Impact of Physical Exercise on Symptoms of Depression and Anxiety in Pre-adolescents: A Pilot Randomized Trial

The effects of different levels of sports activity on health-related quality of life and lifestyle habits in high school Italian students

Physical activity (PA) is an important predictor of physical and mental health preventing chronic degenerative diseases. The purpose of this study was to investigate in a group of Italian high school students whether health-related quality of life (HRQoL) and lifestyle habits (diet) are associated with the level of physical activity performed (low, moderate, high). Data were collected from 2819 adolescents (n = 951 males). HRQoL was analyzed using the Italian version of the KIDSCREEN-52. Physical activity level was analyzed using the PAQ-A, while eating habits with KIDMED. Practicing physical activity in general improves HRQoL. Specifically, adolescents practicing moderate or high PA, in single dimensions of HRQoL, showed better mood (p < 0.001), self-perception (p < 0.001), family relationships (p < 0.001), reported a higher perception of socioeconomic status (p < 0.05), relationship with peers (p < 0.001), and social acceptance (p < 0.001). High PA subjects reported increased physical (p < 0.001) and mental health (p < 0.001), increased autonomy (p < 0.001), and school learning (p < 0.001). For lifestyle habits, practicing moderate PA showed higher adherence tox the Mediterranean diet (p < 0.001). Conclusion: Our results highlighted a positive association between the frequency of PA levels, some dimensions of HRQoL, and risk behaviors. These findings demonstrated the protective role of sports not only as a preventive strategy for the onset of chronic degenerative diseases, but also as an educator of healthy lifestyle habits, thus suggesting the importance and need to implement strategies to promote sports practice.

The relationship between physical activity and Internet addiction among adolescents in western China: a chain mediating model of anxiety and inhibitory control

This study aims to investigate the mediating effect of anxiety and inhibitory control in the relationship between physical activity and Internet addiction (IA) among adolescents. A total of 951 adolescents from western China completed a self-report survey assessing physical activity, anxiety, inhibitory control, and IA. Descriptive analysis, correlation analysis, and mediation analysis were conducted using SPSS software and the Process plug-in. Controlling for age, gender, and only child status, the findings revealed a negative association between physical activity and anxiety, inhibitory control, and IA. Moreover, anxiety were positively correlated with inhibitory control and IA. Additionally, anxiety exhibited a positive association with inhibitory control. Notably, physical activity directly and negatively predicted IA in adolescents, while also indirectly predicting it through anxiety and inhibitory control. This study contributes to a deeper understanding of the mechanisms that underlie the complex effects of physical activity on IA among adolescents.

[Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents]

Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents Abstract: Mental disorders are among the most common chronic diseases in childhood and adolescence in Germany and worldwide. The health benefits of a physically active lifestyle during adolescence are well documented. Furthermore, a growing body of evidence suggests a positive impact of physical activity on mental health and emotional well-being. Longitudinal studies also show an association between physical activity and reduced risk of developing a mental disorder. Therefore, therapeutic exercise plays an important role in child and adolescent psychiatry. High-quality randomized-controlled trials are needed to substantiate the described effects.

Muscle Quality Index is inversely associated with psychosocial variables among Chilean adolescents

A good muscle quality index (MQI) may have an inverse relationship with psychosocial variables of depression, anxiety, and stress in adolescents. Unfortunately, little scientific evidence has related MQI to psychosocial variables in this population. Therefore, this research aimed to determine the relationship between the MQI and psychosocial variables of depression, anxiety, and stress in Chilean adolescents. In this quantitative correlational design study, sixty adolescents participated voluntarily (mean ± standard deviation [SD]: age 15.11 ± 1.78 years). Anthropometric parameters, prehensile strength, MQI, and psychosocial variables were evaluated. The results showed that adolescents with high levels of MQI presented lower levels of depression (7.50 ± 6.06 vs. 10.97 ± 5.94), anxiety (5.64 ± 4.81 vs. 9.66 ± 5.12), and stress (6.79 ± 5.09 vs. 10 ± 5.58), in addition to reported lower abdominal obesity (WtHR, 0.47 ± 0.07 vs. 0.52 ± 0.07) than those with low levels of MQI. The group with high levels of MQI reported a higher prevalence of nonanxiety (81.3%, p = 0.031) and a lower prevalence of abdominal obesity (55.8%, p = 0.023). Likewise, a significant inverse association was evidenced between MQI and depression (β; -6.18, 95% CI; -10.11: -2.25, p = 0.003), anxiety (β; -6.61, 95% CI; -9.83: -3.39, p < 0.001) and stress (β; -4.90, 95% CI; -8.49: -1.32 p = 0.008). In conclusion, the results suggest that high levels of MQI are associated with a higher prevalence of nonanxiety in adolescents and a significant inverse association between MQI and levels of depression, anxiety, and stress.

Adolescent nonpharmacological interventions for early-life stress and their mechanisms

Those with a negative experience of psychosocial stress during the early stage of life not only have a high susceptibility of the psychiatric disorder in all phases of their life span, but they also demonstrate more severe symptoms and poorer response to treatment compared to those without a history of early-life stress. The interventions targeted to early-life stress may improve the effectiveness of treating and preventing psychiatric disorders. Brain regions associated with mood and cognition develop rapidly and own heightened plasticity during adolescence. So, manipulating nonpharmacological interventions in fewer side effects and higher acceptance during adolescence, which is a probable window of opportunity, may ameliorate or even reverse the constantly deteriorating impact of early-life stress. The present article reviews animal and people studies about adolescent nonpharmacological interventions for early-life stress. We aim to discuss whether those adolescent nonpharmacological interventions can promote individuals' psychological health who expose to early-life stress.

High anteromedial insertion reduced anteroposterior and rotational knee laxity on mid-term follow-up after anatomic anterior cruciate ligament reconstruction

Background

The position of the femoral insertion has a great influence on the laxity of the knee joint after ACLR, especially for rotational laxity.

Purpose

To compare the effects of different femoral tunnel positions on knee stability after arthroscopic anterior cruciate ligament reconstruction (ACLR).

Methods

The clinical outcomes of 165 patients after autograft ACLR were analyzed retrospectively. The patients were separated into three groups according to the position of the femoral tunnel, as follows: low center (LC) group, 53 patients; high center (HC) group, 45 patients; and high anteromedial (HAM) group, 67 patients. The side-to-side differences (SSDs) in anteroposterior knee laxity measured using a KT-2000 arthrometer and the pivot shift test (PST) pre- and postoperatively were compared among the three groups and analyzed.

Results

After 5 years postoperatively, the SSD in the anteroposterior knee laxity in the three groups was significantly decreased postoperatively compared with preoperatively in knees; meanwhile, the negative PST rate was significantly increased in the three groups. The postoperative SSD in anteroposterior knee laxity was significantly increased in the HC group compared with the LC and HAM groups (1.5 ± 1.3 VS 1.0 ± 1.1 VS 1.0 ± 1.0, P<0.05). The negative postoperative PST rate was higher in both the LC and HAM groups than in the HC group (84.9% VS 91.0% VS 71.1%, P<0.05), and there was no significant difference in the negative PST rate between the LC and HAM groups (84.9% VS 91.0%, P>0.05). The negative postoperative PST rate was significantly higher in the HAM group than in the LC and HC groups for patients with a high degree of laxity preoperatively (31.3% VS 3.3% VS 14.4%, P>0.05).

Conclusion

Patients in HAM group showed better control over anteroposterior laxity, rotational laxity, and subjective knee function compared to other groups post operation. Therefore, the HAM point is the closest to the I.D.E.A.L point concept, and is recommended as the preferred location for the femoral tunnel in ACLR.

The impact of physical activity intervention on perinatal depression: A systematic review and meta-analysis

BACKGROUND

No meta-analysis has analyzed the effect of physical activity level, period of physical activity intervention, and duration of intervention, on perinatal depression. This study was to evaluate the impact of physical activity intensity, dose, period, and duration on perinatal depression.

METHODS

The literature was searched via the PubMed, Embase, Cochrane Library, and Web of Science databases. Weighted mean difference (WMD) or the risk ratio (RR) was used as the effect indicator, and the effect size was represented by the 95 % confidence interval (CI). Subgroup analysis based on the perinatal stage, physical activity intensity, physical activity equivalent, and intervention duration was performed.

RESULTS

Totally, 35 studies including 5084 women were included. Physical activity could reduce the incidence and severity of depression in perinatal women. Among depressed women with prenatal depression, low-intensity physical activity, with metabolic equivalents (METs)-min/week being <450, was associated with lower levels of depression. In the general population, the risk of postpartum depression was lower in the physical activity group when the duration of intervention was ≥12 weeks, being II, III stage, and ≥450 METs-min/week. Both low and moderate-intensity physical activity were beneficial to an improved depression severity among depressed women with postpartum depression, and moderate exercise intervention could decrease the risk of postpartum depression in general pregnant women.

LIMITATIONS

Different types of physical activities may affect the effectiveness of interventions.

CONCLUSION

Our study indicated physical activity specifically targeted at pregnant women could reduce depression risk and severity.

Decreased physical activity with subjective pleasure is associated with avoidance behaviors

The main hypothesis for the relation between physical activity and mental health is that autonomous motivation, such as subjective pleasure for the activity, plays an important role. However, no report has described empirical research designed to examine the role of subjective pleasure in the relation between objectively measured physical activity and psychological indexes. We used accelerometers to collect data indicating participants' physical activity intensity during a week. Participants recorded their subjective pleasure of activity per hour. In 69% of them, the individual correlation coefficients between physical activity and pleasure in an hour (an index of Physical Activity-Pleasure; PA-PL) were positive (r = 0.22, 95%Cl = [0.11-0.38]), indicating that pleasant sensations increased concomitantly with increasing physical activity. Conversely, 31% participants exhibited negative values of PA-PL, which means that the increase in physical activity had the opposite effect, decreasing pleasure. Multiple linear regression analysis showed that avoidance/rumination behaviors decreased significantly with increased PA-PL (β = -6.82, 95%CI: [-13.27 to -0.38], p < .05). These results indicate that subjective pleasure attached to the PA is more important than the PA amount for reducing depressive behavior.

Environmental Physical Activity Cues and Children's Active vs. Sedentary Recreation

Physical activity (PA) benefits health, and intensive environmental modifications can increase children’s PA. Research has not yet addressed if subtle environmental cues, such as posters depicting PA, increase child PA. In the current study, it was hypothesized that children exposed to active posters (vs. nature posters) would spend a larger proportion of free play time engaging with active toys (relative to sedentary toys). Participants were randomly assigned to one of two conditions in which posters on a laboratory wall depicted 1. People being active, or 2. Nature scenes. Children aged 5–10 years (N = 175) could play with up to eight toys (four active, four sedentary) while parents completed study-related surveys. The proportion of playtime that was active was compared between groups. Poster type did not have a significant effect on proportion of active playtime. Previous environmental interventions that increase children’s PA have done so through enhancing access to active opportunities, rather than via signage. It is possible that poster interventions such as this may not influence children’s PA, or perhaps other types of cues would have been more effective. Future research should investigate subtle environmental cues that match both the target audience and the accessible PA options (e.g., posters depicting children playing with available active toys) and explore other low-investment environmental modifications to boost children’s PA.

Monetary valuation of a Quality-Adjusted Life Year (QALY) for depressive disorders among patients and non-patient respondents: A matched willingness to pay study

Background

As estimated by the World Health Organization, depressive disorders will be the leading contributor to the Global Burden of Disease by 2030. In light of this fact, we designed a study whose aim was to investigate whether the value placed on health-related quality of life (HRQoL) for a depressive disorder is higher in patients diagnosed with a major depressive disorder (MDD) compared to non-patients in a matched sample.

Method

We collected data on willingness to pay (WTP) for a total of four health-gain scenarios, which were presented to 18 outpatients diagnosed with a MDD versus 18 matched non-patient respondents with no symptoms of depression. Matching characteristics included age, income, level of education, and type of health insurance. Respondents were presented with different HRQoL scenarios in which they could choose to pay money to regain their initial health state through various treatment options (e.g., inpatient treatment, electroconvulsive therapy). To test whether the probability of stating a positive WTP differed significantly between the two samples, Fisher’s exact test was used. Differences regarding stated WTP between the samples were investigated using the Mann-Whitney U-test.

Results

For most of the health scenarios, the probability of stating a positive WTP did not differ between the two samples. However, patient respondents declared WTP values up to 7.4 times higher than those stated by matched non-patient respondents.

Conclusion

Although the perceived necessity to pay for mental-HRQoL gains did not differ between respondents with MDD and respondents with no symptoms of depression, patient respondents stated higher values.

Association between handgrip strength and mental health in Korean adolescents

BACKGROUND AND OBJECTIVES

Muscle strength is associated with adverse mental health outcomes in adults; however, few studies have examined this association among adolescents. This study investigated the association between handgrip strength and mental health in a nationally representative sample of Korean adolescents.

METHODS

We performed a cross-sectional study of 3530 adolescent (12-18 years old) from the 2014-2017 Korean National Health and Nutrition Survey. Handgrip strength was defined as the maximum measurement in kilograms from the dominant hand. Adverse mental health included the presence of perceived stress, depressive mood and suicidal ideation. Logistic regression models were used with adjustment for potential confounders.

RESULTS

The mean age ± SD of the study participants was 14.9 ± 2.0 years. Girls (47.5% of participants) had poorer mental health than boys. For boys, each 1-kg increase in handgrip strength was associated with a 3% decrease in the odds of having perceived stress and depressive moods. For girls, there was a positive association between handgrip strength and perceived stress. The relationship between handgrip strength and perceived stress was dose dependent for both sexes.

CONCLUSIONS

Low handgrip strength was associated with poor mental health among boys. Future research is required to validate our findings and to establish whether interventions to increase muscular strength can reduce the prevalence of perceived stress and depressive mood in boys.

Prevalence of anxiety symptom and depressive symptom among college students during COVID-19 pandemic: A meta-analysis

BACKGROUND

The global pandemic of COVID-19 has brought huge changes to people's lifestyles, college students have also been affected seriously. Evidence about these significant changes indicated that college students were more prone to feel anxious and depressed. To derive a precise assessment of the prevalence of anxiety symptom and depressive symptom among college students worldwide, we conducted this meta-analysis.

METHODS

Based on the guidance of PRISMA, literature was searched in Pubmed, Web of Science, Embase, and PsycArticles (last search November 6, 2020). These articles after the screening were analyzed by a random-effects model to estimate the pooled prevalence of anxiety symptom and depressive symptom. Also, subgroup analysis, sensitivity analysis, and publication bias were performed in this meta-analysis.

RESULTS

The results showed that the pooled anxiety symptom prevalence was 31% (95% CI: 23-39%), pooled depressive symptom prevalence was 34% (95% CI: 27-41%). Subgroup analysis showed that the prevalence of anxiety symptom and depressive symptom among different countries' college students were different, and the pooled depressive symptom prevalence of females was higher compared with males.

LIMITATIONS

The prevalence of anxiety symptom and depressive symptom in worldwide college students could be better assessed by a standard and reliable questionnaire.

CONCLUSIONS

The results suggest that the prevalence of anxiety symptom and depressive symptom during the COVID-19 pandemic is relatively high. Except for interventions that should be taken to control the pandemic urgently, mental health services are also needed to decrease the risk of anxiety and depression among college students.

Age-varying Bi-directional Associations Between Momentary Affect and Movement Behaviors in Children: Evidence From a Multi-wave Ecological Momentary Assessment Study

BACKGROUND

The bi-directional associations between affective states and movement behaviors (e.g., physical activity, sedentary behavior) have been observed in children. It is unclear if the strength of these bi-directional associations varies with age as children transition from childhood to adolescence.

PURPOSE

This multi-wave ecological momentary assessment (EMA) study investigates the acute time-varying associations between affect and movement behaviors among youth.

METHODS

Children (N = 195, baseline mean age = 10.72, range = 8-12 years, mean BMI-z = 0.49, 51% female) participated in a six-wave EMA study across three years. Each EMA survey captured momentary positive and negative affect. Time spent in moderate-to-vigorous physical activity (MVPA) and sedentary time in the 15-min window before and after each EMA survey was calculated using accelerometry data. Time-varying effect models (TVEM) examined the acute bi-directional associations between momentary positive/negative affect and MVPA/sedentary time across ages 8 to 14.

RESULTS

Children provided 14,246 valid activity-matched EMA surveys across all waves. TVEM plots revealed that the directionality and the strength (time-varying slopes) of associations between momentary affect and activity levels vary across ages. Positive affect was associated with higher MVPA levels and lower sedentary time at younger ages, whereas negative affect linked to lower MVPA levels and more sedentary time at older ages.

CONCLUSIONS

The acute associations between momentary affect and (in)activity levels may vary as a function of children's age. Applying TVEM to intensive longitudinal data could provide valuable information for developing age-tailored interventions that promote healthy lifestyles among children and adolescents.

Physical Activity, Sedentariness, Eating Behaviour and Well-Being during a COVID-19 Lockdown Period in Greek Adolescents

Adolescents' daily life has dramatically changed during the COVID-19 era due to the social restrictions that have been imposed, including closures of schools, leisure centers and sport facilities. The purpose of this study was to examine levels of well-being and mood and their relations with physical (in)activity and eating behaviors in adolescents during a lockdown period in Greece. A total of 950 adolescents (Mean Age = 14.41 years ± 1.63) participated in a web-based survey while education was conducted online and organized sport activities were interrupted. Participants showed poor well-being, insufficient physical activity levels and moderate scores of healthy eating behavior. Hierarchical regression analysis showed that, after controlling for the effect of gender and body mass index, increased physical activity and healthier eating behavior predicted better well-being (b = 0.24, p < 0.01 and b = 0.19, p < 0.01, respectively), whereas sedentariness predicted worse well-being (b = -0.16, p < 0.01). Furthermore, it was revealed that days of physical activity per week was a stronger predictor of well-being than minutes of physical activity per week, and that both in-house and out-of-house physical activity were beneficial. Considering that well-being in our study was below the threshold recommended by the World Health Organization as indicative of possible depressive symptoms, measures to increase physical activity, decrease sedentariness and improve eating behavior should become a priority for communities and policy makers.

The Roles of Physical Activity, Exercise, and Fitness in Promoting Resilience During Adolescence: Effects on Mental Well-Being and Brain Development

Adolescence is a critical yet vulnerable period for developing behaviors important for mental well-being. The existing literature suggests that physical activity (PA), exercise, and aerobic fitness promote well-being and reduce risk of mental health problems. In this review, we focus on PA, exercise, and fitness as modifiable resilience factors that may help promote self-regulation via strengthening of top-down control of bottom-up processes in the brain, thereby acting as a buffer against mental health problems during this period of vulnerability. First, we briefly review the link between PA, exercise, and aerobic fitness with mental well-being and reduced mental health problems in adolescence. Then we present how impairments in self-regulation, which involves top-down control to modulate bottom-up processes, are common across a wide range of mental health disorders. Finally, we use the extant neuroimaging literature to highlight how neural systems underlying top-down control continue to develop across adolescence, and propose that PA, exercise, and aerobic fitness may facilitate resilience through strengthening individual brain regions as well as large-scale neural circuits to improve emotional and behavioral regulation. Future neuroimaging studies assessing the effects of PA, exercise, and aerobic fitness at various developmental stages in each sex and studies considering the characteristics (e.g., frequency, intensity, type) and social context of PA and exercise are vital to better understand both macro- and microscale mechanisms by which these behaviors and attributes may facilitate mental health resilience during adolescent development.

Reducing Allostatic Load in Depression and Anxiety Disorders: Physical Activity and Yoga Practice as Add-On Therapies

The allostatic load (AL) index constitutes a useful tool to objectively assess the biological aspects of chronic stress in clinical practice. AL index has been positively correlated with cumulative chronic stress (physical and psychosocial stressors) and with a high risk to develop pathological conditions (e.g., metabolic syndrome, cardiovascular pathology, inflammatory disorders) and the so-called stress-related psychiatric disorders, including anxiety and depressive disorders. Chronic stress has negative effects on brain neuroplasticity, especially on hippocampal neurogenesis and these effects may be reversed by antidepressant treatments. Several evidences indicate that non-pharmacological interventions based on physical activity and yoga practice may add synergizing benefits to classical treatments (antidepressant and benzodiazepines) for depression and anxiety, reducing the negative effects of chronic stress. The aim of this review is to provide a general overview of current knowledge on AL and chronic stress in relation to depression and anxiety, physical activity and yoga practice.