Associations of 24-Hour Movement Behavior with Depressive Symptoms and Anxiety in Children: Cross-Sectional Findings from a Chinese Sample.

Md Mahbub Hossain,Si-Tong Chen,Liye Zou,Ting Wang,Boris Cheval,Ran Bao,Can Jiao,Shenghua Lu,Scott Doig,Jinming Li,Qian Yu,Jin Kuang,Alyx Taylor,Zhe Yan

doi:10.3390/healthcare9111532

Abstract

This study examined the associations between adherence to 24-hour movement behavior guidelines (24-HMB) and the mental-health-related outcomes of depressive symptoms and anxiety in Chinese children. Data on movement behavior from 5357 children (4th and 5th grades), including physical activity, recreational screen time and sleep, were self-reported using the Health Behavior School-Aged Children Survey. Depressive symptoms and anxiety were self-reported using the Chinese version of the nine-item Patient Health Questionnaire and the Generalized Anxiety Disorder Scale, respectively. Depressive symptoms and anxiety were treated as categorical variables. Only 3.2% of the participants met physical activity, screen time, and sleep 24-HMB guidelines. Ordinal logistic regressions showed that, compared with participants who met the 24-HMB guidelines, participants who met none (odds ratio (OR) = 2.62, 95% CI: 1.76–3.90) or any one of the guidelines (OR = 1.88, 95% CI: 1.27–2.77) had higher odds of depressive symptoms. Similarly, there were higher odds of anxiety in participants who met none (OR = 2.32, 95% CI: 1.45–3.70) or any one of the recommendations (OR = 1.62, 95% CI: 1.03–2.57) compared with participants who met all the 24-HMB guidelines. Meeting the 24-HMB guidelines is associated with better mental-health-related outcomes in Chinese children. Because of the low prevalence of Chinese children meeting the 24-HMB recommendations, the present findings highlight the need to encourage children to regularly engage in physical activity, decrease their time spent sitting, and improve their sleep patterns.

Highlights

Anxiety and depressive symptoms are concerning public health problems, because of their high prevalence and associated adverse health effects [1,2]
Our results showed that participants who met none or only one recommendation contained in the 24-hour movement behavior guidelines (24-HMB) guidelines have higher odds of being affected by anxiety and depressive symptoms compared with those who met all the three behavior guidelines
Our results indicate that children who met none or only one recommendation within the 24-hour movement guidelines are exposed to an increased risk of anxiety and depressive symptoms as compared with those who met all three recommendations of the 24-hour guidelines

Summary

Introduction

Anxiety and depressive symptoms are concerning public health problems, because of their high prevalence and associated adverse health effects [1,2]. In the US, nationally representative data indicates that 7.1% of 3- to 17-year-old children exhibit anxiety-related problems [1], which are responsible for multiple negative health outcomes [5] Both anxiety and depressive symptoms are associated with an increased risk of engaging in detrimental health behaviors, such as obesity-related behaviors (e.g., excessive screen time and low levels of daily exercise), substance use (e.g., use of cigarettes and alcohol), a lack of social interaction, and even suicidality [6,7,8]. This evidence stimulates an urgent call for effective actions against anxiety and depressive symptoms in adolescents, which can establish a healthier society in the long run

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