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Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Physical activity inversely associated with the presence of depression among urban adolescents in regional China

Authors: Xin Hong, JieQuan Li, Fei Xu, Lap Ah Tse, YaQiong Liang, ZhiYong Wang, Ignatius Tak-sun Yu, Sian Griffiths

Published in: BMC Public Health | Issue 1/2009

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Abstract

Background

An inverse relationship between physical activity (PA) and depression among adolescents has been reported in developed communities without consideration of sedentary behaviors (SB, including sitting for course study, viewing TV, and sleeping). We explored the association between recreational PA time (hr/wk) and depression after adjustment with SB and other possible confounders among Chinese adolescents.

Methods

A population-based cross-sectional study was conducted in Nanjing municipality of China in 2004 using a multi-stage cluster sampling approach. A total of 72 classes were randomly selected from 24 urban junior high schools and all students completed the structured questionnaire. Adolescent depression was examined by the Children's Depression Inventory (CDI) of Chinese version with cutoff point value of 20 or above as the presence of depression. Recreational PA time was measured by a question on weekly hours of PA outside of school. Descriptive statistics, multivariate logistic and linear regression models were used in analysis.

Results

The overall prevalence of depression was 15.7% (95%CI: 14.3%, 17.1%) among 2,444 eligible participants. It was found that physical activity was negatively associated with depression. After adjustment for sedentary behaviors and other potential confounders, participants who spent 1–7 hr/wk, 8–14 hr/wk and 15+ hr/wk for recreational PA, respectively, had odds ratios of 0.70 (95% CI = 0.57, 0.86), 0.68 (95% CI = 0.53, 0.88) and 0.66 (95% CI = 0.50, 0.87) for likelihood of being depressive, compared to their counterparts who spent 0–0.9 hr/wk for PA. This inverse relationship between PA time and depression remained statistically significant by gender and grade.

Conclusion

This study, conducted among Chinese adolescents, strengthened the evidence that physical activity was inversely associated with depression. Our study has important implications for health officers and public health professionals to pay much attention to the relationship between physical activity and depression in Mainland China.
Literature
1.
go back to reference Murray CJ, Lopez AD: Evidence-based health policy-lessons from the Global Burden of Disease Study. Science. 1996, 274: 740-743. 10.1126/science.274.5288.740.CrossRefPubMed Murray CJ, Lopez AD: Evidence-based health policy-lessons from the Global Burden of Disease Study. Science. 1996, 274: 740-743. 10.1126/science.274.5288.740.CrossRefPubMed
2.
go back to reference Allen NB, Hetrick SE, Simmons JG, Hickie IB: Early intervention for depressive disorders in young people: the opportunity and the (lack of) evidence. Med J Aust. 2007, 187: S15-17.PubMed Allen NB, Hetrick SE, Simmons JG, Hickie IB: Early intervention for depressive disorders in young people: the opportunity and the (lack of) evidence. Med J Aust. 2007, 187: S15-17.PubMed
3.
go back to reference Field T, Diego M, Sanders CE: Exercise is positively related to adolescents' relationships and academics. Adolescence. 2001, 36: 105-110.PubMed Field T, Diego M, Sanders CE: Exercise is positively related to adolescents' relationships and academics. Adolescence. 2001, 36: 105-110.PubMed
4.
go back to reference Sanders CE, Field TM, Diego M, Kaplan M: Moderate involvement in sports is related to lower depression levels among adolescents. Adolescence. 2000, 35: 793-797.PubMed Sanders CE, Field TM, Diego M, Kaplan M: Moderate involvement in sports is related to lower depression levels among adolescents. Adolescence. 2000, 35: 793-797.PubMed
5.
go back to reference Brodersen NH, Steptoe A, Williamson S, Wardle J: Sociodemographic, developmental, environmental, and psychological correlates of physical activity and sedentary behavior at age 11 to 12. Ann Behav Med. 2005, 29: 2-11. 10.1207/s15324796abm2901_2.CrossRefPubMed Brodersen NH, Steptoe A, Williamson S, Wardle J: Sociodemographic, developmental, environmental, and psychological correlates of physical activity and sedentary behavior at age 11 to 12. Ann Behav Med. 2005, 29: 2-11. 10.1207/s15324796abm2901_2.CrossRefPubMed
6.
go back to reference Kirkcaldy BD, Shephard RJ, Siefen RG: The relationship between physical activity and self-image and problem behaviour among adolescents. Soc Psychiatry Psychiatr Epidemiol. 2002, 37: 544-550. 10.1007/s00127-002-0554-7.CrossRefPubMed Kirkcaldy BD, Shephard RJ, Siefen RG: The relationship between physical activity and self-image and problem behaviour among adolescents. Soc Psychiatry Psychiatr Epidemiol. 2002, 37: 544-550. 10.1007/s00127-002-0554-7.CrossRefPubMed
7.
go back to reference Ussher MH, Owen CG, Cook DG, Whincup PH: The relationship between physical activity, sedentary behaviour and psychological wellbeing among adolescents. Soc Psychiatry Psychiatr Epidemiol. 2007, 42: 851-856. 10.1007/s00127-007-0232-x.CrossRefPubMed Ussher MH, Owen CG, Cook DG, Whincup PH: The relationship between physical activity, sedentary behaviour and psychological wellbeing among adolescents. Soc Psychiatry Psychiatr Epidemiol. 2007, 42: 851-856. 10.1007/s00127-007-0232-x.CrossRefPubMed
8.
go back to reference Allison KR, Adlaf EM, Irving HM, Hatch JL, Smith TF, Dwyer JJ, Goodman J: Relationship of vigorous physical activity to psychologic distress among adolescents. J Adolesc Health. 2005, 37: 164-166. 10.1016/j.jadohealth.2004.08.017.CrossRefPubMed Allison KR, Adlaf EM, Irving HM, Hatch JL, Smith TF, Dwyer JJ, Goodman J: Relationship of vigorous physical activity to psychologic distress among adolescents. J Adolesc Health. 2005, 37: 164-166. 10.1016/j.jadohealth.2004.08.017.CrossRefPubMed
9.
go back to reference Tomson LM, Pangrazi RP, Friedman G: Childhood depressive symptoms, physical activity and health related fitness. J Sport Exerc Psychol. 2003, 25: 419-439. Tomson LM, Pangrazi RP, Friedman G: Childhood depressive symptoms, physical activity and health related fitness. J Sport Exerc Psychol. 2003, 25: 419-439.
10.
go back to reference Fulkerson JA, Sherwood NE, Perry CL, Neumark-Sztainer D, Story M: Depressive symptoms and adolescent eating and health behaviours: a multifaceted view in a population-based sample. Prev Med. 2004, 38: 865-875. 10.1016/j.ypmed.2003.12.028.CrossRefPubMed Fulkerson JA, Sherwood NE, Perry CL, Neumark-Sztainer D, Story M: Depressive symptoms and adolescent eating and health behaviours: a multifaceted view in a population-based sample. Prev Med. 2004, 38: 865-875. 10.1016/j.ypmed.2003.12.028.CrossRefPubMed
11.
go back to reference Brosnahan J, Steffen LM, Lytle L, Patterson J, Boostrom A: The relation between physical activity and mental health among Hispanic and non-Hispanic white adolescents. Arch Pediatr Adolesc Med. 2004, 158: 818-823. 10.1001/archpedi.158.8.818.CrossRefPubMed Brosnahan J, Steffen LM, Lytle L, Patterson J, Boostrom A: The relation between physical activity and mental health among Hispanic and non-Hispanic white adolescents. Arch Pediatr Adolesc Med. 2004, 158: 818-823. 10.1001/archpedi.158.8.818.CrossRefPubMed
12.
go back to reference Desha LN, Ziviani JM, Nicholson JM, Martin G, Darnell RE: Physical activity and depressive symptoms in American adolescents. J Sport Exerc Psychol. 2007, 29: 534-543.PubMed Desha LN, Ziviani JM, Nicholson JM, Martin G, Darnell RE: Physical activity and depressive symptoms in American adolescents. J Sport Exerc Psychol. 2007, 29: 534-543.PubMed
13.
go back to reference Johnson CC, Murray DM, Elder JP, et al: Depressive symptoms and physical activity in adolescent girls. Med Sci Sports Exerc. 2008, 40: 818-826. 10.1249/MSS.0b013e3181632d49.CrossRefPubMed Johnson CC, Murray DM, Elder JP, et al: Depressive symptoms and physical activity in adolescent girls. Med Sci Sports Exerc. 2008, 40: 818-826. 10.1249/MSS.0b013e3181632d49.CrossRefPubMed
14.
go back to reference Tao FB, Xu ML, Kim SD, Sun Y, Su PY, Huang K: Physical activity might not be the protective factor for health risk behaviours and psychopathological symptoms in adolescents. J Paediatr Child Health. 2007, 43: 762-767. 10.1111/j.1440-1754.2007.01217.x.CrossRefPubMed Tao FB, Xu ML, Kim SD, Sun Y, Su PY, Huang K: Physical activity might not be the protective factor for health risk behaviours and psychopathological symptoms in adolescents. J Paediatr Child Health. 2007, 43: 762-767. 10.1111/j.1440-1754.2007.01217.x.CrossRefPubMed
15.
go back to reference Clark C, Haines MM, Head J, Klineberg E, Arephin M, Viner R, Taylor SJ, Booy R, Bhui K, Stansfeld SA: Psychological symptoms and physical health and health behaviours in adolescents: a prospective 2-year study in East London. Addiction. 2007, 102: 126-135. 10.1111/j.1360-0443.2006.01621.x.CrossRefPubMed Clark C, Haines MM, Head J, Klineberg E, Arephin M, Viner R, Taylor SJ, Booy R, Bhui K, Stansfeld SA: Psychological symptoms and physical health and health behaviours in adolescents: a prospective 2-year study in East London. Addiction. 2007, 102: 126-135. 10.1111/j.1360-0443.2006.01621.x.CrossRefPubMed
16.
go back to reference Motl RW, Birnbaum AS, Kubik MY, Dishman RK: Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosom Med. 2004, 66: 336-342. 10.1097/01.psy.0000126205.35683.0a.PubMed Motl RW, Birnbaum AS, Kubik MY, Dishman RK: Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosom Med. 2004, 66: 336-342. 10.1097/01.psy.0000126205.35683.0a.PubMed
17.
go back to reference Sagatun A, Søgaard AJ, Bjertness E, Selmer R, Heyerdahl S: The association between weekly hours of physical activity and mental health: a three-year follow-up study of 15–16-year-old students in the city of Oslo, Norway. BMC Public Health. 2007, 7: 155-163. 10.1186/1471-2458-7-155.CrossRefPubMedPubMedCentral Sagatun A, Søgaard AJ, Bjertness E, Selmer R, Heyerdahl S: The association between weekly hours of physical activity and mental health: a three-year follow-up study of 15–16-year-old students in the city of Oslo, Norway. BMC Public Health. 2007, 7: 155-163. 10.1186/1471-2458-7-155.CrossRefPubMedPubMedCentral
18.
go back to reference Ornelas IJ, Perreira KM, Ayala GX: Parental influences on adolescent physical activity: a longitudinal study. Int J Behav Nutr Phys Act. 2007, 4: 3-12. 10.1186/1479-5868-4-3.CrossRefPubMedPubMedCentral Ornelas IJ, Perreira KM, Ayala GX: Parental influences on adolescent physical activity: a longitudinal study. Int J Behav Nutr Phys Act. 2007, 4: 3-12. 10.1186/1479-5868-4-3.CrossRefPubMedPubMedCentral
19.
go back to reference Dunn AL, Trivedi MH, Kampert JB, Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO, et al: The DOSE study: a clinical trial to examine efficacy and dose response of exercise as treatment for depression. Control Clin Trials. 2002, 23: 584-603. 10.1016/S0197-2456(02)00226-X.CrossRefPubMed Dunn AL, Trivedi MH, Kampert JB, Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO, et al: The DOSE study: a clinical trial to examine efficacy and dose response of exercise as treatment for depression. Control Clin Trials. 2002, 23: 584-603. 10.1016/S0197-2456(02)00226-X.CrossRefPubMed
20.
go back to reference Yang XZ, Liu BC: Cross-sectional comparison of study burden among students in different countries. Shanghai Educ Res. 2002, 4: 58-61. Yang XZ, Liu BC: Cross-sectional comparison of study burden among students in different countries. Shanghai Educ Res. 2002, 4: 58-61.
21.
go back to reference Kovacs M: Rating scales to assess depression in school-aged children. Acta Paedopsychiatr. 1981, 46: 305-315.PubMed Kovacs M: Rating scales to assess depression in school-aged children. Acta Paedopsychiatr. 1981, 46: 305-315.PubMed
22.
go back to reference Cowell JM, Gross D, McNaughton D, Ailey S, Fogg L: Depression and suicidal ideation among Mexican American school-aged children. Res Theory Nurs Pract. 2005, 19: 77-94. 10.1891/rtnp.19.1.77.66337.CrossRefPubMed Cowell JM, Gross D, McNaughton D, Ailey S, Fogg L: Depression and suicidal ideation among Mexican American school-aged children. Res Theory Nurs Pract. 2005, 19: 77-94. 10.1891/rtnp.19.1.77.66337.CrossRefPubMed
23.
go back to reference Poli P, Sbrana B, Marcheschi M, Masi G: Self-reported depressive symptoms in a school sample of Italian children and adolescents. Child Psychiatry Hum Dev. 2003, 33: 209-226. 10.1023/A:1021404613832.CrossRefPubMed Poli P, Sbrana B, Marcheschi M, Masi G: Self-reported depressive symptoms in a school sample of Italian children and adolescents. Child Psychiatry Hum Dev. 2003, 33: 209-226. 10.1023/A:1021404613832.CrossRefPubMed
24.
go back to reference Frigerio A, Pesenti S, Molteni M, Snider J, Battaglia M: Depressive symptoms as measured by the CDI in a population of northern Italian children. Eur Psychiatry. 2001, 16: 33-37. 10.1016/S0924-9338(00)00533-2.CrossRefPubMed Frigerio A, Pesenti S, Molteni M, Snider J, Battaglia M: Depressive symptoms as measured by the CDI in a population of northern Italian children. Eur Psychiatry. 2001, 16: 33-37. 10.1016/S0924-9338(00)00533-2.CrossRefPubMed
25.
go back to reference Swallen KC, Reither EN, Haas SA, Meier AM: Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics. 2005, 115: 340-347. 10.1542/peds.2004-0678.CrossRefPubMed Swallen KC, Reither EN, Haas SA, Meier AM: Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics. 2005, 115: 340-347. 10.1542/peds.2004-0678.CrossRefPubMed
26.
go back to reference Ozmen D, Ozmen E, Ergin D, Cetinkaya AC, Sen N, Dundar PE, Taskin EO: The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents. BMC Public Health. 2007, 7: 80-86. 10.1186/1471-2458-7-80.CrossRefPubMedPubMedCentral Ozmen D, Ozmen E, Ergin D, Cetinkaya AC, Sen N, Dundar PE, Taskin EO: The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents. BMC Public Health. 2007, 7: 80-86. 10.1186/1471-2458-7-80.CrossRefPubMedPubMedCentral
27.
go back to reference Li YP, Ma GS, Schouten EG, Hu XQ, Cui ZH, Wang D, Kok FJ: Report on childhood obesity in China (5) body weight, body dissatisfaction, and depression symptoms of Chinese children aged 9–10 years. Biomed Environ Sci. 2007, 20: 11-18.PubMed Li YP, Ma GS, Schouten EG, Hu XQ, Cui ZH, Wang D, Kok FJ: Report on childhood obesity in China (5) body weight, body dissatisfaction, and depression symptoms of Chinese children aged 9–10 years. Biomed Environ Sci. 2007, 20: 11-18.PubMed
28.
go back to reference Chao CC, Chen SH, Wang CY, Wu YC, Yeh CH: Psychosocial adjustment among pediatric cancer patients and their parents. Psychiatry Clin Neurosci. 2003, 57: 75-81. 10.1046/j.1440-1819.2003.01082.x.CrossRefPubMed Chao CC, Chen SH, Wang CY, Wu YC, Yeh CH: Psychosocial adjustment among pediatric cancer patients and their parents. Psychiatry Clin Neurosci. 2003, 57: 75-81. 10.1046/j.1440-1819.2003.01082.x.CrossRefPubMed
29.
go back to reference Chang HJ, Yang CY, Lin CR, Ku YL, Lee MB: Determinants of suicidal ideation in Taiwanese urban adolescents. J Formos Med Assoc. 2008, 107: 156-164. 10.1016/S0929-6646(08)60129-1.CrossRefPubMed Chang HJ, Yang CY, Lin CR, Ku YL, Lee MB: Determinants of suicidal ideation in Taiwanese urban adolescents. J Formos Med Assoc. 2008, 107: 156-164. 10.1016/S0929-6646(08)60129-1.CrossRefPubMed
30.
go back to reference Yu DW, Li X: Preliminary use of the children's depression inventory in China. Zhong Guo Xin Li Wei Sheng Za Zhi. 2000, 14: 225-227. Yu DW, Li X: Preliminary use of the children's depression inventory in China. Zhong Guo Xin Li Wei Sheng Za Zhi. 2000, 14: 225-227.
31.
go back to reference Qu NN, Li KJ: Study on the reliability and validity of international physical activity questionnaire. Zhonghua Liu Xing Bing Xue Za Zhi. 2004, 25: 265-268.PubMed Qu NN, Li KJ: Study on the reliability and validity of international physical activity questionnaire. Zhonghua Liu Xing Bing Xue Za Zhi. 2004, 25: 265-268.PubMed
32.
go back to reference Group of China Obesity Task Force: Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents. Zhonghua Liu Xing Bing Xue Za Zhi. 2004, 25: 97-102. Group of China Obesity Task Force: Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents. Zhonghua Liu Xing Bing Xue Za Zhi. 2004, 25: 97-102.
34.
go back to reference Schmalz DL, Deane GD, Birch LL, Davison KK: A longitudinal assessment of the links between physical activity and self-esteem in early adolescent non-Hispanic females. J Adolesc Health. 2007, 41: 559-565. 10.1016/j.jadohealth.2007.07.001.CrossRefPubMedPubMedCentral Schmalz DL, Deane GD, Birch LL, Davison KK: A longitudinal assessment of the links between physical activity and self-esteem in early adolescent non-Hispanic females. J Adolesc Health. 2007, 41: 559-565. 10.1016/j.jadohealth.2007.07.001.CrossRefPubMedPubMedCentral
35.
go back to reference Marquez DX, McAuley E: Social cognitive correlates of leisure time physical activity among Latinos. J Behav Med. 2006, 29: 281-289. 10.1007/s10865-006-9055-6.CrossRefPubMed Marquez DX, McAuley E: Social cognitive correlates of leisure time physical activity among Latinos. J Behav Med. 2006, 29: 281-289. 10.1007/s10865-006-9055-6.CrossRefPubMed
36.
go back to reference Ekeland E, Heian F, Hagen KB: Can exercise improve self esteem in children and young people? A systematic review of randomized controlled trials. Br J Sports Med. 2005, 39: 792-798. 10.1136/bjsm.2004.017707.CrossRefPubMedPubMedCentral Ekeland E, Heian F, Hagen KB: Can exercise improve self esteem in children and young people? A systematic review of randomized controlled trials. Br J Sports Med. 2005, 39: 792-798. 10.1136/bjsm.2004.017707.CrossRefPubMedPubMedCentral
37.
go back to reference Cohen S: Social relationships and health. Am Psychol. 2004, 59: 676-684. 10.1037/0003-066X.59.8.676.CrossRefPubMed Cohen S: Social relationships and health. Am Psychol. 2004, 59: 676-684. 10.1037/0003-066X.59.8.676.CrossRefPubMed
38.
go back to reference Kawachi I, Kennedy BP, Glass R: Social capital and self-rated health: A contextual analysis. Am J Public Health. 1999, 89: 1187-1193. 10.2105/AJPH.89.8.1187.CrossRefPubMedPubMedCentral Kawachi I, Kennedy BP, Glass R: Social capital and self-rated health: A contextual analysis. Am J Public Health. 1999, 89: 1187-1193. 10.2105/AJPH.89.8.1187.CrossRefPubMedPubMedCentral
39.
go back to reference Emslie GJ, Rush AJ, Weinberg WA, Kowatch RA, Hughes CW, Carmody T, Rintelmann J: A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry. 1997, 54: 1031-1037.CrossRefPubMed Emslie GJ, Rush AJ, Weinberg WA, Kowatch RA, Hughes CW, Carmody T, Rintelmann J: A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry. 1997, 54: 1031-1037.CrossRefPubMed
40.
go back to reference Berkey CS, Rockett HR, Field AE, Gillman MW, Frazier AL, Camargo CA, Colditz GA: Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics. 2000, 105: E56-10.1542/peds.105.4.e56.CrossRefPubMed Berkey CS, Rockett HR, Field AE, Gillman MW, Frazier AL, Camargo CA, Colditz GA: Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics. 2000, 105: E56-10.1542/peds.105.4.e56.CrossRefPubMed
41.
go back to reference Rifas-Shiman SL, Gillman MW, Field AE, Frazier AL, Berkey CS, Tomeo CA, Colditz GA: Comparing physical activity questionnaires for youth: seasonal vs annual format. Am J Prev Med. 2001, 20: 282-285. 10.1016/S0749-3797(01)00296-3.CrossRefPubMed Rifas-Shiman SL, Gillman MW, Field AE, Frazier AL, Berkey CS, Tomeo CA, Colditz GA: Comparing physical activity questionnaires for youth: seasonal vs annual format. Am J Prev Med. 2001, 20: 282-285. 10.1016/S0749-3797(01)00296-3.CrossRefPubMed
42.
go back to reference Booth ML, Okely AD, Chey T, Bauman A: The reliability and validity of the physical activity questions in the WHO health behaviour in schoolchildren (HBSC) survey: a population study. Br J Sports Med. 2001, 35: 263-267. 10.1136/bjsm.35.4.263.CrossRefPubMedPubMedCentral Booth ML, Okely AD, Chey T, Bauman A: The reliability and validity of the physical activity questions in the WHO health behaviour in schoolchildren (HBSC) survey: a population study. Br J Sports Med. 2001, 35: 263-267. 10.1136/bjsm.35.4.263.CrossRefPubMedPubMedCentral
Metadata
Title
Physical activity inversely associated with the presence of depression among urban adolescents in regional China
Authors
Xin Hong
JieQuan Li
Fei Xu
Lap Ah Tse
YaQiong Liang
ZhiYong Wang
Ignatius Tak-sun Yu
Sian Griffiths
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-148

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