Physical activity and exercise as a universal depression prevention in young people: A narrative review

Potential role of hippocampal neurogenesis in spinal cord injury induced post-trauma depression

It has been reported both in clinic and rodent models that beyond spinal cord injury directly induced symptoms, such as paralysis, neuropathic pain, bladder/bowel dysfunction, and loss of sexual function, there are a variety of secondary complications, including memory loss, cognitive decline, depression, and Alzheimer's disease. The large-scale longitudinal population-based studies indicate that post-trauma depression is highly prevalent in spinal cord injury patients. Yet, few basic studies have been conducted to address the potential molecular mechanisms. One of possible factors underlying the depression is the reduction of adult hippocampal neurogenesis which may come from less physical activity, social isolation, chronic pain, and elevated neuroinflammation after spinal cord injury. However, there is no clear consensus yet. In this review, we will first summarize the alteration of hippocampal neurogenesis post-spinal cord injury. Then, we will discuss possible mechanisms underlie this important spinal cord injury consequence. Finally, we will outline the potential therapeutic options aimed at enhancing hippocampal neurogenesis to ameliorate depression.

The effects of physical activity on adolescents' depression: evidence from China

Background

Depression is becoming a common threat to the mental health of Chinese adolescents. As an intermediate stage between being healthy and having depression, identifying factors influencing depressive may contribute to providing more options for the prevention and treatment of depression.

Objective

The study aims to explore the effects of physical activity on adolescent depression, focusing on the times and hours of activity per week.

Methods

The study used a cross-sectional dataset collected in Ruyang County, Henan Province in September 2022, including a sample of 5,629 adolescents in 31 compulsory public schools in the county. We utilized Ordinary Least Squares (OLS) to analyze the impact of physical activity on adolescents' depression scores, and probit model to analyze the influence of physical activity on adolescents' depression. To examine whether there is a U-shaped relationship between physical activity and depression, we included the squared terms of times and hours of activity in models.

Results

The results showed that: (1) The times of physical activity significantly reduces Chinese adolescent depression. An increase in physical activity by one time per week is associated with a mean decrease of 0.354 points in depression scores (p < 0.01). However, an increase of one time of physical activity per week is associated with an average 1% increase in the likelihood of experiencing depression(p < 0.05), while the hours of physical activity was statistically insignificant. (2) Physical activity has a U-shaped (not linear) relationship with adolescent depression, with 7-8 times per week or 7-9 h of physical activity per week being the optimal range.

Conclusion

The study found that increasing the frequency of physical activity positively impacts adolescent depression, while increasing the hours does not show a significant association. Furthermore, a U-shaped relationship exists between times of activity, hours of activity, and adolescent depression, suggesting that moderate activity is optimal.

The role of a mindful movement-based program (Movimento Biologico) in health promotion: results of a pre-post intervention study

Introduction

Mindful movement is a comprehensive approach that integrates various bodily, emotional and cognitive aspects into physical activity, promoting overall well-being. This study assessed the impact of a mindful movement program, known as Movimento Biologico (MB), on participants psychological well-being (PWB), positive mental health (PMH), sense of coherence (SOC), and interoceptive awareness.

Methods

MB program was conducted for students attending the bachelor's degree in Kinesiology and Sport Sciences of University of Perugia over 8 weeks (from October 16 to November 27, 2022). Participants were requested to fill in four questionnaires before and after the MB program: (1) 18-item PWB scale; (2) 9-item PMH scale; (3) 13-item SOC scale; (4) 32-item scale for Multidimensional Assessment of Interoceptive Awareness (MAIA). Wilcoxon signed-rank tests were used to assess changes, with significance set at p < 0.05.

Results

Thirty-eight students (mean age 21.2, 60.5% male) participated. Several MAIA subscales, including noticing (p = 0.003), attention management (p = 0.002), emotional awareness (p = 0.007), self-regulation (p < 0.001), body listening (p = 0.001), and trusting (p = 0.001), showed significant improvements. PMH increased significantly (p = 0.015), and there was a significant enhancement in the autonomy subscale of PWB (p = 0.036). SOC and overall PWB also improved, though not significantly.

Conclusion

The MB program significantly improved participants' positive mental health and interoceptive awareness. This likely resulted from better recognition and management of positive physiological sensations, a stronger link between physical sensations and emotions, enhanced confidence in one's body, and increased autonomy.

A scoping review of physical activity interventions in youth attending child and adolescent mental health services

BACKGROUND

There has been an international effort to improve physical health in general and in those with mental illness. Physical activity (PA) may be beneficial as an adjunctive treatment for mental health disorders and to improve physical well-being.

AIMS

The objective of this scoping review is to understand the extent and type of evidence in relation to PA interventions offered in child and adolescent mental health services (CAMHS). Eligibility was determined using the Population, Concept, Context framework. Studies were included if the participants were under 18 years old, attending CAMHS and where PA interventions were offered.

METHODS

PubMed, MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO and SportDiscus were searched without language or date restrictions. Titles and abstracts, followed by full texts, were screened by two independent reviewers. Two reviewers carried out data extraction, and discrepancies in any of these processes were resolved in consultation with a third reviewer.

RESULTS

After 2213 non-duplicate titles and abstracts were screened, 2090 were excluded and 123 full texts were screened. Seventeen studies met inclusion criteria. Included studies demonstrated PA interventions to be effective in reducing depressive symptoms and improving psychosocial functioning. While no study reported significant changes in anthropometric measurements, 2 studies demonstrated increased aerobic fitness.

CONCLUSION

Evidence that PA interventions are being offered in CAMHS worldwide is limited. Included studies demonstrate potential benefits in depressive symptoms, psychosocial functioning, self-esteem and aerobic fitness in youth attending CAMHS. Future research should identify effective ways to incorporate exercise interventions in CAMHS and evaluate long-term benefits.

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.

The dynamic relationships between well-being, behavioral restrictions, and health behaviors during the COVID-19 pandemic: A large-scale intensive longitudinal network study

The behavioral restrictions disrupting daily life during the COVID-19 pandemic have profoundly impacted well-being, and health behaviors have been advocated to prevent decline. To understand how processes related to fluctuation in well-being unfold within individuals, analyses on the within-person level are required. In this preregistered intensive longitudinal study, 1,709 individuals from the Norwegian adult population provided data daily over 40 consecutive days during the pandemic. The responses were modeled in a multilevel vector autoregressive model to estimate within-person networks, across and within-day, and a between-person network. All three networks revealed productivity, relatedness, and optimism as positively associated. Social distancing was contemporaneously negatively associated with productivity and relatedness. Among behavioral factors, being physically active predicted lower relatedness across days but displayed positive associations with relatedness, productivity, and optimism contemporaneously. Alcohol consumption predicted lower productivity across and within-day, although revealing a positive association with optimism within-day. Being social online and feeling related to others displayed a temporal negative bidirectional relationship. In contrast, being social online was positively associated with optimism, productivity, and relatedness contemporaneously. Our study emphasizes the dynamic nature of well-being and its complex associations with behavioral factors during the pandemic. The study shed light on opposing associations of behavioral factors at the within- and between-person level.

Path of Physical Exercise's Impact on Deviant Behavior Among Chinese Adolescents

Purpose

Physical exercise is an important predictor of deviant behavior in adolescents; however, the paths and mechanisms underlying this relationship remain understudied.

Patients and Methods

This cross-sectional study used education tracking data of 8725 Chinese adolescents (4453 males, 4240 females, average age 14 ± 0.73) to construct a chain mediation model to explore whether sleep quality and mental health mediated the relationship between physical exercise and adolescent deviant behavior.

Results

The results show that physical exercise cannot directly predict adolescent deviant behavior; however, it can indirectly affect deviant behavior through the mediating effect of sleep quality and mental health as well as the chain mediating benefit of "sleep quality-mental health".

Conclusion

Sleep quality and mental health are important internal factors of physical exercise that inhibit deviant adolescent behavior. The lack of physical activity and poor sleep quality should be prioritized in interventions regarding deviant behavior among Chinese adolescents.

Development of a multivariate prediction model for antidepressant resistant depression using reward-related predictors

Introduction

Individuals with depression who do not respond to two or more courses of serotonergic antidepressants tend to have greater deficits in reward processing and greater internalizing symptoms, yet there is no validated self-report method to determine the likelihood of treatment resistance based on these symptom dimensions.

Methods

This online case-control study leverages machine learning techniques to identify differences in self-reported anhedonia and internalizing symptom profiles of antidepressant non-responders compared to responders and healthy controls, as an initial proof-of-concept for relating these indicators to medication responsiveness. Random forest classifiers were used to identify a subset from a set of 24 reward predictors that distinguished among serotonergic medication resistant, non-resistant, and non-depressed individuals recruited online (N = 393). Feature selection was implemented to refine model prediction and improve interpretability.

Results

Accuracies for full predictor models ranged from .54 to .71, while feature selected models retained 3-5 predictors and generated accuracies of .42 to .70. Several models performed significantly above chance. Sensitivity for non-responders was greatest after feature selection when compared to only responders, reaching .82 with 3 predictors. The predictors retained from feature selection were then explored using factor analysis at the item level and cluster analysis of the full data to determine empirically driven data structures.

Discussion

Non-responders displayed 3 distinct symptom profiles along internalizing dimensions of anxiety, anhedonia, motivation, and cognitive function. Results should be replicated in a prospective cohort sample for predictive validity; however, this study demonstrates validity for using a limited anhedonia and internalizing self-report instrument for distinguishing between antidepressant resistant and responsive depression profiles.

Irisin/BDNF signaling in the muscle-brain axis and circadian system: A review

In mammals, the timing of physiological, biochemical and behavioral processes over a 24-h period is controlled by circadian rhythms. To entrain the master clock located in the suprachiasmatic nucleus of the hypothalamus to a precise 24-h rhythm, environmental zeitgebers are used by the circadian system. This is done primarily by signals from the retina via the retinohypothalamic tract, but other cues like exercise, feeding, temperature, anxiety, and social events have also been shown to act as non-photic zeitgebers. The recently identified myokine irisin is proposed to serve as an entraining non-photic signal of exercise. Irisin is a product of cleavage and modification from its precursor membrane fibronectin type Ⅲ domain-containing protein 5 (FNDC5) in response to exercise. Apart from well-known peripheral effects, such as inducing the "browning" of white adipocytes, irisin can penetrate the blood-brain barrier and display the effects on the brain. Experimental data suggest that FNDC5/irisin mediates the positive effects of physical activity on brain functions. In several brain areas, irisin induces the production of brain-derived neurotrophic factor (BDNF). In the master clock, a significant role in gating photic stimuli in the retinohypothalamic synapse for BDNF is suggested. However, the brain receptor for irisin remains unknown. In the current review, the interactions of physical activity and the irisin/BDNF axis with the circadian system are reconceptualized.

Results from Estonia's 2022 Report Card on Physical Activity for Children and Youth: Research Gaps and Five Key Messages and Actions to Follow

The aim of this article is to summarize the results of the 2022 Estonian Physical Activity Report Card across 10 indicators based on available scientific data and national databases, and, additionally, to compare the current results with previous Report Card results. A national expert panel, consisting of research and policy experts, identified the available sources and synthesized as well as graded relevant data related to the physical activity (PA) of Estonian children and youth. Grade B was assigned to Organized Sports and Physical Activity (B-), Community and Environment (B+), and Government (B). Grade C was assigned to Overall Physical Activity (C+), Physical Fitness (C+), Family and Peers (C-), and School (C+). The lowest grade, D, was assigned to Active Play (D), Active Transportation (D+), and Sedentary Behaviors (D-). In Estonia, the participation rate in organized sport is relatively high, and government in addition to community support seem to be at a relatively good level. However, a relatively high number of children and youth did not meet the current PA guidelines, and the levels of sedentary behavior and screen time were very high. The PA of children and youth should be a cross-disciplinary priority, and focus should be put on developing schoolyards and outdoor breaks, varied and easily accessible organized sport, the use of active transportation, and the implementation of physical education that supports leisure time activities.

Physical activity and depression of Chinese college students: chain mediating role of rumination and anxiety

Objective

To explore the relationship between physical activity and depression among college students, as well as the mediating role of rumination and anxiety.

Methods

A total of 1,292 Chinese college students were investigated by physical activity questionnaire, rumination scale, self-rating anxiety scale (SAS), and depression scale.

Results

(1) There was a significant negative correlation between physical activity and depression (r = -0.399, p < 0.01), and the direct path of physical activity on depression was significant (β = -0.399, t = -13.374, p < 0.01). (2) Physical activity negatively predicted rumination (β = -0.322, t = -10.440, p < 0.01) and anxiety (β = -0.222, t = -7.089, p < 0.01). Rumination positively predicted anxiety (β = 0.283, t = 9.017, p < 0.01) and depression (β = 0.267, t = 9.046, p < 0.01). Anxiety positively predicted depression (β = 0.262, t = 8.902, p < 0.01). (3) Rumination and anxiety play a significant mediating role between physical activity and depression. The mediating effect involves three paths: physical activity → rumination → depression (the mediating effect value: -0.076); physical activity → anxiety → depression (the mediating effect value: -0.052). Physical activity → rumination → anxiety → depression (the mediating effect value: -0.021).

Conclusion

(1) Physical activity can negatively predict the rumination, anxiety, and depression of college students, which means physical activity can reduce rumination, anxiety, and depression of college students. (2) Physical activity can not only directly affect the depression of college students, but also indirectly affect depression through the independent intermediary role of rumination and anxiety, and the chain mediation of rumination and anxiety.

Sport and physical exercise in sustainable mental health care of common mental disorders: Lessons from the COVID-19 pandemic

The large-scale disruptions to physical activity during the coronavirus pandemic have been found to be a leading predictor of common mental disorders. In addition, regular physical exercise has been found to alleviate anxiety, sadness and depression during the pandemic. These findings, together with numerous studies published before the pandemic on the effects of physical activity on mental health, should be considered in the provision of mental health care following the pandemic. Cross-sectional research has revealed that all types of exercise and sport are associated with a reduced mental health burden. Therefore, the effectiveness of exercise and sport participation in sustainable mental health care as well as the causal relationship between exercise, psychosocial health and common mental disorders merit further investigation. Physical activity and sport, with their global accessibility, significant and clinically meaningful efficacy as well as virtual absence of adverse effects, offer a promising option for the promotion of mental health, including the prevention and treatment of common mental disorders. Physical exercise and sport are likely to become valuable public mental health resources in the future.

Changes in physical activity, diet, sleep, and mental well-being when starting university: A qualitative exploration of Australian student experiences

Objective: To explore young adult's experiences of how starting university influenced their physical activity, diet, sleep, and mental well-being, and barriers and enablers to health behavior change. Participants: University students aged 18-25 years. Methods: Three focus groups were conducted in November 2019. Inductive thematic approach was utilized to identify themes. Results: Students (female: n = 13, male: n = 2, other gender identity: n = 1, 21.2 (1.6) years) reported mental well-being, physical activity levels, diet quality and sleep health were negatively affected. Stress, study demands, university timetabling, not prioritizing physical activity, cost and availability of healthy foods, and difficulty falling asleep were key barriers. Health behavior change interventions aiming to support mental well-being need to include both information and support features. Conclusions: There is a significant opportunity to improve the transition to university for young adults. Findings highlight areas to target in future interventions to improve physical activity, diet, and sleep of university students.

Adaptogens on Depression-Related Outcomes: A Systematic Integrative Review and Rationale of Synergism with Physical Activity

Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) Hypericum perforatum (St. John's Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by Crocus sativus L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John's Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression.

Nomogram including indirect bilirubin for the prediction of post-stroke depression at 3 months after mild acute ischemic stroke onset

Background

Post-stroke depression (PSD) has been proven to be associated with stroke severity. Thus, we hypothesized that the prevalence of PSD would be lower in patients with mild stroke. We aim to explore predictors of depression at 3 months after mild acute ischemic stroke (MAIS) onset and to develop a practical and convenient prediction model for the early identification of patients at high risk.

Methods

A total of 519 patients with MAIS were consecutively recruited from three hospitals in Wuhan city, Hubei province. MAIS was defined as a National Institute of Health Stroke Scale (NIHSS) score of ≤5 at admission. Meeting the DSM-V diagnostic criteria and a 17-item Hamilton Rating Scale for Depression (HAMD-17) score of >7 at their 3-month follow-up were considered the primary outcomes. A multivariable logistic regression model was used to determine the factors adjusted for potential confounders, and all independent predictors were brought into the construction of a nomogram to predict PSD.

Results

The prevalence of PSD is up to 32% at 3 months after MAIS onset. After adjusting for potential confounders, indirect bilirubin (p = 0.029), physical activity (p = 0.001), smoking (p = 0.025), hospitalization days (p = 0.014), neuroticism (p < 0.001), and MMSE (p < 0.001) remained independently and significantly related with PSD. The concordance index (C-index) of the nomogram jointly constructed by the aforementioned six factors was 0.723 (95% CI: 0.678-0.768).

Conclusion

The prevalence of PSD seems equally high even if the ischemic stroke is mild, which calls for great concern from clinicians. In addition, our study found that a higher level of indirect bilirubin can lower the risk of PSD. This finding may provide a potential new approach to PSD treatment. Furthermore, the nomogram including bilirubin is convenient and practical to predict PSD after MAIS onset.

Physical Activity Alters Functional Connectivity of Orbitofrontal Cortex Subdivisions in Healthy Young Adults: A Longitudinal fMRI Study

Physical activity (PA) plays an important role in affect processing. Studies describe the orbitofrontal cortex (OFC) as a major hub for emotion processing and the pathophysiology of affective disorders. Subregions of the OFC show diverse functional connectivity (FC) topographies, but the effect of chronic PA on subregional OFC FC still lacks scientific understanding. Therefore, we aimed at investigating the effects of regular PA on the FC topographies of OFC subregions in healthy individuals within a longitudinal randomized controlled exercise study. Participants (age: 18-35 years) were randomly assigned to either an intervention group (IG; N = 18) or a control group (CG; N = 10). Fitness assessments, mood questionnaires, and resting state functional magnetic resonance imaging (rsfMRI) were performed four times over the duration of 6 months. Using a detailed parcellation of the OFC, we created subregional FC topography maps at each time point and applied a linear mixed model to assess the effects of regular PA. The posterior-lateral right OFC showed a group and time interaction, revealing decreased FC with the left dorsolateral prefrontal cortex in the IG, while FC in the CG increased. Group and time interaction in the anterior-lateral right OFC with the right middle frontal gyrus was driven by increased FC in the IG. The posterior-lateral left OFC showed a group and time interaction based on differential change in FC to the left postcentral gyrus and the right occipital gyrus. This study emphasized regionally distinctive FC changes induced by PA within the lateral OFC territory, while providing aspects for further research.

Moderated by personal perception: The preventive relationship between home HIIT dance and depression during the COVID-19 pandemic in China

Introduction

Lockdowns during the COVID-19 pandemic were believed to greatly increase the risk of depression among isolated residents in both China and in Western countries. How to effectively reduce this risk has become one of the key issues in the field of public mental health.

Methods

The present study seeks to examine the preventive relationship between doing home HIIT dance-which became popular during Shanghai's COVID-19 lockdown in 2022-and depression, and how such a preventive relationship has been mediated by different personal perception factors using an online survey with 528 samples.

Results

The preventive relationship between doing home HIIT dance and depression was differently mediated by residents' personal perception factors, such as perceived benefits, severity, and self-efficacy, based on the health belief model.

Discussion

These results deepen the research on the psychological effects of doing home HIIT dance on preventing depression, especially in the COVID-19 lockdown period, emphasizing the possible moderation effects of different self-perception factors.

Experience of childhood sexual violence and its associations with depressive symptoms among university students in Guangdong, China

BACKGROUND

Sexual violence, especially childhood sexual violence, is a serious social issue, yet the prevalence of childhood sexual violence among university students is unknown. We aimed to investigate the prevalence of these experiences and assess their associations with depressive symptoms.

METHODS

The study included 29,311 participants, mean (SD) age 20.5 (1.4) years, from a cross-sectional survey of a multi-stage stratified cluster random sample from all universities in Guangdong province of China. Data were obtained through an anonymous electronic questionnaire from December 2 to 15, 2019. Undergraduates' experiences of childhood sexual violence were self-reported. Current depressive symptoms were measured by Center for Epidemiological Studies Depression Scale (CESD-10). Stress measures in recent months were measured by the College Student Stress Scale.

RESULTS

The prevalence of childhood sexual violence experience among university students was 4.8 % (95 % confidence interval (CI) = 4.6 %-5.0 %), 7.3 % (95 % CI = 6.9 %-7.7 %) for female students and 1.8 % (95 % CI = 1.6 %-2.0 %) for male students. Sexual violence in childhood was related to students' current depressive symptoms after adjustment for stress and socio, demographic characteristics (adjusted prevalence ratio (PRa) = 1.36, 95 % CI = 1.30-1.42). Significant differences in the association between childhood sexual violence and depressive symptoms were also found by sex.

CONCLUSIONS

Experiences of childhood sexual violence among university students are not negligible and associated with their current depressive symptoms. The association between childhood sexual violence and depressive symptoms among female and male students is different. Schools, families, and society as a whole should be encouraged to provide education on healthy sexual behavior preventive interventions related to sexual violence for childhood students.

The moderating effect of physical activity on the relationship between bullying and mental health among sexual and gender minority youth

BACKGROUND

Sexual and gender minority youth frequently experience bullying, which often contributes to higher depressive symptoms and lower self-esteem. Given that physical activity (PA) can mitigate depressive symptoms and improve self-esteem, we examined the moderating effect of PA on the relationship between bullying and mental health among sexual and gender minority youth.

METHODS

Data from the Lesbian, Gay, Bisexual, Transgender, and Queer National Teen Survey (n = 9890) were analyzed. Hierarchical regression analyses examined the influence of history and frequency of being bullied, PA, and the interaction of these variables on depressive symptoms and self-esteem. Simple slopes analyses were used to probe significant interactions.

RESULTS

Results indicated the importance of accounting for bullying history when examining effects of PA on mental health. PA was negatively related to depression (t = -4.18, p < 0.001) and positively related to self-esteem (t = 12.11, p < 0.001). Bullying frequency was positively related to depression (t = 19.35, p < 0.001) and negatively related to self-esteem (t = -12.46, p < 0.001). There was a significant interaction between bullying frequency and PA for depression (t = 4.45, p < 0.001) and self-esteem (t = -4.69, p < 0.001). Post hoc analyses suggested that the positive effects of PA on mental health may be limited to those not bullied because it had a negligible effect on those who were bullied.

CONCLUSION

Results suggest that sexual and gender minority youth exercise interventions aiming to improve mental health should first address bullying history; otherwise, their effectiveness may be limited to those who have been bullied.

Mindfulness is associated with reduced barriers to exercise via decreasing psychological distress in help-seeking young adults: A cross-sectional brief report

AIM

Mental illness is common among young people. Exercise has benefits for mental health; however, young people experience a range of barriers to engaging in physical activity, one of which is psychological distress. Mindfulness is a modifiable factor that can reduce distress and may, in turn, reduce perceived barriers to physical activity. The aim of this work was to explore associations between dispositional mindfulness, psychological distress and barriers to engaging in physical activity.

METHODS

We used cross-sectional survey data from young adults aged 15-25 years who attended youth mental health services (headspace centres). Demographic, mindfulness, exercise barriers and wellbeing data were collected.

RESULTS

Mediation analysis showed that greater dispositional mindfulness reduced perceived barriers to exercise via reductions in psychological distress among 88 help-seeking young Australians.

CONCLUSION

Interventions to increase dispositional mindfulness may be helpful in reducing psychological distress and lessening barriers to exercise engagement, therefore promoting mental health among young people experiencing mental health symptoms.

Health-Related Behaviors and Perceived Addictions: Predictors of Depression During the COVID Lockdown

ABSTRACT

The COVID-19 pandemic led to a worldwide implementation of measures to contain the virus from spreading, and social isolation was one of those measures. Social isolation is associated with increased susceptibility to various neuropsychiatric disorders, including depression. Because this risk varies between populations and their respective habits, understanding which behaviors play a positive or harmful role is fundamental for people with depression under these conditions. This study aims to 1) compare health-related behaviors (HRBs) and perceived addictions between healthy individuals and individuals who reported having a depressive disorder at the time of the first outbreak of the COVID-19 pandemic in Portugal, and 2) test which HRB and perceived addictions are associated with depression. Participants were a matched for age and sex and comprised 968 adults divided into two groups: healthy (484, 50%) and depressed (484, 50%). They completed online self-report questionnaires, and the data were analyzed in SPSS. Logistic regressions showed that being a health professional, getting up in a later time during weekends, and a higher consumption of soft drinks increased the risk for depression. In contrast, higher education and higher intensity of physical activity decreased this risk. Perceived addictions to TV, social networking, and gaming increased the risk for depression. HRBs and the identified addictions associated with depression during the confinement should be targeted in clinical and community interventions.

Will Sirtuin 2 Be a Promising Target for Neuroinflammatory Disorders?

Neuroinflammatory disorder is a general term that is associated with the progressive loss of neuronal structure or function. At present, the widely studied diseases with neuroinflammatory components are mainly divided into neurodegenerative and neuropsychiatric diseases, namely, Alzheimer’s disease, Parkinson’s disease, depression, stroke, and so on. An appropriate neuroinflammatory response can promote brain homeostasis, while excessive neuroinflammation can inhibit neuronal regeneration and damage the central nervous system. Apart from the symptomatic treatment with cholinesterase inhibitors, antidepressants/anxiolytics, and neuroprotective drugs, the treatment of neuroinflammation is a promising therapeutic method. Sirtuins are a host of class III histone deacetylases, that require nicotinamide adenine dinucleotide for their lysine residue deacetylase activity. The role of sirtuin 2 (SIRT2), one of the sirtuins, in modulating senescence, myelin formation, autophagy, and inflammation has been widely studied. SIRT2 is associated with many neuroinflammatory disorders considering it has deacetylation properties, that regulate the entire immune homeostasis. The aim of this review was to summarize the latest progress in regulating the effects of SIRT2 on immune homeostasis in neuroinflammatory disorders. The overall structure and catalytic properties of SIRT2, the selective inhibitors of SIRT2, the relationship between immune homeostasis and SIRT2, and the multitasking role of SIRT2 in several diseases with neuroinflammatory components were discussed.

Physical Inactivity and Sedentariness: Languorous Behavior Among Adolescents in 80 Countries

PURPOSE

High rates of adolescent physical inactivity and sedentary behavior have been reported worldwide, but the combined prevalence of languorous behavior (physical inactivity and/or sedentary behavior) may more accurately reflect just how few adolescents meet World Health Organization recommendations.

METHODS

We analyzed nationally representative data from 325,219 students in 80 countries that participated in the Global School-based Student Health Survey between 2009 and 2018. Students were classified as physically inactive if they reported engaging in moderate or vigorous physical activity less than 60 minutes daily. Students were classified as being sedentary if they sat for three or more hours per day outside of school, such as when having screen time not related to studying. Statistics for each country were generated using complex samples analysis, then the results from all countries were synthesized.

RESULTS

In total, 84% of students were physically inactive, 37% were sedentary, and 91% met the definition for the concept we are calling languorous behavior.

DISCUSSION

Establishing specific evidence-based guidelines for increasing physical activity and decreasing sitting time will enable progress toward reducing languorous behavior among adolescents.

EFFECT OF PHYSICAL EXERCISE ON MEDICAL REHABILITATION TREATMENT OF DEPRESSION

ABSTRACT Introduction: Depression is a common disease worldwide. The main treatment methods currently include medication, psychotherapy, and physical therapy. However, due to limitations in treatment methods, treatment compliance is poor. Participating in various sports is very effective in treating depression. Objective: To verify the influence of sports on the condition of depression and on the effect of its clinical treatment. Methods: The article selected a total of 60 hospitalized patients with depression who were randomly divided into two groups: an experimental group and a control group. The control group took antidepressant drugs for eight weeks, and the experimental group took the drugs with the supplementary practice of sports. The two groups of patients were tested for serum β-endorphin (β-EP) levels before and after treatment, and HAMD scores were performed. Results: The scores and serum β-endorphin (β-EP) levels of the two groups of patients were different, showing that effect of the treatment was better in the experimental group. Conclusion: Physical exercise therapy can mobilize the enthusiasm of patients with depression. This treatment plan increases treatment efficiency and is suitable for long-term clinical promotion and application. Level of evidence II; Therapeutic studies - investigation of treatment results.

Effects of a 6-Month Aerobic Exercise Intervention on Mood and Amygdala Functional Plasticity in Young Untrained Subjects

Acute exercise has beneficial effects on mood and is known to induce modulations in functional connectivity (FC) within the emotional network. However, the long-term effects of exercise on affective brain circuits remain largely unknown. Here, we investigated the effects of 6 months of regular exercise on mood, amygdala structure, and functional connectivity. This study comprised N = 18 healthy sedentary subjects assigned to an intervention group (IG; 23.9 ± 3.9 years; 3 trainings/week) and N = 10 subjects assigned to a passive control group (CG; 23.7 ± 4.2 years). At baseline and every two months, performance diagnostics, mood questionnaires, and structural and resting-state-fMRI were conducted. Amygdala-nuclei segmentation and amygdala-to-whole-brain FC analysis were performed. Linear mixed effects models and correlation analyses were conducted between FC, relVO_2max, and mood scores. Data showed increases in relVO_2max exclusively in the IG. Stronger anticorrelation in amygdala-precuneus FC was found, along with a stronger positive correlation in the amygdala-temporal pole FC in the IG after 4 and 6 months, while mood and amygdala volume did not reveal significant interactions. The relVO_2max/amygdala-temporal pole FC correlated positively, and the amygdala-precuneus/amygdala-temporal pole FC correlated negatively. Findings suggest that exercise induced long-term modulations of the amygdala FC with the precuneus and temporal pole, shedding light on potential mechanisms by which exercise has positive influences on mood-related networks, typically altered in affective disorders.

Higher Concentration of Adrenocorticotropic Hormone Predicts Post-Stroke Depression

Background

Post-stroke depression (PSD) is the most common neuropsychiatric complication after stroke, seriously affecting the quality of survivors’ life. As one of the important causes of PSD, neuroendocrine mechanism has been widely studied in recent years. The main objective of this study was to investigate the relationship between adrenocorticotropic hormone (ACTH) on admission and PSD at 3 months.

Methods

This is a hospital-based prospective cohort study, which was conducted at three independent hospitals (Tongji Hospital, Wuhan First Hospital and Wuhan Central Hospital) between August 2018 and June 2019. A total of 768 ischemic stroke patients were finally eligible for analysis and categorized into equal tertiles according to the distribution of ACTH and the number of patients. The χ²-test, Mann–Whitney U-test and Kruskal–Wallis test were used to check for statistical significance. And restricted cubic spline (RCS) regression model was used to explore the non-linear relationship between continuous ACTH levels and PSD at 3 months.

Results

The optimal cut-off points of ACTH were as follows: (T1) 0.32–20.55 pg/mL, (T2) 20.56–39.79 pg/mL, (T3) 39.80–143.40 pg/mL. A total of 305 patients (39.7%) were diagnosed as PSD at 3 months follow-up. Significant differences were found between the PSD and non-PSD groups in ACTH concentration (P = 0.001). After adjustment for all conventional confounders, the odds ratios of PSD were 1.735 (95% CI = 1.176–2.560, P = 0.005) for the highest tertile of ACTH and 1.496 (95% CI = 1.019–2.194, P = 0.040) for the middle tertile of ACTH, as compared with the lowest tertile. In multiple-adjusted RCS regression, continuous ACTH showed saturation effect relation with PSD risk after 31.02 pg/mL (P for nonlinear = 0.0143).

Conclusion

Higher ACTH level on admission is a significant and independent biomarker to predict the development of PSD at 3 months follow-up. Besides, saturation effect was revealed even if the underlying mechanism is unclear. For stroke patients, doctors should pay attention to the baseline ACTH for screening high-risk PSD in clinical practice.

Psychological distress and associated factors among kidney transplant recipients and living kidney donors during COVID-19

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has caused significant psychological distress globally. Our study assessed the prevalence of psychological distress and associated factors during COVID-19 pandemic among kidney transplant recipients and kidney donors.

METHODS

A cross-sectional survey of 497 participants (325 recipients and 172 donors) was conducted from 1st May to 30th June 2020 in Singapore. The survey questionnaire assessed knowledge levels of COVID-19, socio-demographic data, health status, psychosocial impact of COVID-19, and precautionary behaviors during the pandemic. Psychological distress was defined as having anxiety, depression, or stress measured by the validated Depression, Anxiety and Stress Scale-21. Linear regression analyses were used to assess factors associated with higher psychological distress.

RESULTS

The prevalence of psychological distress was 14.3% (95% confidence interval: 11.5-17.6%) in the overall population; it was 12.8% (9.79-16.6%) in recipients and 13.4% (9.08-19.6%) in donors with no significant difference (P = 0.67). Younger age (21-49 vs. ≥50 years), unmarried status, non-Singapore citizen, worse health conditions, and worrying about physical and mental health were associated with higher psychological distress. Malays (versus Chinese), taking precautionary measures (hand sanitization), and receiving enough information about COVID-19 were associated with lower psychological distress. No interactions were observed between recipients and donors.

CONCLUSIONS

At least one in ten recipients and donors suffer from psychological distress during COVID-19 pandemic. Focused health education to younger adults, unmarried individuals, non-Singapore citizens, and those with poor health status could potentially prevent psychological distress in recipients and donors.

Somatic, psychological and economic benefits of regular physical activity beginning in childhood

Physical activity is a natural part of a healthy life-style, which should be nurtured from early childhood. Regular physical activity mitigates against the global problems of overweight and obesity, hypertension, anxiety and depression. It lowers the morbidity and mortality from cardiovascular disease and provides hope for sustainable economics to support an ageing population into their retirement. This is preventative health economics that can be achieved with integrated support from families, communities, health-care professionals and governments at all levels. At present, children lack the support of those responsible for them at a societal level to adequately protect them from the physical and emotional consequences of reduced physical activity.

Personalized individual-based exercise prescriptions are effective in treating depressive symptoms of college students during the COVID-19: A randomized controlled trial in China

BACKGROUND

The COVID-19 pandemic has seriously increased depression prevalence among the public, including Chinese college students. However, many exercise cannot be performed as usual under the stay-at-home order. This study was a 12-week three-arm randomized controlled trial using the intention-to-treat principle, aiming to explore and compare the feasibility and effect of individual-based personalized aerobic-exercise and resistance-training prescriptions on depressive symptoms in college students, and conclude with some recommendations for individual-based exercise prescriptions.

METHODS

Eighty-six college students with depressive symptoms were randomized into aerobic-exercise (AE), resistance-training (RT), and wait-list control (WLC) groups. Participants in two experimental groups received 12-week personalized AE and RT prescriptions on their individual situations, respectively. No intervention was implemented on participants in the WLC group. Depressive symptoms and physical activity (PA) were measured by Zung Self-Rating Depression Scale (SDS) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All data were collected at the baseline, 4, 8, and 12 weeks, and 4-week post-intervention.

RESULTS

At 12 weeks, 72.09% of depressive participants improved to "normal." Participants exhibited a statistical reduction in SDS in all 3 groups (p < 0.05) at 12 weeks compared to baseline. Follow-up assessments showed no significant increase in SDS at 4-week post-intervention compared to 12 weeks (p > 0.05). The independent t-test revealed significantly lower SDS in AE and RT group than in WLC group (p _AE < 0.001 and p _RT < 0.05) at 4, 8, and 12 weeks, and 4-week post-intervention. Furthermore, the PA of participants (including total PA and intensities) in both experimental groups represented a significant improvement at 4-week post-intervention compared to baseline (p < 0.05), while no differences were observed in the PA of participants in the WLC group (p > 0.05).

CONCLUSION

Personalized exercise prescriptions have good feasibility as they can increase adherence to intervention and reduce serious adverse events. Besides, individual-based personalized aerobic-exercise and resistance-training prescriptions result in a similar effect in relieving depressive symptoms and improving physical activity in college students. The individual-based exercise programs performed in 45- to 60- min with progressive moderate-to-vigorous intensity, 3 times/week for at least 12 weeks, may reduce depressive symptoms in college students during the COVID-19.

Pediatric orthopedic injury prevention for team sports post COVID-19

Queries of youth orthopedic sports injuries from the U.S. National Electronic Surveillance System, a database from the Consumer Product Safety Commission, demonstrate decreased orthopedic injuries related to team sports during the COVID-19 pandemic, indicative of reduced sports participation. Multiple articles have shown that COVID-19 had a marked effect on the physical and psychological wellbeing of the youth. The lockdown resulted in a cessation in school attendance and sports activities, especially team sports. Though increased emphasis has been placed on children infected by COVID-19, less attention has been given to healthy children. Numerous articles discussed the physical and psychological benefits for the youth returning to physical activity and sports; however, few have addressed detraining and deconditioning concerns postpandemic. This article discusses a safe return to team sports for the youth experiencing physical and psychological changes related to the pandemic. Orthopedic injuries are anticipated to increase as restrictions are relaxed. A multidisciplinary team presents a review of common youth sports orthopedic injuries, a discussion of psychological issues youths have experienced during COVID and why sports participation is beneficial for youth, and a risk assessment for pain and limited range of motion for youth returning to sports. The intent of this article is to increase awareness of the physical and psychological changes experienced by youth due to their inability to participate in team sports during the pandemic. Family medicine and primary care providers need to recognize the increased risks for injury and proactively encourage the youth to return to sports in a safe manner.

Exercise interventions in child and adolescent mental health care: An overview of the evidence and recommendations for implementation

Background

The use of physical activity interventions in mental health care for adults has a large academic evidence base and numerous examples of real-world implementation. However, the use of physical activity within mental health care for children and young people (CYP) has received less attention to date.

Methods

A narrative review was conducted to summarize the relevant literature in the area. Online databases were searched using terms synonymous with CYP, exercise, physical health, and mental health. Findings from existing systematic reviews, meta-analyses, meta-syntheses, and consensus statements were reviewed, and used alongside the authors' experience to inform clinical recommendations.

Results

We first discuss the importance of applying physical health interventions in early stages of mental illness for CYP to prevent physical comorbidities and premature mortality in the long term. We then provide a brief summary of the current evidence of the benefits of exercise interventions in CYP with mental illness. We then present our top five recommendations on the implementation of exercise interventions within CYP mental health care.

Conclusion

The key conclusions from this suggest there is an increasingly strong evidence base for the benefits of using physical activity interventions to improve, prevent, and manage physical and mental health outcomes in CYP with mental illness. However, more work needs to be done to improve the evidence base, refine its implementation into standard mental health care, and develop strategies for large-scale dissemination of such interventions across various care and cultural contexts.

Artificial neural network and decision tree models of post-stroke depression at 3 months after stroke in patients with BMI ≥ 24

OBJECTIVE

Previous studies have shown that excess weight (including obesity and overweight) can increase the risk of cardiovascular, cerebrovascular and other diseases, but there is no study on the incidence of post-stroke depression (PSD) and related factors in patients with excessive weight. The main purpose of this study was to find related factors of PSD at 3 months after stroke in patients with excessive weight and construct artificial neural network (ANN) and decision tree (DT) models.

METHODS

This is a prospective multicenter cohort study (Registration number: ChiCTR-ROC-17013993). Five hundred and three stroke patients with Body Mass Index(BMI) ≥ 24 were included in this study. The diagnostic criteria of PSD is according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) diagnostic criteria for depression due to other medical conditions and the HAMD-17 scores > 7 at 3 months after stroke was used as the primary endpoint. The χ² test, Mann-Whitney U test or t-test were used to check for statistical significance.

RESULTS

Our study found that sleeping time < 5 h, CHD, physical exercise, BI score, N dimension(EPQ) and subjective support(SSRS) were associated with PSD in patients with excessive weight. Physical exercise(odd ratio [OR] = 0.49, p = 0.001, 95%CI [confidence interval]: 0.32-0.75) and BI score(OR = 0.99, p < 0.001, 95%CI: 0.98-0.99) were protective factors; sleeping time < 5 h(OR = 2.86, p < 0.001, 95%CI: 1.62-5.04), CHD(OR = 2.18, p = 0.018, 95%CI: 1.14-4.15), N dimension(OR = 1.08, p = 0.001, 95%CI: 1.03-1.13) and subjective support(OR = 1.04, p = 0.022, 95%CI: 1.01-1.07) were risk factors.

CONCLUSION

This study found several factors related to the occurrence of PSD at 3 months in patients with excessive weight. Meanwhile, ANN and DT models were constructed for clinicians to use.

PHYSICAL EXERCISES IN RELIEVING THE CURRENT STATE OF DEPRESSION

ABSTRACT Introduction: Physical exercise has become a common method at home and abroad as a means of psychotherapy and mental health. Objective: Observing the current situation and characteristics of physical exercise and depressive disorders and examining the influence of physical exercise on depressive disorders in the human body. Methods: The article compares and analyzes the relationship between human physical exercise and the level of depression and body self-esteem from the perspective of psychology. Results: The incidence of depression is higher. There are significant differences in the attitude towards physical exercise and the degree of depression in the three types of subjects in the study. Physical exercise is conducive to the relief of depression. Conclusion: Physical exercise is one of the effective ways to improve the depressive state of the human body. The effect of an exercise has no relation with the specific exercise method selected. Level of evidence II; Therapeutic studies - investigation of treatment results.

Progress and Challenges in the Biology of FNDC5 and Irisin

In 2002, a transmembrane protein-now known as FNDC5-was discovered and shown to be expressed in skeletal muscle, heart, and brain. It was virtually ignored for 10 years, until a study in 2012 proposed that, in response to exercise, the ectodomain of skeletal muscle FNDC5 was cleaved, traveled to white adipose tissue, and induced browning. The wasted energy of this browning raised the possibility that this myokine, named irisin, might mediate some beneficial effects of exercise. Since then, more than 1000 papers have been published exploring the roles of irisin. A major interest has been on adipose tissue and metabolism, following up the major proposal from 2012. Many studies correlating plasma irisin levels with physiological conditions have been questioned for using flawed assays for irisin concentration. However, experiments altering irisin levels by injecting recombinant irisin or by gene knockout are more promising. Recent discoveries have suggested potential roles of irisin in bone remodeling and in the brain, with effects potentially related to Alzheimer's disease. We discuss some discrepancies between research groups and the mechanisms that are yet to be determined. Some important questions raised in the initial discovery of irisin, such as the role of the mutant start codon of human FNDC5 and the mechanism of ectodomain cleavage, remain to be answered. Apart from these specific questions, a promising new tool has been developed-mice with a global or tissue-specific knockout of FNDC5. In this review, we critically examine the current knowledge and delineate potential solutions to resolve existing ambiguities.

Implications of Argentine Tango for Health Promotion, Physical Well-Being as Well as Emotional, Personal and Social Life on a Group of Women Who Dance

Background: The aim of the research was to determine the effect that dance has on the promotion of health, physical well-being, as well as the emotional, personal and social life of women who dance. In addition, the impact of the physical activity of long, often all-night dancing events on women’s health was investigated. This included possible disturbances in their monthly cycle and circadian rhythm, taking into account symptoms of biological rhythm disturbances. Methods: The study involved 214 women: tango group: 109, sedentary group: 105. The Mann–Whitney U and chi² tests were used to compare the groups, as well as multiple ordinal regression to analyse individual predictors of missed menstrual periods. Results: The tango vs. sedentary groups did not differ in the duration of menstrual bleeding, the degree of pain during menstruation, the regularity of menstruation, the number of regular monthly cycles per year, and amenorrhea. Intermenstrual spotting was more common in dancers (tango 12.8% vs. sedentary 4.8%; p = 0.038). The frequency of missed periods was not increased by any of the assessed aspects. In 59.6% of female dancers, milongas caused disturbances in circadian rhythms, including extreme fatigue and drowsiness (36.7%), 66.0% of the dancers mentioned only positive aspects of Argentine Tango’s impact on their personal life. Conclusions: tango plays a positive and multifaceted role in the lives of dancers and fulfils the need for social contact. The physical effort put into this form of physical activity does not significantly affect the menstrual cycle, and thus the reproductive functions, and can be recommended as an attractive and safe form of physical recreation for women.

Facilitating improvements in young people's social relationships to prevent or treat depression: A review of empirically supported interventions

Interpersonal difficulties are often implicated in the onset of depressive disorders, and typically exacerbate depressive symptoms. This is particularly true for young people, given rapid changes in, and the increased importance of, their social relationships. The purpose of this narrative review was to identify empirically supported interventions that aim to prevent or treat depression in young people by facilitating improvements in their social environment. We conducted a search of controlled trials, systematic reviews and meta-analyses of such interventions, published between 1980 and June 2020. Our literature search and interpretation of results was informed by consultations with clinical experts and youth consumers and advocates. A number of promising approaches were identified with respect to prevention and treatment. Preliminary evidence was identified suggesting that school- and Internet-based approaches present a viable means to prevent the worsening of depressive symptoms in young people. Notably, delivering interpersonal psychotherapy-adolescent skills training (IPT-AST) in schools appears to be a promising early intervention strategy for young people at risk of full-threshold depressive disorder. In terms of treating depressive disorders in young people, there is strong evidence for the efficacy of interpersonal psychotherapy for adolescents (IPT-A), and preliminary evidence in favour of attachment-based family therapy (ABFT). Results are discussed with respect to recommendations for future research and practice.

The Effects and Mechanisms of Exercise on the Treatment of Depression

Background: It is necessary to seek alternative therapies for depression, because side effects of medications lead to poor adherence and some patients do not achieve a clinical treatment effect. Recently the role of exercise as a low-cost and easy-to-use treatment for depression has gained attention with a number of studies showing that exercise is effective at reducing depressive symptoms and improving body functions such as cardiorespiratory system and cognitive function. Because of the heterogeneity of exercise therapy programs, there is no standardized and unified program. Few studies have summarized the specific properties of exercise programs (type, intensity, duration, and frequency) and clinical prescriptions for exercise are not mentioned in most articles. Aims: This study aimed to investigate the feasibility and efficacy of exercise therapy for patients with depression, in order to appraise the evidence and outline accepted guidelines to direct individualized treatment plans for patients with depression based on their individual situations. Methods: A systematic review of English language literature including papers published from 2010 to present in PubMed was performed. Given the feasibility of prescribing exercise therapy for patients with depression, nearly 3 years of clinical studies on the treatments of depressive symptoms with exercise were first reviewed, comparing the exercise programs utilized. Conclusions: Exercise has therapeutic effects on depression in all age groups (mostly 18-65 years old), as a single therapy, an adjuvant therapy, or a combination therapy, and the benefits of exercise therapy are comparable to traditional treatments for depression. Moderate intensity exercise is enough to reduce depressive symptoms, but higher-dose exercise is better for overall functioning. Exercise therapy has become more widely used because of its benefits to the cardiovascular system, emotional state, and systemic functions. Recommendations: Aerobic exercise/mind-body exercise (3-5 sessions per week with moderate intensity lasting for 4-16 weeks) is recommended. Individualized protocols in the form of group exercise with supervision are effective at increasing adherence to treatment.

The Gender Difference in Association between Home-Based Environment and Different Physical Behaviors of Chinese Adolescents

Purpose: The aim of this study was to evaluate the home-based physical activity (PA) environmental characteristics, and different types of physical behavior level of adolescents in different genders, and explore the impact of different domains of home-based PA environmental factors on different physical behaviors of adolescents in different genders. Methods: Five hundred forty-four adolescents aged from 12 to 18 years old (males: n = 358, females: n = 186) and their parents were analyzed in this cross-sectional survey. The volume of various physical behaviors of all adolescent subjects were measured by the ActiGraph wGT3X-BT accelerometer, and the level in different domains of home-based environmental characteristics were assessed by the Gattshall’s home-based PA environment questionnaire, which was answered by adolescents’ parents. The difference in the volume of different physical behaviors was examined using Kruskal–Wallis analysis. The difference in home physical environment and home social environment for adolescents was examined using one-way analysis of variance (ANOVA). Multiple linear regression analysis in the adjusted model was used to evaluate the influence of different home-based PA environmental domains (PA availability, PA accessibility, Parental role-modeling of PA, and Parental policies around PA) on different physical behaviors (sedentary behavior, SB; light-intensity physical activity, LPA; and moderate-vigorous physical activity, MVPA) of adolescents (boys and girls). Results: The volume of LPA and MVPA, the score of PA accessibility in the home physical environment, and the score of home social environment of boys are significantly higher than those of girls, while the SB volume of boys is significantly lower than that of girls. The PA availability, the parents’ role-modeling of PA in same-sex parent–child dyads, and the parents’ policies around PA in opposite-sex parent–child dyads are significantly associated with adolescents’ decreased SB and increased LPA and MVPA. Conclusion: There is significant gender difference in adolescents’ physical behaviors and home-based environmental characteristics, as well as in the association between adolescents’ physical behaviors and their home-based environment. The PA availability, the parents’ role-modeling of PA in same-sex parent–child dyads, and the parents’ policies around PA in opposite-sex parent–child dyads can significantly promote adolescents’ healthy physical behaviors.

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.

'When you have the adrenalin pumping, it kind of flushes out any negative emotions': a qualitative exploration of the benefits of playing football for people with mental health difficulties

BACKGROUND

Physical activity is a factor by which mental health can be improved. However, the association between mental health and physical exercise, in a "team-based sport" setting within the community, remains unclear.

AIMS

The current paper aims to provide an evaluation of a football programme, implemented by Time to Change Wales, funded by the Welsh Government, to improve mental health.

METHODS

Participants attended weekly 90-120 minute football sessions, held in local community venues across Wales, UK, with no requirement on the number of sessions that participants had to attend. A qualitative method was employed to explore the experiences of those who took part.

RESULTS

Individuals who participated in the programme reported psychosocial and physical benefits, such as improved physical and mental health, improved social confidence and having a sense of purpose added to their day-to-day living. Factors affecting participation were also identified within the data, such as environmental barriers. Conclusion: The findings provide both support and contextual extension to previous research in this area; demonstrating the positive effects of sport-based therapy for those with mental health difficulties. Implications and conclusions should be used to inform future research into developing community sport-based programmes to improve mental health.

Exercise interventions for mental disorders in young people: a scoping review

AIMS

This scoping review determines the breadth and outcomes of controlled trials testing the effect of physical activity/exercise interventions across mental health outcomes in young people with a mental disorder.

METHODS

The literature search was conducted using the open-access 'Evidence Finder', a comprehensive youth mental health-specific database that is systematically populated from MEDLINE, Embase, PsycINFO and Cochrane CENTRAL databases.

RESULTS

Sixteen publications were identified after meeting the following eligibility criteria: (1) participants were young people (mean age 12-25.9 years) with a mental disorder diagnosed by a trained clinician or by reaching a predefined cut score on a symptom measure, (2) interventions were exercise, (3) designs were randomised or non-randomised controlled trials, (4) outcomes were mental health related. Eight studies included young people with depression, three included people with psychosis/schizophrenia, three included people with eating disorders and two included people with anxiety. The available evidence suggests that moderate-to-vigorous-intensity exercise may be beneficial, particularly for reducing depression. The available evidence for other intervention intensities, and for other mental disorders, is mixed.

CONCLUSIONS

Overall, the evidence regarding the impact of exercise interventions on a range of mental health outcomes in clinical populations of young people with various mental disorders looks promising but requires further development. Findings from this scoping review can inform the development of future exercise interventions in the youth mental health field.

Using measures of intrinsic homeostasis and extrinsic modulation to evaluate mental health in adolescents: Preliminary results from the longitudinal adolescent brain study (LABS)

Adolescence is a period when complex interactions occur between mental health risk factors. The Longitudinal Adolescent Brain Study (LABS) commenced in 2018, to monitor environmental and psychosocial factors thought to influence mental health in 500 young people. Participants commence at 12 years of age, via a community-based recruitment model, and data is collected at 15 time-points over five years. This study examines demographic and psychosocial self-report data from time-point 1, for the first 50 participants. Here we investigate associations between environmental and psychosocial factors, considered as measures of intrinsic homeostasis and extrinsic modulation. Numerous strong correlations were found. Findings indicate that sleep dysfunction and social connectedness were strongly associated external modulators of intrinsic homeostasis in this sample of 12-year old participants. To successfully address the increase in mental health problems in young people, comprehensive evaluation of lifestyle and environmental risk factors is recommended in addition to medicalised approaches. Interventions to promote mental health wellbeing in young adolescents should include a focus on sleep quality and patterns and the positive and negative aspects of social connectedness.

Multimorbidity in Children and Youth Across the Life-course (MY LIFE): protocol of a Canadian prospective study

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).

Prevalence and associated factors of depression among Korean adolescents

This study aimed to identify factors significantly associated with recent depressive mood with respect to health-related behavioral patterns at the individual level, perceived safety in the school environment, and willingness to share concerns with family and social networks. Self-reported responses to questions regarding recent feelings of depression, health-related behaviors in physical, psychological, and spiritual subdomains, school refusal and perceived safety at school, and perceived social support were obtained from 1,991 in-school adolescents (mean [SD] age = 15.3 [1.7] years; male/female = 936/1055). Multivariate logistic regression analyses were used to identify explanatory factors significantly associated with recent depression, defined as feelings of sadness or hopelessness for more than 2 weeks (during the last 12 months) that interfered with everyday functioning. Of the 1,991 students, 271 (13.6%) reported recent depression. Multivariate logistic regression analyses revealed higher odds of recent depression in adolescents with frequent thoughts of school refusal (odds ratio [95% confidence interval] = 3.25 [2.44-4.32]) and those who engaged in regular physical exercise (1.57 [1.19-2.07]), whereas a positive mindset (0.65 [0.49-0.86]), perceived safety at school (0.62 [0.47-0.82]), and perceived social support from one's mother (0.54 [0.40-0.72]) were associated with lower odds of recent depression. Taken together, our findings suggest that parents and teachers should talk regularly with adolescents about recent life (dis)satisfaction and stressors, particularly when they report frequent thoughts of school refusal. Perceived social support would increase perceived safety on school grounds and make it easier for teenagers to share their concerns with parents, thereby reducing the risk for depressive symptoms. School-based programs that promote a positive mindset would be helpful in preparing students for the challenges of adulthood.