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

Move for Your Heart, Break a Sweat for Your Mind: Providing Precision in Adolescent Health and Physical Activity Behaviour Pattern

PURPOSE

Adolescent health benefits of different physical activity (PA) intensities, especially of lower intensities, are debated due to challenges in accelerometer data processing and analyses. Using a new accelerometer data processing method and multivariate pattern analysis, this study investigated the association of PA intensities with indicators of cardiovascular and mental health.

METHODS

Adolescents (n = 1,235, mean age 13.6 years, 41% males) were examined for cardiovascular health: body mass index (BMI) z-score, waist circumference (WC), resting heart rate and blood pressure, white blood cell count (WBC), pulse wave velocity (PWV), and answered questionnaires assessing stress and psychosomatic symptoms. Sex, age, and socioeconomic status were confounders. Hip-worn accelerometer data were processed with 10 Hz frequency extended method and a spectrum of 22 PA intensity categories was analyzed for association with health using partial least squares regression.

RESULTS

Total explained variances for BMI z-score, WC, resting heart rate, stress, and psychosomatic symptoms were higher (3.3%-8.7%) compared to diastolic blood pressure, WBC, and PWV (0.9%-1.4%). We found positive associations of high-end moderate PA and vigorous PA with cardiovascular and mental health indicators. More sedentary time and lower level of light PA were associated with higher BMI z-score, WC, resting heart rate, diastolic blood pressure, WBC, and PWV, but not with mental health indicators. Very vigorous PA was negatively associated with resting heart rate, stress, and psychosomatic symptoms.

DISCUSSION

In adolescents, PA of varying intensities were generally found to be positively associated with better cardiovascular health, but only higher intensity PA was associated with better mental health.

Accumulation of health complaints is associated with persistent musculoskeletal pain two years later in adolescents: The Fit Futures study

There is limited knowledge on the association between different health complaints and the development of persistent musculoskeletal pain in adolescents. The aims of this study were to assess whether specific health complaints, and an accumulation of health complaints, in the first year of upper-secondary school, were associated with persistent musculoskeletal pain 2 years later. We used data from a population-based cohort study (the Fit Futures Study in Norway), including 551 adolescents without persistent musculoskeletal pain at baseline. The outcome was persistent musculoskeletal pain (≥3 months) 2 years after inclusion. The following self-reported health complaints were investigated as individual exposures at baseline: asthma, allergic rhinitis, atopic eczema, headache, abdominal pain and psychological distress. We also investigated the association between the accumulated number of self-reported health complaints and persistent musculoskeletal pain 2 years later. Logistic regression analyses estimated adjusted odds ratios (ORs) with 95% confidence intervals (CIs). At the 2-year follow-up, 13.8% (95% CI [11.2-16.9]) reported persistent musculoskeletal pain. Baseline abdominal pain was associated with persistent musculoskeletal pain 2 years later (OR 2.33, 95% CI [1.29-4.19], p = 0.01). Our analyses showed no statistically significant associations between asthma, allergic rhinitis, atopic eczema, headache or psychological distress and persistent musculoskeletal pain at the 2-year follow-up. For the accumulated number of health complaints, a higher odds of persistent musculoskeletal pain at the 2-year follow-up was observed for each additional health complaint at baseline (OR 1.33, 95% CI [1.07-1.66], p = 0.01). Health care providers might need to take preventive actions in adolescents with abdominal pain and in adolescents with an accumulation of health complaints to prevent development of persistent musculoskeletal pain. The potential multimorbidity perspective of adolescent musculoskeletal pain is an important topic for future research to understand the underlying patterns of persistent pain conditions in adolescents.

Criterion validity of the Saltin-Grimby Physical Activity Level Scale in adolescents. The Fit Futures Study

Background

The Saltin-Grimby Physical Activity Level Scale (SGPALS) is commonly used to measure physical activity (PA) in population studies, but its validity in adolescents is unknown. This study aimed to assess the criterion validity of the SGPALS against accelerometry in a large sample of adolescents. A secondary aim was to examine the validity across strata of sex, body mass index (BMI), parental educational level, study program and self-reported health.

Methods

The study is based on data from 572 adolescents aged 15–17 years who participated in the Fit Futures Study 2010–11 in Northern Norway. The participants were invited to wear an accelerometer (GT3X) attached to their hip for seven consecutive days. We used Spearman’s rho and linear regression models to assess the validity of the SGPALS against the following accelerometry estimates of PA; mean counts/minute (CPM), steps/day, and minutes/day of moderate-to-vigorous physical activity (MVPA).

Results

The SGPALS correlated with mean CPM (ρ = 0.40, p<0.01), steps/day (ρ = 0.35, p<0.01) and MVPA min/day (ρ = 0.35, p<0.01). We observed no differences between correlations within demographic strata (all p>0.001). Higher scores on SGPALS were associated with a higher CPM, higher number of steps per day and more minutes of MVPA per day, with the following mean differences in PA measurements between the SGPALS ranks: CPM increased by 53 counts (95% CI: 44 to 62), steps/day increased by 925 steps (95% CI: 731 to 1118), and MVPA by 8.4 min/day (95% CI: 6.7 to 10.0). Mean difference between the highest and lowest SGPALS category was 2947 steps/day (6509 vs. 9456 steps/day) and 26.4 min/day MVPA (35.2 minutes vs 61.6 minutes).

Conclusion

We found satisfactory ranking validity of SGPALS measured against accelerometry in adolescents, which was fairly stable across strata of sex, BMI, and education. However, the validity of SGPALS in providing information on absolute physical activity levels seem limited.

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

BACKGROUND

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

METHODS

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

RESULTS/FINDINGS

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

CONCLUSIONS

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

Low social acceptance among peers increases the risk of persistent musculoskeletal pain in adolescents. Prospective data from the Fit Futures Study

BACKGROUND

Musculoskeletal pain has a high prevalence in adolescence and causes huge consequences for the individuals and the society. Little knowledge exists on social risk factors for musculoskeletal pain in adolescents. This study aimed to investigate if low social acceptance among peers during the first year of upper secondary school was associated with persistent and severe persistent musculoskeletal pain 2 years later and if psychological distress modified this association.

METHODS

Longitudinal data from the Norwegian Fit Futures Study was used. Students in the first year of upper secondary school answered an electronic questionnaire, covering health status, pain, social acceptance among peers, and psychological distress. Persistent musculoskeletal pain was measured 2 years later. Multiple logistic regression analyses and moderation analyses were conducted adjusting for sex and chronic diseases. Main analyses were conducted on participants without persistent musculoskeletal pain at baseline, and secondary analyses were conducted on all participants with and without persistent musculoskeletal pain at baseline.

RESULTS

Of 775 participants (52% females), 556 (71.7%) were pain-free at baseline and included in the main analyses. Significant associations between low social acceptance among peers and persistent musculoskeletal pain 2 years later were found in crude (Odds ratio (OR) = 1.8, 95%CI [1.0-3.1]) and adjusted analyses (OR = 1.8, 95%CI [1.0-3.2]). No statistically significant effect modification of psychological distress (p = 0.89) on this association was found. A significant association between low social acceptance and persistent musculoskeletal pain was found in adjusted secondary analyses of all the students (n = 692) (OR = 1.6, 95%CI [1.0-2.3]).

CONCLUSIONS

Our results indicate that low social acceptance among peers increases the risk of future persistent musculoskeletal pain in adolescents. Thus, interventions strengthening adolescent's social arenas may be helpful to prevent persistent musculoskeletal pain.

TRIAL REGISTRATION

Retrospective registered at clinicaltrials.org NCT04526522 .

The longitudinal association between objectively measured physical activity and mental health among Norwegian adolescents

Background

Mental health among young people in many countries, including Norway, seems to be deteriorating. Physical activity (PA) has been positively associated with mental health. However, methodological issues related to study design and measurement of PA and mental health outcomes currently limits our understanding of the relationship. The purpose of the present study is to explore the prospective relationship between objectively measured PA and mental health outcomes. More specifically, volume (total PA), intensity (moderate-to-vigorous PA [MVPA]) and sedentary behaviour (SED) were explored in relation to mental health problems (MHP) and mental wellbeing (MWB).

Methods

Data from 599 adolescents (54.4% female, mean age at baseline ±SD 13.3 ± 0.3 years) were collected annually during their 3 years (T1, T2 and T3) at lower secondary school. PA was measured using accelerometry. MWB was measured using the ‘Warwick-Edinburgh Mental Wellbeing Scale’ and MHP by the ‘Strengths and Difficulties Questionnaire’. Multiple linear regression was performed to explore relationships between changes in PA/SED (between T1-T3) and MWB/MHP (at T3). The term ‘movement categories’ was used to refer to components on the movement continuum and includes volume (total PA), intensity (MVPA) and SED.

Results

Among boys, any increase in SED was positively associated with MWB (β = 0.05, 95% CI: 0.01 to 0.10), whereas a small positive association between an increase in total PA (volume) and MWB was found among girls (β = 1.13, 95% CI: 0.05 to 2.21). There were no associations between changes in any movement categories [total PA (volume), MVPA, SED] and score on MHP at T3, neither for girls nor boys.

Conclusion

This study provided no clear evidence of any association between change in volume or intensity of PA and MHP among an overall healthy adolescent study sample. There was, however, evidence of a relationship between increased SED and MWB among boys and increased volume of PA and MWB among girls. The relationship between movement categories and mental health may depend on the measurement used to assess both PA/SED and variables of mental health. Future research would be strengthened by researchers clarifying what construct of mental health is being used and measured.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01211-x.

When Much Is Too Much-Compared to Light Exercisers, Heavy Exercisers Report More Mental Health Issues and Stress, but Less Sleep Complaints

BACKGROUND

Physical inactivity has become a global somatic and mental health issue. To counterbalance, promoting regular physical activity appears plausible, above all among adults, where physical inactivity is particularly high. However, some, but sparse, research also indicates that excessive exercising might be associated with unfavorable mental health dimensions. Here, we tested the hypothesis that excessive exercising was associated with more mental health issues. To this end, we assessed mental health issues, stress, mental toughness, and sleep disturbances among heavy and light adult exercisers.

METHODS

A total of 200 adults (mean age: 35 years; 62% females) took part in the study. Of those, 100 were heavy exercisers (18-22 h/week), and 100 were light exercisers (1-6 h/week). Participants completed questionnaires covering sociodemographic information, mental health issues, perceived stress, mental toughness, and sleep disturbances.

RESULTS

Compared with light exercisers, heavy exercisers reported higher mental health issues, more stress, but also higher mental toughness scores and less sleep disturbances. Higher age, lower mental toughness scores, heavy exerciser-status, and more sleep disturbances predicted higher mental health complaints.

CONCLUSIONS

Compared with light exercising, heavy exercising might be associated with more mental health issues. As such, it appears that the association between exercise frequency, intensity, and duration and psychological well-being might be related to an optimum point, but not to a maximum point. In a similar vein, heavily exercising athletes, their coaches, parents, and representatives of sports associations should get sensitized to possible adverse psychological effects of excessive physical activity patterns.

Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study

BACKGROUND

The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched.

OBJECTIVE

We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents.

METHODS

A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as △) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent-adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of △SFUI with △CES-D and the association of △EFUI with △CES-D were tested using hierarchical regression models.

RESULTS

The association between △SFUI and △CES-D was partially mediated by △mother-adolescent conflict (mediation effect size 5.11%, P=.02) and △social nonconfidence (mediation effect size 20.97%, P<.001) but partially suppressed by △friendship quality, △perceived family support, and △perceived friend support, with suppression effects of -0.011 (P=.003), -0.009 (P=.003), and -0.022 (P<.001), respectively. The association between △EFUI and △CES-D was partially mediated by △social nonconfidence (mediation effect size 30.65%, P<.001) but partially suppressed by △perceived family support and △perceived friend support, with suppression effects of -0.036 (P<.001) and -0.039 (P<.001), respectively.

CONCLUSIONS

The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother-adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents.

Is There a Dose-Response Relationship between Acute Physical Activity and Sleep Length? A Longitudinal Study with Children and Adolescents Living in Sweden

A declining physical activity (PA) and sleep in children and adolescents have been observed during the previous decades. PA could benefit sleep, but the findings are mixed. The aim of the present study was to examine if there is a dose-response relationship between time spent in acute moderate and vigorous physical activity (MVPA) and sleep length in children and adolescents. Additional aims were to examine if the sleep length is higher for children and adolescents who conduct at least an average of 60 min in MVPA/day and to study differences between sex and school years. The study population consists of 262 participants in school year 5 (aged 11 years), 7 (aged 13 years), and 9 (aged 15 years). Accelerometers measured MVPA while sleep diaries measured sleep length. A linear and longitudinal mixed effect linear regression was conducted to study the primary aim. The secondary aims were studied with linear regressions. Included confounders were sex, school year, school stress, screen time, menstruation onset, family household economy, and health status. A stratified regression for sex and school year was conducted. The linear regression showed no statistically significant findings in the crude or adjusted model. The stratified linear regression found a significant positive association for girls but a negative association for school year 5. No associations were found in the longitudinal regression or when comparing sleep length for participants that did and did not spend an average of at least 60 min in MVPA/day. A dose-response relationship was found in the stratified linear regression, implying a possible weak association. The statistically non-significant differences between participants that did and did not spend an average of at least 60 min in MVPA/day implies that spending an average of at least 60 min in MVPA/day may not be associated with a higher mean sleep length.

Daily physical activity, human development index and insomnia in a representative sample of Brazilian adolescents: a cross-sectional analysis

BACKGROUND

Although there is a growing body of research pointing towards the need to investigate how different movement behaviors, such as physical activity and sleep, influence each other, the joint relationship between these factors and insomnia has been little explored among adolescents in developing countries.

OBJECTIVES

To investigate the association between daily physical activity and insomnia in a national sample of Brazilian adolescents, according to the Human Development Index (HDI) of each Brazilian region.

DESIGN AND SETTINGS

Cross-sectional study on 102,072 Brazilian students aged 11 to 19 years, selected from all regions of the country.

METHODS

Information on insomnia and physical activity was self-reported by adolescents.

RESULTS

Our analyses revealed that girls who accumulated at least 60 minutes/day of physical activity on up to three days/week were less prone to present insomnia. This pattern of association was maintained only for those who lived in high HDI regions (odds ratio, 0.87; 95% confidence interval, 0.75-0.99). For boys, there was a positive association between the number of active days and protection against insomnia, especially for those who lived in high HDI regions.

CONCLUSION

Even amounts of physical activity that were lower than the weekly guidelines, were associated with better sleep quality for Brazilian adolescents, especially girls, and even for those who lived in regions with greater social and economic vulnerability.

Sports Participation from Childhood to Adolescence is Associated with Lower Body Dissatisfaction in Boys-A Sex-Specific Analysis

OBJECTIVES

This study aimed to analyze the association between body dissatisfaction and sports participation from childhood to adolescence in a school-based sample of adolescents, according to sex.

METHODS

A total of 1011 adolescents of 13.1 ± 2.3 years of age were evaluated. Body dissatisfaction was assessed by the Silhouettes Scale and sports participation for at least one consecutive year was retrospectively assessed by closed specific questions related to childhood and adolescence periods. Body mass index (BMI) and abdominal obesity were objectively measured. Habitual practice of physical activity (PA), socioeconomic status (SES), and ethnicity were assessed through questionnaires.

RESULTS

Sports participation from childhood to adolescence was observed in 55.1% of boys and in 41.2% of girls. Boys with body dissatisfaction showed lower habitual PA in leisure time (Baecke score = 4.38 ± 2.27 vs. 5.15 ± 2.25, p < 0.05) and in total (Baecke score = 9.34 ± 2.64 vs. 9.96 ± 2.68, p < 0.05) than those who were satisfied. No differences were observed among girls. Sports participation from childhood to adolescence was associated with 42% less chance of having body dissatisfaction in boys (OR = 0.58 [95%CI = 0.36-0.94]). No significant association was observed among girls.

CONCLUSIONS FOR PRACTICE

Sports participation from childhood to adolescence was negatively associated with body dissatisfaction in boys. The continuity of physical activity during youth may be an important modifiable factor to reduce body dissatisfaction.

No Evidence of Systematic Change of Physical Activity Patterns Before and During the Covid-19 Pandemic and Related Mood States Among Iranian Adults Attending Team Sports Activities

Objective: To cope with the Coronavirus Disease 2019 (COVID-19) pandemic health authorities released social restrictions. Such social restrictions impacted on the people's possibilities to move deliberately in a public space and to gather with other people. In the present study, we investigated the impact of COVID-19-related restrictions ("confinement") on physical activity (PA) patterns before and during the confinement among team sports participants. Such PA patterns were further related to current mood states, and possible sex differences were also explored. Methods: A total of 476 adults exercising team sport (football, futsal, volleyball, handball, and basketball; mean age: 24.66 years; 48.1% females) completed a series of self-rating questionnaires covering sociodemographic information, former and current PA patterns, and current mood states. Results: Compared with the period before the confinement, PA intensity decreased, but PA frequency increased during the confinement. Past, current, and changes in physical activity patterns were unrelated to participants' mood states. Sex differences in mood were spurious. Sex differences in physical activity patterns were modest, with male participants reporting a higher physical activity intensity during the confinement. Conclusions: The present pattern of results suggests that the COVID-19-related confinement did not impact in a uniform fashion on PA patterns of adults attending team sports. Furthermore, mood states were unrelated to current physical activity patterns. Given the complex psychosocial situation of COVID-19-related confinement, it appeared very unlikely that sole physical activity patterns could counterbalance possible impaired states of mood and behavior.

Mental Health and Physical Activity among Children and Adolescents during the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) is causing disruptions in the global social system. Japanese children and adolescents have had their schools closed, government-mandated activity restrictions imposed, and interactions outside the home reduced. These restrictions can have a considerable psychological impact on children and adolescents. This review aims to describe the impacts of COVID-19 pandemic on physical activity and psychological status of this population. The review was conducted by searching PubMed for information on the impact of COVID-19-related activity restrictions on children and adolescents. The search identified 11 articles, three of which contained data on anxiety and psychological problems due to physical inactivity. Next, a PubMed search was conducted about physical activity and psychological status in children and adolescents under psychological stress. The search identified 368 articles, 28 of which were included in the review. For children, data that revealed a correlation between physical activity and psychological health and sedentary time leading to mood disorders were included. For adolescents, there were nine studies that reported a correlation between physical activity and psychological health and four studies that reported no correlation between physical activity and psychological health. Of the studies that reported a correlation, seven reported that physical activity improves psychological health. The impact of psychologically stressful situations such as COVID-19 on children and adolescents has been experienced worldwide. Physical activity has been correlated with psychological health, and it may improve psychological status; physical activity should be recommended to better support the psychological health of children and adolescents under the influence of COVID-19.

Physical activity in early adolescence predicts depressive symptoms 3 years later: A community-based study

BACKGROUND

Physical activity (PA) during adolescence is associated with a wide range of health benefits, including lower levels of internalizing and externalizing problems. Although the association between PA and mental health has been established, there are few prospective studies investigating if the association between PA and internalizing/externalizing symptoms remains after adjustment for the baseline occurrence of such symptoms, and those exploring any sex-specific pattern of the association.

METHODS

Swedish adolescents (N = 1428; mean age = 14.38 years) were assessed and followed up 3 years later. Self-reported data were collected for PA (recoded as low, moderate and high levels), internalizing (depression and anxiety) and externalizing (attention-deficit/hyperactivity disorder and disruptive behaviours) symptoms. A full path analysis was used to determine the main and interaction effects of PA and sex on internalizing/externalizing symptoms 3 years later, adjusting for these symptoms at baseline.

RESULTS

Higher levels of PA were correlated with lower internalizing/externalizing symptoms. In the full path analysis, PA during early adolescence predicted lower levels of depressive symptoms, but not anxiety or externalizing problems, 3 years later. A sex-specific effect of PA on depressive symptoms was found, wherein boys, but not girls, with high levels of PA showed reduced symptoms.

LIMITATIONS

Including parental ratings, diagnostic assessments and objective measures of PA would have provided additional information to the study.

CONCLUSIONS

Low levels of PA during early adolescence are a unique predictor for the development of depressive symptoms among boys. PA should be considered when discussing prevention and treatment for depression in adolescents.

Association between Health-Related Physical Fitness and Self-Rated Risk of Depression in Adolescents: Dados Study

Depression is the most common mental disorder, affecting around 5% of adolescents. Physical fitness is considered a powerful marker of physical and mental health. The scientific results on the relationship between physical fitness and depression in the adolescent population are mixed. Therefore, the aim of the current study was to analyse the association between objectively assessed physical fitness and self-rated risk of depression in a group of adolescents. A total of 225 participants (44% girls), aged 13.9 ± 0.3 years, from the Deporte, ADOlescencia y Salud (DADOS) study were included in the analyses. Field-based Assessing Levels of Physical fitness and Health in Adolescents (ALPHA) health-related fitness test battery was used to objectively assess physical fitness components. The Behavior Assessment System for Children (BASC) level 3 was used to evaluate self-rated risk of depression. Our results showed that self-rated risk of depression was inversely associated with cardiorespiratory fitness (β = −0.172), as well as positively associated with body mass index (β = 0.146) and waist circumference (β = 0.137) (all p < 0.05). Adolescents with low levels of cardiorespiratory fitness had significantly higher odds of self-rated risk of depression (OR = 7.17; 95% CI, 1.51–33.95). These findings suggest that health-related physical fitness, particularly cardiorespiratory fitness and body composition, is associated with depression in adolescents.

Self-reported symptoms of depression, anxiety and stress in Portuguese primary school-aged children

BACKGROUND

Symptoms of depression, anxiety and stress experienced during childhood might have a negative impact on development. This study explores factors associated with such symptoms among Portuguese primary school-aged children.

METHODS

A sample of children (n = 1022, mean age = 8.77 years old) was recruited in public and private schools from the cities of Coimbra, Lisbon and Porto, Portugal. The children's version of the Depression, Anxiety and Stress Scale (DASS-C) was self-administered. Multivariate logistic regression models were fitted to measure associations (expressed as Odds Ratio, OR and 95% Confidence Intervals, CI) between each DASS-C subscale, dichotomized by its 4th vs. 3rd or less quartiles (symptoms increase with scores), and covariates: child sex, age, socioeconomic status (SES), sports activity beyond school, children self-assessed health status, child and mother's body mass index and mother's DASS scores.

RESULTS

Age was negatively associated with anxiety symptoms (adjusted OR, 95% CI: 0.70, 0.57-0.87) and girls, compared to boys, presented lower odds of depressive and stress symptoms (adjusted OR, 95% CI: 0.65, 0.47-0.92 and 0.57, 0.41-0.80, respectively). A low socioeconomic status was associated with more frequent symptoms of stress (adjusted OR, 95%CI for low compared to high SES: 1.61, 1.01-2.56). Children with poorer self-assessed health status and whose mothers scored higher in the DASS also presented significantly higher odds of scoring in the 4th quartile (vs. 3rd or less) of the three DASS-C subscales.

CONCLUSIONS

These results suggest the need to tailor preventive efforts targeting childhood mental health symptoms.

Is change in mental distress among adolescents predicted by sedentary behaviour or screen time? Results from the longitudinal population study The Tromsø Study: Fit Futures

OBJECTIVE

There is growing interest in the relationship between sedentary behaviour and mental distress among adolescents, but the majority of studies to date have relied on self-reported measures with poor validity. Consequently, current knowledge may be affected by various biases. The aim of this study was to investigate the cross-sectional and longitudinal association between (1) objectively measured sedentary time and (2) self-reported screen time with mental distress among adolescents participating in The Tromsø Study: Fit Futures, in order to see if the association is dependent on mode of measurement of sedentary behaviour.

DESIGN

Prospective study.

SETTING

Sample drawn from upper secondary school students (mean age 16.3 years at baseline) from two municipalities in Northern Norway participating in The Tromsø Study: Fit Futures 1 and 2.

PARTICIPANTS

686 adolescents (54.5% female), with complete self-reported and accelerometer data after multiple imputation.

PRIMARY OUTCOME MEASURES

Mental distress assessed via the Hopkins Symptom Checklist-10 (HSCL-10).

RESULTS

Minutes in sedentary behaviour measured by accelerometer showed no significant relationship with mental distress in neither crude, partly adjusted nor multiple adjusted hierarchic linear regression analyses. Self-reported screen time was positively associated with mental distress in all analyses (multiple adjusted, B=0.038, p=0.008, 95% CI 0.010 to 0.066). However, the effect was small.

CONCLUSIONS

Self-reported screen time was associated with slightly elevated mental distress 2 years later, whereas objectively measured minutes in sedentary behaviour was not, indicating a discrepancy in the results depending on measurement methods.

The relationship between physical activity, mental wellbeing and symptoms of mental health disorder in adolescents: a cohort study

BACKGROUND

Mental illness is a worldwide public health concern. In the UK, there is a high prevalence of mental illness and poor mental wellbeing among young people. The aim of this study was to investigate whether physical activity is associated with better mental wellbeing and reduced symptoms of mental health disorder in adolescents.

METHODS

A cohort of 928 12-13 year olds (Year 8) from six secondary schools in England, who had participated in the AHEAD trial, 'Activity and Healthy Eating in Adolescence', were followed up three years later (when 15-16 years old, Year 11). At baseline, physical activity was measured using accelerometers. At follow-up, mental wellbeing was measured using the 'Warwick Edinburgh Mental Wellbeing Scale' (WEMWBS) and symptoms of mental health disorder using the 'Strengths and Difficulties Questionnaire' (SDQ). Multivariable linear regression analyses were used to investigate associations between physical activity and both mental wellbeing and symptoms of mental health disorder.

RESULTS

794 (86%) of the eligible 928 young people provided valid accelerometer data at baseline. 668 (72%) provided complete mental wellbeing data and 673 (73%) provided complete symptoms of mental health disorder data at follow-up. The multivariable analyses showed no evidence of an association between physical activity volume (counts per minute (cpm)) or intensity (Moderate to Vigorous Physical Activity (MVPA)) and mental wellbeing (WEMWBS overall score) or overall symptoms of mental health disorder (SDQ Total Difficulties Score). However, higher levels of physical activity volume at age 12-13 years were associated with lower scores on the emotional problems subscale of the SDQ at age 15-16 years.

CONCLUSIONS

This cohort study found no strong evidence that physical activity is associated with better mental wellbeing or reduced symptoms of mental health disorder in adolescents. However, a protective association between physical activity and the emotional problems subscale of the SDQ was found. This suggests that physical activity has the potential to reduce symptoms of depression and anxiety in adolescents. Future cohort study designs should allow for repeated measures to fully explore the temporal nature of any relationship.