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Damme KSF, Vargas TG, Walther S, Shankman SA, Mittal VA. Physical and mental health in adolescence: novel insights from a transdiagnostic examination of FitBit data in the ABCD study. Transl Psychiatry 2024; 14:75. [PMID: 38307840 PMCID: PMC10837202 DOI: 10.1038/s41398-024-02794-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
Adolescence is among the most vulnerable period for the emergence of serious mental illnesses. Addressing this vulnerability has generated interest in identifying markers of risk for symptoms and opportunities for early intervention. Physical fitness has been linked to psychopathology and may be a useful risk marker and target for early intervention. New wearable technology has made assessing fitness behavior more practical while avoiding recall and self-report bias. Still, questions remain regarding the clinical utility of physical fitness metrics for mental health, both transdiagnostically and along specific symptom dimensions. The current study includes 5007 adolescents (ages 10-13) who participated in the Adolescent Brain Cognitive Development (ABCD) study and additional sub-study that collected fitness data from wearable technology and clinical symptom measures. Physical fitness metrics included resting heart rate (RHR- an index of cardiovascular health), time spent sedentary (associated with increased inflammation and cardiovascular disease), and time spent in moderate physical activity (associated with increased neurogenesis, neuroplasticity, and healthy neurodevelopment). Self-report clinical symptoms included measures of psychosis-like experiences (PLE), internalizing symptoms, and externalizing symptoms. Increased RHR- lower cardiovascular fitness- related only to greater internalizing symptoms (t = 3.63). More sedentary behavior related to elevated PLE severity (t = 5.49). More moderate activity related to lower PLE (t = -2.69) and internalizing (t = -6.29) symptom severity. Wearable technology fitness metrics linked physical health to specific mental health dimensions, which emphasizes the utility of detailed digital health data as a marker for risk and the need for precision in targeting physical health behaviors to benefit symptoms of psychopathology.
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Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, Evanston, IL, USA.
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA.
| | - Teresa G Vargas
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Sebastian Walther
- University of Bern, University Hospital of Psychiatry, Translational Research Center, Bern, Switzerland
| | | | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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Damme K, Vargas T, Walther S, Shankman S, Mittal V. Physical and Mental Health in Adolescence: Novel Insights from a transdiagnostic examination of FitBit data in the ABCD Study. RESEARCH SQUARE 2023:rs.3.rs-3270112. [PMID: 37886441 PMCID: PMC10602093 DOI: 10.21203/rs.3.rs-3270112/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Adolescence is among the most vulnerable period for the emergence of serious mental illnesses. Addressing this vulnerability has generated interest in identifying markers of risk for symptoms and opportunities for early intervention. Physical fitness has been linked to psychopathology and may be a useful risk marker and target for early intervention. New wearable technology has made assessing fitness behavior more practical while avoiding recall and self-report bias. Still, questions remain regarding the clinical utility of physical fitness metrics for mental health, both transdiagnostically and along specific symptom dimensions. The current study includes 5007 adolescents (ages 10 to 13) who participated in the Adolescent Brain Cognitive Development (ABCD) study and additional sub-study that collected fitness data from wearable technology and clinical symptom measures. Physical fitness metrics included resting heart rate (RHR- an index of cardiovascular health), time spent sedentary (associated with increased inflammation and cardiovascular disease), and time spent in moderate physical activity (associated with increased neurogenesis, neuroplasticity, and healthy neurodevelopment). Self-report clinical symptoms included measures of internalizing symptoms, externalizing symptoms, and psychosis-like experiences - PLE). Increased RHR- lower cardiovascular fitness- related only to greater internalizing symptoms (t = 3.63). More sedentary behavior related to elevated PLE severity (t = 5.49). More moderate activity related to lower PLE (t=-2.69) and internalizing (t=-6.29) symptom severity. Wearable technology fitness metrics linked physical health to specific mental health dimensions, which emphasizes the utility of detailed digital health data as a marker for risk and the need for precision in targeting physical health behaviors to benefit symptoms of psychopathology.
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Swed S, Alibrahim H, Bohsas H, Nashwan AJ, Elsayed M, Almoshantaf MB, Kadri SA, Sawaf B, Albuni MK, Battikh E, Elkalagi NK, Ahmed SM, Ahmed EM, Hasan MM, Patwary MM, Shoib S, Hafez W. Mental distress links with physical activities, sedentary lifestyle, social support, and sleep problems: A Syrian population cross-sectional study. Front Psychiatry 2023; 13:1013623. [PMID: 36727085 PMCID: PMC9885115 DOI: 10.3389/fpsyt.2022.1013623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background Mental diseases are very widespread and difficult to treat, affecting around 12% of the global population in 2019. Since social interaction is crucial to human existence and loneliness has been proven to be a significant predictor of depressive symptoms, it stands to reason that social connection problems would also contribute to depression. Physical inactivity seems to weaken and aggravate insulin tolerance alterations, glucose homeostasis, and plasma triglyceride levels, thereby influencing one's mood and happiness. This suggests that physical inactivity may be a significant risk factor for mental illness. This research contributes to our understanding of the mental health situation in Syria by exploring associations between a set of measurable characteristics that may be adjusted. Methods An online quantitative cross-sectional study was conducted between March and April 2022 in Syria, using a structured questionnaire that assesses data on behaviors of health, health in general, wellbeing, and adult population quality of life. Results Among 1,224 respondents (371 men and 853 women), women have shown higher levels of mental distress, sleep issues, low engagement in structured activities, and a difficult work environment than men. Women experiencing mental anguish have reported being more sedentary, participating in less scheduled activities, and receiving less social support. Conclusions There are observable connections between high sedentary time and women experiencing mental distress. The mental health of Syrian women in distress was associated with a lack of participation in both organized activities and physical exercise in their free time. Furthermore, sleep issues and financial troubles were seen in persons with mental diseases of both males and females.
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Affiliation(s)
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | | | | | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | | | - Saeed A. Kadri
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Bisher Sawaf
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | - Elias Battikh
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Nashaat K. Elkalagi
- Internal and Tropical Medicine Department, Faculty of Medicine, Al Arish University, Al Arish, Egypt
| | | | - Eman M. Ahmed
- Department of Obstetrics and Gynecology, Nile Valley University, Khartoum, Sudan
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | - Wael Hafez
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
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Iverson GL, Iverson IA. Perceived cognitive impairment in high school students in the United States. Front Psychol 2022; 13:1019159. [PMID: 36267070 PMCID: PMC9577466 DOI: 10.3389/fpsyg.2022.1019159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Some youth experience cognitive difficulties that interfere with their ability to learn and function well in a school environment. We examined correlates of perceived cognitive impairment among high school students who completed a national survey conducted by the United States Centers for Disease Control and Prevention (CDC) in 2019. Methods Participants were high school students (grades 9–12) who completed the Youth Risk Behavior Survey (YRBS) in 2019. The CDC uses this survey to monitor risk behaviors. Students answered the following question ‘Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?’ as either ‘yes’ or ‘no.’ Student responses to this question were analyzed in relation to demographic variables and variables pertaining to adversity, mental health problems, and drug use. Results The sample included 8,349 students between the ages of 14 and 18, with 4,093 boys (49%) and 4,256 girls (51%). A large proportion reported having serious difficulty concentrating, remembering, or making decisions due to physical, mental, or emotional problems (38%). A significantly larger proportion of girls (45%) than boys (30%) reported experiencing cognitive impairment [χ2(1) = 212.23, p < 0.001; Odds Ratio = 1.95, 95% confidence interval = 1.78–2.13]. Youth who exercised regularly were significantly less likely to report cognitive impairment. Binary logistic regression was used to examine the associations between perceived cognitive impairment and adversity, mental health, and lifestyle variables separately for boys [χ2(11) = 569.158, p < 0.001; Nagelkerke R2 = 0.212] and girls [χ2(11) = 1,026.189, p < 0.001; Nagelkerke R2 = 0.321]. Being bullied, feeling unsafe or threatened at school, getting very low grades, insufficient sleep, and using illicit drugs were independently associated with perceived cognitive impairment in both boys and girls—after controlling for associations with depression and suicidality. Youth who denied mental health problems, psychosocial adversities, and using illicit drugs reported much lower rates of perceived cognitive impairment (boys = 13%, girls = 15%). Conclusion A remarkably large proportion of high school students in the United States reported experiencing serious difficulty with their cognitive functioning over the past year. Girls were significantly more likely to endorse perceived cognitive difficulties compared to boys. There was a strong association between perceived cognitive impairment and the experience of psychosocial adversity.
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Affiliation(s)
- Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Charlestown, Massachusetts, United States
- MassGeneral Hospital for Children Sports Concussion Program, Boston, Massachusetts, United States
- *Correspondence: Grant L. Iverson,
| | - Ila A. Iverson
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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Adolescents' Physical Activity and Psychological Adjustment Across the First Year of the COVID-19 Pandemic. J Phys Act Health 2022; 19:481-489. [PMID: 35894979 DOI: 10.1123/jpah.2022-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/09/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022]
Abstract
The outbreak of the COVID-19 virus dramatically changed daily life and created many obstacles for adolescents to engage in physical activity (PA). This study tracked rates of self-reported PA and examined its impact on adjustment among adolescents during the first 14 months of the pandemic. Canadian adolescents (N = 1068, 14-18 y, meanage = 16.95 y) reported on their frequency of PA, context of activity, and adjustment across 4 time points (April 2020 to June 2021). In line with our hypothesis, higher average levels of vigorous PA across the pandemic predicted less anxiety and depression and higher self-esteem at our study's end. Vigorous PA also buffered the relationships COVID-19 stress had with anxiety and self-esteem. The results further support recommendations for PA throughout the pandemic and while dealing with lockdown situations.
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Hoffmann MD, Barnes JD, Tremblay MS, Guerrero MD. Associations between organized sport participation and mental health difficulties: Data from over 11,000 US children and adolescents. PLoS One 2022; 17:e0268583. [PMID: 35648742 PMCID: PMC9159603 DOI: 10.1371/journal.pone.0268583] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to explore the association between participation in organized sport and a broad array of mental health difficulties among US children and adolescents. The data (cross-sectional) were from Data Release 3.0 (one-year follow-up visits on the full cohort) of the Adolescent Brain Cognitive Development (ABCD) study-a broadly representative sample of 11,235 US children and adolescents aged 9 to 13 years. Parents/guardians provided self-reports of their child's mental health difficulties using the Child Behavior Checklist. To assess participation in organized sport, children and adolescents were categorized into one of four groups: 1) participation in team sport, 2) participation in individual sport, 3) participation in team and individual sport, and 4) non-sport participation. Participation in team sport compared to non-sport participation was associated with 10% lower anxious/depressed scores, 19% lower withdrawn/depressed scores, 17% lower social problems scores, 17% lower thought problems scores, and 12% lower attention problems scores. Participation in team sport compared to non-sport participation was also associated with 20% lower rule-breaking behavior scores for females (compared to males). Conversely, participation in individual sport compared to non-sport participation was associated with 16% higher anxious/depressed scores, 14% higher withdrawn/depressed scores, 12% higher social problems scores, and 14% higher attention problems scores. Participation in both team and individual sport compared to non-sport participation was associated with 17% lower rule-breaking behavior scores for females (compared to males). Results indicate that team sport participation was associated with fewer mental health difficulties, whereas individual sport participation was associated with greater mental health difficulties. The findings complement previous research suggesting that team sport participation may be a vehicle to support child and adolescent mental health. Additional research is needed to determine to what extent, and under what circumstances, participation in individual sport may be problematic for younger cohorts.
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Affiliation(s)
- Matt D Hoffmann
- Department of Kinesiology, California State University, Fullerton, California, United States of America
| | | | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Michelle D Guerrero
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
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Chi G, Wang L. The Association of Sports Participation With Depressive Symptoms and Anxiety Disorder in Adolescents. Front Public Health 2022; 10:860994. [PMID: 35719630 PMCID: PMC9203890 DOI: 10.3389/fpubh.2022.860994] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
AimAn increasing body of evidence has evidenced that physical activity is negatively associated with depression and anxiety in adolescents, although the associations between various modalities of PA with depression and anxiety have yet to be effectively explored. This study aimed to investigate the associations between sports participation and depression and anxiety among a sample of Chinese adolescents.Methods2,374 adolescents from eight schools were invited to participate in this survey, of whom 1,714 adolescents from grades 7, 8, 10 and 11 were included for final analysis. Depressive symptoms and anxiety disorder were assessed using the Patient Health Questionnaire−9 (PHQ-9), as well as the Generalized Anxiety Disorder−7 (GAD-7), respectively. Sport participation was assessed using a single question. Additionally, sociodemographic factors were assessed using a self-reported questionnaire. Ordinal logistic regression was used to estimate sport participation's associations with depressive symptoms and anxiety disorders separately, having controlled for all sociodemographic covariates.ResultsAmong all study participants, those with less participation in sport-related activities had a greater likelihood of reporting depressive symptoms (Odd ratio [OR] for never = 2.07; OR for 1–3 times per month = 1.77; OR for 1–2 times per week = 1.77), as well as anxiety disorders (OR for never = 1.61; OR for 1–3 times per month = 1.69; OR for 1–2 times per week = 1.38).ConclusionEncouraging adolescents to engage in more sports participation would provide an effective and feasible approach for mental health promotion. Despite this study having found promising evidence, the research findings should be replicated using more improved research with an enhanced study design. Future researchers are encouraged to design and implement sports participation interventions aimed at promoting mental health among adolescents, while future China-based studies are encouraged to replicate or negate our study findings.
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Affiliation(s)
- Guijun Chi
- China Volleyball College, Beijing Sport University, Beijing, China
- Department of Physical Education, Tangshan Normal University, Tangshan, China
| | - Lei Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
- *Correspondence: Lei Wang
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Iverson GL, Karr JE. Association Between Concussions and Suicidality in High School Students in the United States. Front Neurol 2022; 13:810361. [PMID: 35493820 PMCID: PMC9039310 DOI: 10.3389/fneur.2022.810361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Importance Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality. Objective To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables. Design This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender. Setting A national sampling of U.S. high school students. Participants Eleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls. Exposure(s) Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality. Main Outcomes and Measures The main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis. Results The final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)]. Conclusions and Relevance There was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys.
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Affiliation(s)
- Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Spaulding Research Institute, Charlestown, MA, United States
- MassGeneral Hospital for Children Sports Concussion Program, Boston, MA, United States
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, United States
- *Correspondence: Grant L. Iverson
| | - Justin E. Karr
- Department of Psychology, University of Kentucky, Lexington, KY, United States
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Cheng W, Liu J, Zhi M, Shen D, Shao M, Zhang C, Wang G, Jiang Z. Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device. Ann Noninvasive Electrocardiol 2021; 27:e12903. [PMID: 34669995 PMCID: PMC8739623 DOI: 10.1111/anec.12903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022] Open
Abstract
Background Heart rate variability (HRV), a sensitive marker of stress and autonomic nervous disorders, was significantly decreased in cardiovascular disease, inflammation, and surgical injury. However, the effect of radical gastrectomy on HRV parameters needs to be further investigated. Methods A prospective, observational study including 45 consecutive enrolled patients undergoing radical gastrectomy in our enhanced recovery after surgery (ERAS) programs was conducted. Frequency‐ and time‐domain parameters of HRV from 1 day prior to operation to 4 days postoperatively were continuously measured. Meanwhile, plasma cortisol and inflammatory markers were recorded and correlated to HRV parameters. Results Heart rate variability showed a solidly circadian rhythm. Anesthesia severely disturbed HRV parameters, resulting in a reduction of most of the HRV parameters. Frequency‐domain parameter (including VLF) and time‐domain parameters (including the SDNN, SDANN, and triangular index) of HRV demonstrated a significant reduction compared to preoperative values on the postoperative day 1 (Pod1), and these HRV parameters could return to baseline on Pod2 or Pod3, indicating surgical stress and autonomic nerve dysfunction existed in the early postoperative period. Inflammatory biomarkers were significantly elevated on Pod1 and Pod3. Plasma cortisol decreased significantly on Pod1 and Pod3. Both inflammatory biomarkers and plasma cortisol had no significant correlation with HRV parameters. Conclusions Compared with plasma cortisol and inflammation biomarkers, HRV is more sensitive to detect surgical stress and autonomic nervous dysfunction induced by radical gastrectomy in patients with gastric cancer.
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Affiliation(s)
- Wei Cheng
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiang Liu
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mengwei Zhi
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Danli Shen
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mingyue Shao
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Cheng Zhang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Gang Wang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhiwei Jiang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Vreeker A, Fears SC, Service SK, Pagani L, Takahashi JS, Araya C, Araya X, Bejarano J, Lopez MC, Montoya G, Montoya CP, Teshiba TM, Escobar J, Cantor RM, López-Jaramillo C, Macaya G, Molina J, Reus VI, Sabatti C, Ophoff RA, Freimer NB, Bearden CE. Genetic analysis of activity, brain and behavioral associations in extended families with heavy genetic loading for bipolar disorder. Psychol Med 2021; 51:494-502. [PMID: 31813409 DOI: 10.1017/s0033291719003416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Disturbed sleep and activity are prominent features of bipolar disorder type I (BP-I). However, the relationship of sleep and activity characteristics to brain structure and behavior in euthymic BP-I patients and their non-BP-I relatives is unknown. Additionally, underlying genetic relationships between these traits have not been investigated. METHODS Relationships between sleep and activity phenotypes, assessed using actigraphy, with structural neuroimaging (brain) and cognitive and temperament (behavior) phenotypes were investigated in 558 euthymic individuals from multi-generational pedigrees including at least one member with BP-I. Genetic correlations between actigraphy-brain and actigraphy-behavior associations were assessed, and bivariate linkage analysis was conducted for trait pairs with evidence of shared genetic influences. RESULTS More physical activity and longer awake time were significantly associated with increased brain volumes and cortical thickness, better performance on neurocognitive measures of long-term memory and executive function, and less extreme scores on measures of temperament (impulsivity, cyclothymia). These associations did not differ between BP-I patients and their non-BP-I relatives. For nine activity-brain or activity-behavior pairs there was evidence for shared genetic influence (genetic correlations); of these pairs, a suggestive bivariate quantitative trait locus on chromosome 7 for wake duration and verbal working memory was identified. CONCLUSIONS Our findings indicate that increased physical activity and more adequate sleep are associated with increased brain size, better cognitive function and more stable temperament in BP-I patients and their non-BP-I relatives. Additionally, we found evidence for pleiotropy of several actigraphy-behavior and actigraphy-brain phenotypes, suggesting a shared genetic basis for these traits.
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Affiliation(s)
- Annabel Vreeker
- Department of Genetics, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Scott C Fears
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Susan K Service
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Lucia Pagani
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Dobeco Spa a Socia Unico, Milano, Italy
| | - Joseph S Takahashi
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Carmen Araya
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San José, Costa Rica
| | - Xinia Araya
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San José, Costa Rica
| | - Julio Bejarano
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San José, Costa Rica
| | - Maria C Lopez
- Departamento de Psiquiatría Facultad de Medicina, Grupo de Investigación en Psiquiatría (Research Group in Psychiatry; GIPSI), Universidad de Antioquia, Medellín, Colombia
| | - Gabriel Montoya
- Departamento de Psiquiatría Facultad de Medicina, Grupo de Investigación en Psiquiatría (Research Group in Psychiatry; GIPSI), Universidad de Antioquia, Medellín, Colombia
| | - Claudia Patricia Montoya
- Departamento de Psiquiatría Facultad de Medicina, Grupo de Investigación en Psiquiatría (Research Group in Psychiatry; GIPSI), Universidad de Antioquia, Medellín, Colombia
| | - Terri M Teshiba
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Javier Escobar
- Department of Psychiatry and Family Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Rita M Cantor
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Carlos López-Jaramillo
- Departamento de Psiquiatría Facultad de Medicina, Grupo de Investigación en Psiquiatría (Research Group in Psychiatry; GIPSI), Universidad de Antioquia, Medellín, Colombia
- Mood Disorders Program, Hospital Universitario San Vicente Fundacion, Medellín, Colombia
| | - Gabriel Macaya
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San José, Costa Rica
| | | | - Victor I Reus
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Chiara Sabatti
- Department of Health Research and Policy, Division of Biostatistics, Stanford University, Stanford, CA, USA
| | - Roel A Ophoff
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University California Los Angeles, Los Angeles, CA, USA
| | - Nelson B Freimer
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University California Los Angeles, Los Angeles, CA, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University California Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University California Los Angeles, Los Angeles, CA, USA
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11
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Chauhan S, Srivastava S, Kumar P, Patel R, T. M, Dhillon P. Interaction of substance use with physical activity and its effect on depressive symptoms among adolescents. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1851411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Muhammad T.
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
| | - Preeti Dhillon
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India
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12
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Xie Y, Zhu M, Wu X, Tao S, Yang Y, Li T, Zou L, Xu H, Tao F. Interaction between physical activity and problematic mobile phone use on suicidality in Chinese college students. BMC Psychiatry 2020; 20:517. [PMID: 33097008 PMCID: PMC7585233 DOI: 10.1186/s12888-020-02920-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has found a relationship between problematic mobile phone use (PMPU) and suicidality. However, few studies have examined the interaction effects between low physical activity (PA) and PMPU on suicidality among college students. This study aimed to examine the interactions of PA and PMPU and their impact on suicidality in a school-based sample among Chinese college students. METHODS Analysis is based on date from two university in China, which recruited 4787 participants. Binomial logistic regression models were used to explore the associations of PA, PMPU with suicidal ideation and suicide attempt, as well as the interaction of PA and PMPU with suicidality. RESULTS The prevalence of suicide attempt and suicidal ideation were 3.5 and 7.2%, respectively. Low PA was significantly associated with suicide attempt (OR = 3.48, 95%CI: 2.52-4.81) and suicidal ideation (OR = 1.90, 95%CI: 1.46-2.46). PMPU was significantly associated with suicide attempt (OR = 3.65, 95%CI: 2.66-5.01) and suicidal ideation (OR = 2.83, 95%CI: 2.25-3.54). Interaction analysis indicated that low PA and PMPU were interactively associated with suicide attempt (OR = 9.51, 95%CI: 6.15-14.73, P < 0.001), RERI = 4.85(1.20-8.50), AP = 0.51(0.29-0.73), SI = 2.32(1.34-4.04). There was no additive interaction effects between PA and PMPU on suicidal ideation. CONCLUSIONS The findings reveals that the intervention programs of suicide attempt should consider the students PA levels and PMPU.
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Affiliation(s)
- Yang Xie
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Ming Zhu
- grid.12981.330000 0001 2360 039XZhongshan School of Medicine, Sun Yat-Sen University, 74 2nd Zhongshan Road, Yuexiu District, Guangzhou, 510000 Guangdong China
| | - Xiaoyan Wu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Shuman Tao
- grid.452696.aDepartment of Nephrology, The Second Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601 Anhui China
| | - Yajuan Yang
- grid.186775.a0000 0000 9490 772XSchool of Nursing, Anhui Medical University, 15 Feicui Road, Hefei, 230601 Anhui China
| | - Tingting Li
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Liwei Zou
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Honglv Xu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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13
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Ferro MA, Lipman EL, Van Lieshout RJ, Gorter JW, Shanahan L, Boyle M, Georgiades K, Timmons B. Multimorbidity in Children and Youth Across the Life-course (MY LIFE): protocol of a Canadian prospective study. BMJ Open 2019; 9:e034544. [PMID: 31685517 PMCID: PMC6859408 DOI: 10.1136/bmjopen-2019-034544] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Multimorbidity, the co-occurrence of a chronic physical condition and mental disorder, affects a substantial number of children and youth and can lead to compromised quality of life, hardship for families, and an increased burden on the healthcare system. We are conducting a study to document the course of mental disorder in children and youth diagnosed with a chronic physical condition; identify predictors of child and youth multimorbidity; examine whether the effects of these predictors are moderated by relevant psychosocial and biological factors; explore potential inflammatory and stress biomarkers that mediate the onset of child and youth multimorbidity; and, assess whether multimorbidity in children and youth alters patterns of mental health service use. METHODS AND ANALYSIS Multimorbidity in Children and Youth Across the Life-course (MY LIFE) is a prospective study. Two hundred and fifty children and youth aged 2-16 years diagnosed with a chronic physical condition along with one parent will be recruited from the outpatient clinics at a paediatric tertiary care centre. Data will be collected using a multi-informant, multimethod design at four time-points (at recruitment, and at 6, 12 and 24 months postrecruitment). Parents will provide reports for all children/youth. In addition, youth ≥10 years will self-report. Mental disorder will be assessed using structured interviews. On completion of data collection, participant-reported data will be linked to provincial health records to identify mental health services use. Multilevel analyses (survival, proportional hazard, structural equation modelling) will be used to address MY LIFE objectives. ETHICS AND DISSEMINATION This study has been approved by the University of Waterloo Human Research Ethics Board and the Hamilton Integrated Research Ethics Board. Findings will be disseminated to key stakeholders using a number of outlets (peer-reviewed publications and conferences, lay informational pamphlets, social media).
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Affiliation(s)
- Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michael Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Kathy Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Brian Timmons
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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14
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Barwise AK, Patten CA, Bock MJ, Hughes CA, Brockman TA, Valdez Soto MA, Wi CI, Juhn YJ, Witt DR, Sinicrope S, Kreps SR, Saling HD, Levine JA, Balls-Berry JE. Acceptability of Robotic-Assisted Exercise Coaching Among Diverse Youth: Pilot Study. JMIR Pediatr Parent 2019; 2:e12549. [PMID: 31518333 PMCID: PMC6715060 DOI: 10.2196/12549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/11/2019] [Accepted: 04/30/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Almost 80% of adolescents do not achieve 60 minutes or more of physical activity each day as recommended by current US national guidelines. There is a need to develop and promote interventions that increase physical activity among adolescents. With increased interest in digital technologies among adolescents, robotic-assisted platforms are a novel and engaging strategy to deliver physical activity interventions. OBJECTIVE This study sought to assess the potential acceptability of robotic-assisted exercise coaching among diverse youth and to explore demographic factors associated with acceptance. METHODS This pilot study used a cross-sectional survey design. We recruited adolescents aged 12-17 years at three community-based sites in Rochester, MN. Written informed consent was obtained from participants' parents or guardians and participants gave consent. Participants watched a brief demonstration of the robotic system-human interface (ie, robotic human trainer). The exercise coaching was delivered in real time via an iPad tablet placed atop a mobile robotic wheel base and controlled remotely by the coach using an iOS device or computer. Following the demonstration, participants completed a 28-item survey that assessed sociodemographic information, smoking and depression history, weight, and exercise habits; the survey also included the eight-item Technology Acceptance Scale (TAS), a validated instrument used to assess perceived usefulness and ease of use of new technologies. RESULTS A total of 190 adolescents participated in this study. Of the participants, 54.5% were (103/189) male, 42.6% (81/190) were racial minorities, 5.8% (11/190) were Hispanic, and 28.4% (54/190) lived in a lower-income community. Their mean age was 15.0 years (SD 2.0). A total of 24.7% (47/190) of participants met national recommendations for physical activity. Their mean body mass index (BMI) was 21.8 kg/m2 (SD 4.0). Of note, 18.4% (35/190) experienced depression now or in the past. The mean TAS total score was 32.8 (SD 7.8) out of a possible score of 40, indicating high potential receptivity to the technology. No significant associations were detected between TAS score and gender, age, racial minority status, participant neighborhood, BMI, meeting national recommendations for physical activity levels, or depression history (P>.05 for all). Of interest, 67.8% (129/190) of participants agreed that they and their friends were likely to use the robot to help them exercise. CONCLUSIONS This preliminary study found that among a racially and socioeconomically diverse group of adolescents, robotic-assisted exercise coaching is likely acceptable. The finding that all demographic groups represented had similarly high receptivity to the robotic human exercise trainer is encouraging for ultimate considerations of intervention scalability and reach among diverse adolescent populations. Next steps will be to evaluate consumer preferences for robotic-assisted exercise coaching (eg, location, duration, supervised or structured, choice of exercise, and/or lifestyle activity focus), develop the treatment protocol, and evaluate feasibility and consumer uptake of the intervention among diverse youth.
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Affiliation(s)
- Amelia K Barwise
- Clinical and Translational Science PhD Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States.,Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Behavioral Health Research Program, Minnesota BioBusiness Center, Mayo Clinic, Rochester, MN, United States
| | - Martha J Bock
- Department of Psychiatry and Psychology, Behavioral Health Research Program, Minnesota BioBusiness Center, Mayo Clinic, Rochester, MN, United States
| | - Christine A Hughes
- Department of Psychiatry and Psychology, Behavioral Health Research Program, Minnesota BioBusiness Center, Mayo Clinic, Rochester, MN, United States
| | - Tabetha A Brockman
- Center for Clinical and Translational Science,Community Engagement Program, Department of Psychiatry and Psychology, Minnesota BioBusiness Center, Mayo Clinic, Rochester, MN, United States
| | - Miguel A Valdez Soto
- Center for Clinical and Translational Science, Community Engagement Program, Mayo Clinic, Rochester, MN, United States
| | - Chung-Il Wi
- Asthma Epidemiology Research Unit and Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
| | - Young J Juhn
- Asthma Epidemiology Research Unit and Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
| | - Daniel R Witt
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Stephen Sinicrope
- Department of Psychiatry and Psychology, Behavioral Health Research Program, Minnesota BioBusiness Center, Mayo Clinic, Rochester, MN, United States
| | - Samantha R Kreps
- Health Sciences, University of Minnesota, Rochester, MN, United States.,Center for Clinical and Translational Science, Community Engagement Program, Minnesota BioBusiness Center, Mayo Clinic, Rochester, MN, United States
| | - Henry D Saling
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - James A Levine
- Fondation Ipsen, Paris, France.,Division of Endocrinology, Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Joyce E Balls-Berry
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, United States
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15
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Langvik E, Saksvik-Lehouillier I, Kennair LEO, Sørengaard TA, Bendixen M. Gender differences in factors associated with symptoms of depression among high school students: an examination of the direct and indirect effects of insomnia symptoms and physical activity. Health Psychol Behav Med 2019; 7:179-192. [PMID: 34040846 PMCID: PMC8114401 DOI: 10.1080/21642850.2019.1615926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective Scant research exists on the gender-specific association between physical activity, insomnia symptoms and depressive symptoms among adolescents. The present study investigates the direct and indirect association of insomnia and physical activity with symptoms of depression. Design In a community-based sample (N = 1485) we investigated factors associated with symptoms of depression focusing on insomnia. The study also included measures of physical activity and controlled for parental work- and sexual minority status. Body mass Index (BMI) was calculated for a sub-sample (n = 617) reporting weight and height. Results The results showed that self-reported insomnia was highly prevalent, and the association between insomnia and depression was strong. The association between insomnia and depression was significantly stronger for girls than for boys. The effect of physical activity was substantially weaker compared to insomnia. Insomnia mediated the relationship between physical activity and depression for both boys and girls. Despite expectation based on the existing literature, BMI showed no association with symptoms of depression or physical activity. Conclusion The results address the importance of a gender-specific approach when investigating mental health among adolescents. Given the high prevalence, interventions aimed at reducing insomnia is important in the prevention of mental illness, especially among girls.
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Affiliation(s)
- Eva Langvik
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | | - Mons Bendixen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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