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) were less likely to report high levels of perceived stress, burnout and symptoms of depression and anxiety, as compared to individuals reporting a sedentary lifestyle. The risks of symptoms of depression, burnout, and high stress levels at follow-up were significantly lower for those reporting LPA or MVPA at baseline. For symptoms of anxiety, an activity level corresponding to MVPA was required. Participation in PA appeared to lower the risk of developing MH problems two years later. This relationship involved LPA and MVPA regarding feelings of depression, burnout and perceived stress, and exclusively MVPA regarding feelings of anxiety. The implications of these findings are important, as preventive strategies for psychosocial stress and mental health problems are needed. Copyright © 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                perhpo@rm.dk
                Karin.Biering@vest.rm.dk
                Johan.Hviid.Andersen@vest.rm.dk
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                5 January 2016
                5 January 2016
                2015
                : 16
                : 3
                Affiliations
                Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Hospital West Jutland, Gl. Landevej 61, Herning, 7400 Denmark
                Article
                2658
                10.1186/s12889-015-2658-5
                4700625
                27449417
                91b52e4f-7ac0-435c-a0a3-936c07abcc88
                © Hoegh Poulsen et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 30 October 2015
                : 21 December 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                adolescents,gender,leisure time physical activity,depressive symptoms
                Public health
                adolescents, gender, leisure time physical activity, depressive symptoms

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