Mental health – adults

Background: While randomized controlled trials have demonstrated the short-term benefits of physical activity, particularly during leisure-time, on depressive symptoms, uncertainties persist regarding long-term interventions and the necessary dose in different domains.Purpose: Applying the principles of target trial emulation, our objective was to estimate the effect of sustained physical activity interventions on the 2-year risk of depressive symptoms among adults.Methods: We used the NutriNet-Brasil cohort, including 15,558 adults (12,036 women, 46.0±12.9) without depressive symptoms, as well as with complete data on baseline and pre-baseline potential confounders. Physical activity was assessed using the global physical activity questionnaire. Depressive symptoms were assessed using the Patient Health Questionnaire. We estimated the 2-year risk of developing depressive symptoms from baseline to the end of follow-up, incomplete follow-up or incident depressive symptoms, whichever comes first. We adjusted for pre-baseline, baseline and time-varying potential confounders, using parametric g-formula, to estimate the 2-year risk of depressive symptoms under different physical activity intervention strategies (i.e., domains and durations), comparing them to the natural course.Results: Compared to the estimated 30.7%(95%CI:27.1; 34.3) risk of depressive symptoms under the natural course, the 2-year risk of depressive symptoms was reduced by 0.4 percentage points (pp) (-0.7;-0.1) for ≥75min/wk, 1.2pp(-1.9;-0.4) for ≥ 150min/wk, and 2.2pp(-3.5;-0.8) for ≥300min/wk. Considering leisure-time physical activity, the risk was reduced in 1.5pp(-2.1;-1.1) for practicing any leisure-time physical activity, 3.2pp(-4.2;-2.3) for ≥75min/week, and 4.6pp(-6.1;-3.2) for ≥150min/week. However, emulated interventions on transport physical activity showed no association with a reduced risk of developing depressive symptoms.Conclusions: Adults experience a lower incidence of depressive symptoms with long-term sustained physical activity interventions, even with lower doses.Practical implications: Long-term strategies aimed at preventing incident depressive symptoms should prioritize leisure-time physical activity, particularly targeting individuals who do not engage in any leisure-time physical activity.Funding: São Paulo Research Foundation (process: 2019/24124-7).

Background : In recent decades, the efficacy of Adapted Physical Activity (APA) interventions in enhancing mental health has been well-established. However, a prevalent limitation in existing studies is the exclusive focus on homogeneous participant groups, sharing similar diseases or characteristics. This raises concerns that observed benefits may be attributed more to group effects than the inherent impact of physical activity. Purpose : This study aimed to assess the influence of an eight-week APA intervention on anxiety, depression, and self-esteem within a diverse participant cohort encompassing various health conditions and age groups.Methods : Participants (n = 69) were randomly assigned to either an experimental group (n = 38) undergoing the APA intervention or a control group (n = 31) deferring participation.Results: Compelling evidence emerged, indicating that the APA intervention significantly elevated self-esteem and concurrently alleviated symptoms of anxiety and depression. Importantly, these effects were evident even within a heterogeneous participant group.Conclusions : The outcomes of this study contribute valuable insights into the mental health benefits of APA, emphasizing its efficacy in diverse populations. The findings underscore the need for further research, particularly in comparing homogeneous and heterogeneous groups and delving into the underlying mechanisms.Practical Implications : These results advocate for the widespread implementation of APA interventions in diverse populations to enhance mental well-being. Policymakers and practitioners should consider the inclusive nature of APA interventions for comprehensive mental health support.

Background: Mental health disorders such as depression, anxiety, and stress have been identified as one of the main current societal problems, and are also associated with a lower perception of quality of life. The physical activity (PA) practice in free time is recognized for health benefits, including physical and mental aspects, assuming great importance for Public Health. Purpose: To analyze the association among free-time PA, mental health, and perception of quality of life in Primary Health Care users in the Auriflama municipality, SP, Brazil. Methods: A cross-sectional study, performed from August to October 2022, with 230 adults who answered questionnaires regarding mental health (DASS-21), perception of quality of life (SF-12v.2), and PA practice (IPAQ-long version). Simple and multiple binomial logistic regression models were used for the outcome free-time PA ≥ 150 minutes/week – results are expressed in odds ratio (OR) [95%CI]. Multiple linear regression models were used to compare free-time PA groups for the quality of life domains. Results: Participants classified as inactive during their free time presented a greater indication of risk for depression (3.49[1.54;7.89]) and anxiety (2.11;[1.04;4.27]). In the comparison of groups, inactive participants presented lower scores in all the quality of life domains (functional capacity, physical aspects, body pain, general health status, vitality, social aspects, emotional aspects, and mental health). Conclusion: People who practice at least 150 minutes of PA in free time per week had better outcomes related to mental health and perception of quality of life. Practical implications: It is useful to expand the possibilities of free-time PA access, understanding that these habits may not be choices for the majority and depend on people having basic and dignified living conditions. Funding: Andrella JL received a master’s scholarship from the Coordination for the Improvement of Higher Education Personnel (CAPES) of Brazil.

Background: Low physical activity and high sedentary behavior are independently associated with poorer mental health, however, studies examining their combined associations are scarce. Purpose: To examine the joint association of sedentary behavior and leisure-time physical activity (LTPA) on psychological distress in Finnish adult population from two cross-sectional studies before (2017) and after (2023) COVID-19 pandemic. Methods: Random sample of Finnish adults were asked to fill in questionnaire of the FinHealth 2017 (n=10 300) and Healthy Finland 2023 (n= 10 000) surveys. Analytical samples in 2017 (n=4400) and in 2023 (n=2900) were restricted to working age population. LTPA was classified into: inactive, moderately active, and active and non-work sedentary time into: low sedentary and high sedentary (>5 hours/day) yielding a six-category variable for the joint analyses. Psychological distress was measured with Mental Health Inventory-5 (MHI-5) dichotomized using clinically significant symptoms (≤ 52 points) as a cut-point. Logistic regression analysis was used adjusting for key covariates with SPSS 29. Results: The prevalence of psychological distress increased from 8% to 14% between 2017 and 2023. Compared with the active low sedentary group, the inactive high sedentary group in 2017 (OR 3.46 CI 95% 2.08-5.77) and in 2023 (OR 3.42 CI 95% 2.27-5.16) as well as, the moderate active high sedentary groups and the inactive low sedentary groups had increased likelihood of psychological distress. In 2017, the active high sedentary group also showed a similar association (OR 2.36, 95% CI 1.32-4.23), and in 2023 moderate active low sedentary group (OR 1.69, 95% CI 1.15-2.48) . Conclusions: The study emphasize that both lack of LTPA and high sedentary time associate with psychological distress in adults. Practical implications: Promoting LTPA and reduce sedentariness among the working-age population may prove useful to reduce psychological distress. Funding: Juho Vainio Foundation

Background: Research focused on the provision of on-campus tailored exercise programs for post-secondary student mental health is increasing. Yet, there is limited focus on process evaluation considerations (e.g., reach, engagement motives), which are important for optimizing program delivery and for the dissemination of research findings into practice. Purpose: To explore the reach (e.g., referral pathways, student characteristics, mental health challenges) and motives for engagement in a tailored 6-week exercise program for student mental health. Methods: Students were screened for eligibility (178 screened, 118 eligible) and the analytical sample included students who provided baseline descriptive data (N= 59; Mage = 26.09 years; 82% women; 30% international student). Motives for engagement were open-ended responses and coded using inductive content analysis. Results: Students primarily heard about the program through campus media marketing (29%) or were referred through campus mental health (29%) or student support (15%) services. Respondents reported a history of diagnosed mental illness (56%). Mental health challenges included anxiety (86%), trouble concentrating (74%), difficulty coping with stress in a healthy way (70%), depression (58%), and loneliness (44%). Motives for engagement were offered by 85% of students and included motivation and social support (30%), healthy routine building (22%), and learning strategies for improving overall mental, physical, and academic well-being through exercise (48%). Conclusions: The reach and motives for student engagement in a tailored exercise program for mental health were demonstrated. Practical implications: To optimize program delivery, it is critical to ensure support structures (e.g., training, guidelines, standards of practice) are available to equip program developers, researchers, and practitioners with practical tools and knowledge for delivering exercise programs for student mental health. Funding: Doctoral fellowship from the Social Sciences and Humanities Research Council held by MLD and an Inlight Student Mental Health Grant awarded to MLD and CMS. CMS holds a Canada Research Chair.