Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study

M Claire Buchan,Karen A Patte,Scott T Leatherdale,Alexandra Butler,Rachel E Laxer,Isabella Romano

doi:10.1186/s12966-021-01201-z

Abstract

ObjectiveThe aim of this research was to examine the bidirectional association between self-reported symptoms of mental disorder and physical activity among a large sample of Canadian secondary school students over time.MethodsLinked survey data were obtained from 28,567 grade 9 to 12 students across Canada participating in two waves of the COMPASS Study (2017–18; 2018–19). Autoregressive cross-lagged models were run to examine the reciprocal relationships between self-reported moderate-to-vigorous physical activity (MVPA) and symptoms of depression (CESD-10) and anxiety (GAD-7). Models were stratified by gender, and accounted for grade, ethno-racial identity, and school-level clustering.ResultsAutoregressive associations show that neither symptoms of anxiety nor depression, at baseline, were predictive of mean MVPA at follow-up – consistent for the full sample and among both males and females. Higher MVPA among males at baseline was associated with lower symptoms of both anxiety (β = − 0.03, p = 0.002) and depression (β = − 0.05, p < 0.001) at follow-up. However, among females, higher MVPA at baseline was associated with greater symptoms of anxiety (β = 0.03, p < 0.001), but not symptoms of depression (β = 0.01, p = 0.073), at follow-up.ConclusionIn our large sample of Canadian secondary school students, associations between physical activity and symptoms of mental disorder were not bi-directional, and these relationships differed in males and females. This study illustrates the complex nature of the relationship between physical activity and symptoms of mental disorder among youth. While results support the benefits of promoting physical activity among males to prevent or manage internalizing symptoms, the relationship among females warrants further investigation.

Highlights

Mental disorders and physical inactivity are two leading causes of poor health outcomes and disability later in life in Canada [1,2,3]
Our findings suggest that symptoms of depression or anxiety are not predictive of moderate-to-vigorous physical activity (MVPA) over 1 year; it is possible that a relationship may be present if students were tracked longitudinally through elementary and secondary school, or if the impact of changes in mental disorder over time on physical activity levels was examined
Our findings indicated that in our large sample of Canadian secondary school students, associations between physical activity and symptoms of depression and anxiety were not bidirectional

Summary

Introduction

Mental disorders and physical inactivity are two leading causes of poor health outcomes and disability later in life in Canada [1,2,3]. Symptoms of depression and anxiety often begin in childhood and track into adulthood, with nearly 20% of Canadian youth meeting the criteria for at least one mental disorder diagnosis prior to the age of 18 [4,5,6]. There is an established link between MVPA and mental health in both adult and youth populations [11,12,13,14,15,16], and physical activity is recommended as a first-line treatment for mild-to-moderate depression in clinical samples of adults [17, 18]. While some literature indicates physical activity may be an opportunity for early and cost-effective intervention and a population-based approach [19] to promote mental health, evidence on this relationship remains less documented in youth [20]

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Results

Discussion

Conclusion