The impact of sleep, physical activity and sedentary behaviour on symptoms of depression and anxiety before and during the COVID-19 pandemic in a sample of South African participants

AbstractDuring lockdowns associated with the COVID-19 pandemic, individuals have experienced poor sleep quality and sleep regularity, changes in lifestyle behaviours, and heightened depression and anxiety. However, the inter-relationship and relative strength of those behaviours on mental health outcomes is still unknown. We collected data between 12 May and 15 June 2020 from 1048 South African adults (age: 32.76 ± 14.43 years; n = 767 female; n = 473 students) using an online questionnaire. Using structural equation modelling, we investigated how insomnia symptoms, sleep regularity, exercise intensity/frequency and sitting/screen-use (sedentary screen-use) interacted to predict depressive and anxiety-related symptoms before and during lockdown. We also controlled for the effects of sex and student status. Irrespective of lockdown, (a) more severe symptoms of insomnia and greater sedentary screen-use predicted greater symptoms of depression and anxiety and (b) the effects of sedentary screen-use on mental health outcomes were mediated by insomnia. The effects of physical activity on mental health outcomes, however, were only significant during lockdown. Low physical activity predicted greater insomnia symptom severity, which in turn predicted increased depressive and anxiety-related symptoms. Overall, relationships between the study variables and mental health outcomes were amplified during lockdown. The findings highlight the importance of maintaining physical activity and reducing sedentary screen-use to promote better sleep and mental health.

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The Impact Of Sleep, Physical Activity And Sedentary Behaviour On Symptoms of Depression And Anxiety Before And During The COVID-19 Pandemic

10.21203/rs.3.rs-525775/v1 ◽

2021 ◽

Author(s):

Raphaella Lewis ◽

Laura C. Roden ◽

Karine Scheuermaier ◽

Francesc X. Gomez-Olive ◽

Dale E. Rae ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Health Outcomes ◽

Structural Equation ◽

Relative Strength ◽

Mental Health Outcomes ◽

Depression And Anxiety ◽

Symptoms Of Depression ◽

The Impact ◽

Screen Use

Abstract During lockdowns associated with the COVID-19 pandemic, individuals have experienced changes in sleep and lifestyle behaviours, and heightened depression and anxiety. However, the inter-relationship and relative strength of those behaviours on mental health outcomes is still unknown. Using structural equation modelling, we investigated how insomnia symptoms, sleep regularity, exercise intensity/frequency and sitting/screen-use (sedentary screen-use) interacted to predict depressive and anxiety-related symptoms before and during lockdown in 1048 South African adults (median age: 27y; n = 767 female; n = 473 students). We also controlled for the effects of sex and student status. Irrespective of lockdown, (a) more severe symptoms of insomnia and greater sedentary screen-use predicted greater symptoms of depression and anxiety and (b) the effects of sedentary screen-use on mental health outcomes were mediated by insomnia. The effects of physical activity on mental health outcomes, however, were only significant during lockdown. Low physical activity was associated with greater insomnia symptom severity, which in turn was associated with increased depressive and anxiety-related symptoms. Overall, relationships between the study variables and mental health outcomes were amplified during lockdown. The findings highlight the importance of maintaining physical activity and reducing sedentary screen-use to promote better sleep and mental health.

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The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials

Public Health Nutrition ◽

10.1017/s1368980014002614 ◽

2015 ◽

Vol 18 (11) ◽

pp. 2074-2093 ◽

Cited By ~ 91

Author(s):

Rachelle S Opie ◽

Adrienne O’Neil ◽

Catherine Itsiopoulos ◽

Felice N Jacka

Keyword(s):

Mental Health ◽

Systematic Review ◽

Health Outcomes ◽

Randomised Controlled Trials ◽

Mental Health Outcomes ◽

Controlled Trials ◽

Depression And Anxiety ◽

Dietary Interventions ◽

Randomised Controlled ◽

The Impact

AbstractObjectiveNon-pharmacological approaches to the treatment of depression and anxiety are of increasing importance, with emerging evidence supporting a role for lifestyle factors in the development of these disorders. Observational evidence supports a relationship between habitual diet quality and depression. Less is known about the causative effects of diet on mental health outcomes. Therefore a systematic review was undertaken of randomised controlled trials of dietary interventions that used depression and/or anxiety outcomes and sought to identify characteristics of programme success.DesignA systematic search of the Cochrane, MEDLINE, EMBASE, CINAHL, PubMed and PyscInfo databases was conducted for articles published between April 1971 and May 2014.ResultsOf the 1274 articles identified, seventeen met eligibility criteria and were included. All reported depression outcomes and ten reported anxiety or total mood disturbance. Compared with a control condition, almost half (47 %) of the studies observed significant effects on depression scores in favour of the treatment group. The remaining studies reported a null effect. Effective dietary interventions were based on a single delivery mode, employed a dietitian and were less likely to recommend reducing red meat intake, select leaner meat products or follow a low-cholesterol diet.ConclusionsAlthough there was a high level of heterogeneity, we found some evidence for dietary interventions improving depression outcomes. However, as only one trial specifically investigated the impact of a dietary intervention in individuals with clinical depression, appropriately powered trials that examine the effects of dietary improvement on mental health outcomes in those with clinical disorders are required.

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Prospective examination of mental health in university students during the COVID-19 pandemic

10.1101/2021.07.29.21261196 ◽

2021 ◽

Author(s):

Ru Jia ◽

Holly Knight ◽

Kieran Ayling ◽

Carol Coupland ◽

Jessia Corner ◽

...

Keyword(s):

Mental Health ◽

University Students ◽

Health Outcomes ◽

Positive Mood ◽

Poor Mental Health ◽

Female Students ◽

Mental Health Outcomes ◽

Depression And Anxiety ◽

Mental Health Difficulties ◽

The Impact

Background: The impact of changing social restrictions on the mental health of students during the COVID-19 pandemic warrants exploration. Aims: To prospectively examine changes to university students mental health during the pandemic. Methods: Students completed repeated online surveys at three time points (October 2020 (baseline), February 2021, March 2021) to explore relationships between demographic and psychological factors (loneliness and positive mood) and mental health outcomes (depression, anxiety, and stress). Results: A total of 893 students participated. Depression and anxiety levels were higher at all timepoints than pre-pandemic normative data (p<.001). Scores on all mental health measures were highest in February, with depression and anxiety remaining significantly higher in March than baseline. Female students and those with previous mental health disorders were at greatest risk of poor mental health outcomes. Lower positive mood and greater loneliness at baseline were associated with greater depression and anxiety at follow-ups. Baseline positive mood predicted improvement of depression and anxiety at follow-ups. Conclusion: Depression and anxiety were significantly higher than pre-pandemic norms, with female students and those with previous mental health difficulties being at greatest risk. Given these elevated rates, universities should ensure adequate support is available to meet potentially increased demand for services.

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The Impact of Long-Term Physical Activity Interventions for Overweight/Obese Postmenopausal Women on Adiposity Indicators, Physical Capacity, and Mental Health Outcomes: A Systematic Review

Journal of Obesity ◽

10.1155/2016/6169890 ◽

2016 ◽

Vol 2016 ◽

pp. 1-22 ◽

Cited By ~ 14

Author(s):

Amanda Baker ◽

Héloïse Sirois-Leclerc ◽

Heather Tulloch

Keyword(s):

Mental Health ◽

Physical Activity ◽

Health Outcomes ◽

Postmenopausal Women ◽

Physical Capacity ◽

Mental Health Outcomes ◽

Future Research ◽

Physical Activity Interventions ◽

The Impact

Physical activity interventions have recently become a popular strategy to help postmenopausal women prevent and manage obesity. The current systematic review evaluates the efficacy of physical activity interventions among overweight and obese postmenopausal women and sheds light on the behavioral change techniques that were employed in order to direct future research.Method. Five electronic databases were searched to identify all prospective RCT studies that examine the impact of physical activity on adiposity indicators, physical capacity, and/or mental health outcomes among healthy, sedentary overweight, and obese postmenopausal women in North America. The behavior change technique taxonomy was used to identify the various strategies applied in the programs.Results. Five RCTs met the inclusion criteria. The findings showed that adiposity indicators and physical capacity outcomes significantly improved following long-term interventions; however, mental health outcomes showed nonsignificant changes. Furthermore, 17 behavior change techniques were identified with the taxonomy across all trials. The intrapersonal-level techniques were the most common.Conclusion. Physical activity interventions had a positive effect on adiposity measures and physical capacity. Future research should focus on testing the effectiveness of physical activity interventions on mental health and incorporate strategies at the individual and environmental level to maximize the health impact on the population.

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Effects of Reallocating Physical Activity, Sedentary Behaviors, and Sleep on Mental Health: A Cross-Sectional Examination of Canadian Adolescents in the COMPASS Study

10.21203/rs.3.rs-33268/v1 ◽

2020 ◽

Author(s):

Jenna Gilchrist ◽

Kate Battista ◽

Karen A. Patte ◽

Guy Faulkner ◽

Valerie Carson ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Health Outcomes ◽

Sleep Duration ◽

Screen Time ◽

Critical Role ◽

Mental Health Outcomes ◽

Sedentary Behaviors ◽

Cross Sectional ◽

The Impact

Abstract Background: Physical activity, sedentary behavior, and sleep are associated with mental health in adolescents. Mental health may depend not only on the amount of time spent in a specific activity, but also on the activity it displaces. The aim of this study was to examine the impact of reallocating 15 minutes of time spent in one health behavior with 15 minutes in another on adolescent mental health. Methods: Cross-sectional data from the students participating in the COMPASS Study (2018-2019) were analyzed (N = 46,413). Participants self-reported the amount of time they spent engaged in moderate-to-vigorous physical activity (MVPA), doing homework and using screens, and their sleep duration on average each day. Participants also self-reported depressive symptoms, anxiety, and flourishing. Data were analyzed using isotemporal substitution modeling. Results: Non-linear associations were evident between sleep and the mental health outcomes, so analyses were stratified by sleep duration based on whether students reported meeting current guidelines or not. Among adolescents getting less than the recommended amount of sleep, replacing any behaviour with sleep was generally associated with better mental health outcomes. Conversely, among adolescents getting adequate sleep, the findings did not support replacing other behaviors with sleep with the exception of screen time. Replacing homework and MVPA with sleep was associated with less flourishing regardless of sleep duration. Of the two sedentary behaviors assessed, replacing screen time with homework was associated with less depression and greater flourishing. However, replacing any behavior with homework was associated with greater anxiety regardless of whether participants reported adequate sleep or not.Conclusions: Replacing screen time with any behaviour may be better for mental health outcomes. Results provide further support for the critical role of sleep in promoting healthy development during adolescence, though more sleep than is recommended may confer little benefit for mental health. Youth getting adequate sleep may benefit from replacing screen time with homework or MVPA. The findings demonstrate that mental health benefits may be obtainable at intervals as short as 15 minutes.

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Effect of a physical activity and sleep m-health intervention on a composite activity-sleep behaviour score and mental health: a mediation analysis of two randomised controlled trials

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01112-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Mitch J. Duncan ◽

Anna T. Rayward ◽

Elizabeth G. Holliday ◽

Wendy J. Brown ◽

Corneel Vandelanotte ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Trial Registration ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Sleep Health ◽

Intervention Effects ◽

Symptoms Of Depression ◽

Randomised Controlled

Abstract Background To examine if a composite activity-sleep behaviour index (ASI) mediates the effects of a combined physical activity and sleep intervention on symptoms of depression, anxiety, or stress, quality of life (QOL), energy and fatigue in adults. Methods This analysis used data pooled from two studies: Synergy and Refresh. Synergy: Physically inactive adults (18–65 years) who reported poor sleep quality were recruited for a two-arm Randomised Controlled Trial (RCT) (Physical Activity and Sleep Health (PAS; n = 80), or Wait-list Control (CON; n = 80) groups). Refresh: Physically inactive adults (40–65 years) who reported poor sleep quality were recruited for a three-arm RCT (PAS (n = 110), Sleep Health-Only (SO; n = 110) or CON (n = 55) groups). The SO group was omitted from this study. The PAS groups received a pedometer, and accessed a smartphone/tablet “app” using behaviour change strategies (e.g., self-monitoring, goal setting, action planning), with additional email/SMS support. The ASI score comprised self-reported moderate-to-vigorous-intensity physical activity, resistance training, sitting time, sleep duration, efficiency, quality and timing. Outcomes were assessed using DASS-21 (depression, anxiety, stress), SF-12 (QOL-physical, QOL-mental) and SF-36 (Energy & Fatigue). Assessments were conducted at baseline, 3 months (primary time-point), and 6 months. Mediation effects were examined using Structural Equation Modelling and the product of coefficients approach (AB), with significance set at 0.05. Results At 3 months there were no direct intervention effects on mental health, QOL or energy and fatigue (all p > 0.05), and the intervention significantly improved the ASI (all p < 0.05). A more favourable ASI score was associated with improved symptoms of depression, anxiety, stress, QOL-mental and of energy and fatigue (all p < 0.05). The intervention effects on symptoms of depression ([AB; 95%CI] -0.31; − 0.60,-0.11), anxiety (− 0.11; − 0.27,-0.01), stress (− 0.37; − 0.65,-0.174), QOL-mental (0.53; 0.22, 1.01) and ratings of energy and fatigue (0.85; 0.33, 1.63) were mediated by ASI. At 6 months the magnitude of association was larger although the overall pattern of results remained similar. Conclusions Improvements in the overall physical activity and sleep behaviours of adults partially mediated the intervention effects on mental health and quality of life outcomes. This highlights the potential benefit of improving the overall pattern of physical activity and sleep on these outcomes. Trial registration Australian New Zealand Clinical Trial Registry: ACTRN12617000680369; ACTRN12617000376347. Universal Trial number: U1111–1194-2680; U1111–1186-6588. Human Research Ethics Committee Approval: H-2016-0267; H-2016–0181.

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The impact of sitting time and physical activity on mental health during COVID-19 lockdown

Sport Sciences for Health ◽

10.1007/s11332-021-00791-2 ◽

2021 ◽

Author(s):

Matthew Pears ◽

Susanna Kola-Palmer ◽

Liane Beretta De Azevedo

Keyword(s):

Mental Health ◽

Physical Activity ◽

Health Outcomes ◽

Online Survey ◽

Depression Score ◽

Sitting Time ◽

Multiple Stepwise Regression Analysis ◽

Previous Diagnosis ◽

The Uk ◽

The Impact

Abstract Objective The primary aim of this study was to investigate the association between physical activity (PA) and sitting time on adults’ mental health (i.e., depression, anxiety and wellbeing) and the influence of mediators and confounders. Methods An online survey was disseminated in the UK between May and June 2020. A total of 284 participants (33.5 ± 12.4 years) self-reported their PA, sitting time and mental health through validated questionnaires. Results Multiple stepwise regression analysis revealed that being of younger age, female, on a lower income, with one or more comorbid health conditions, with a previous diagnosis of mood disorder and increased sitting time independently correlated with higher depression scores (F (13,219) = 12.31, p < 0.001), and explained 42% of the variance. Similar results were found for wellbeing where socio-demographic, health outcomes and sitting time influenced the subjective wellbeing (F (14,218) = 5.77, p < 0.001, 27% variance), although only socio-demographic and health outcomes contributed to the variation in anxiety score (F (13,219) = 7.84, p < 0.001, 32% variance). PA did not explain variation when sitting time was taken into account in any of the models. Combined analysis revealed that participants with lower sedentary time (< 8 h) and with both low or moderate and high PA presented a significantly lower depression score [low PA: (B = −2.7, 95% CI −4.88, −0.52); moderate and high PA (B = −2.7, −4.88, −0.52)]. Conclusion Sitting time was strongly associated with adverse mental health during COVID-19 lockdown and should be considered in future public health recommendations.

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Acute psychological impact of coronavirus disease 2019 outbreak among psychiatric professionals in China: a multicentre, cross-sectional, web-based study

BMJ Open ◽

10.1136/bmjopen-2020-047828 ◽

2021 ◽

Vol 11 (5) ◽

pp. e047828

Author(s):

Xin Guo ◽

Robert McCutcheon ◽

Toby Pillinger ◽

Atheeshaan Arumuham ◽

Jianhua Chen ◽

...

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Mental Stress ◽

Structural Equation ◽

Psychiatric Symptoms ◽

Mental Health Outcomes ◽

Considerable Proportion ◽

Cross Sectional ◽

Event Scale ◽

Symptoms Of Depression

ObjectivesTo assess the magnitude of mental health outcomes and associated factors among psychiatric professionals in mental health services during COVID-19 in China.Design, setting and participantsThis cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from psychiatric professionals in 34 hospitals between 29 January and 7 February 2020, in China. Hospitals equipped with fever clinics or deployed on wards for patients with COVID-19 were eligible.Primary outcome and measuresThe severity of symptoms of depression, anxiety, insomnia and distress were assessed by the Chinese versions of 9-item Patient Health Questionnaire, 7-item Generalised Anxiety Disorder, 7-item Insomnia Severity Index and 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression and structural equation modelling was performed to identify factors associated with mental health outcomes.ResultsA total of 610 psychiatric professionals were included. 29.8% were employed in Wuhan, and 22.5% were frontline workers. A considerable proportion of participants reported symptoms of depression (461 (75.6%)), anxiety (282 (46.2%)), insomnia (336 (55.1%)) and mental stress (481 (78.9%)). Psychiatric symptoms were associated with worrying about infection (eg, OR 2.36 (95% CI 1.27 to 4.39) for anxiety), risks of exposure to COVID-19 (eg, having inadequate personal protection equipment, OR 2.43 (1.32 to 4.47) for depression) and self-perceived physical health (eg, OR 3.22 (2.24 to 4.64) for mental stress). Information sources of COVID-19 were also found to be both positively (eg, information from relatives, OR 2.16 (1.46 to 3.21) for mental stress) and negatively (eg, information from TV, OR 0.52 (0.35 to 0.77) for mental stress) associated with mental stress. There is preliminary evidence that mental health might benefit from greater availability of mental healthcare services. The structural equation model analysis indicated that worrying about infection may be the primary mediator via which risk of exposure to COVID-19 pandemic affects the mental health of psychiatric professionals.ConclusionsThe current findings demonstrate several pathways via which the COVID-19 pandemic may have negatively affected the mental health of psychiatric professionals in China.

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The Impact of Mobile Application Systems Use on Mental Health Outcomes: A Secondary Analysis of the Effect of Systems Usage on Anxiety, Worry, & Emotional Reactivity Among Participants in the Unwinding Anxiety Program (Preprint)

10.2196/preprints.33696 ◽

2021 ◽

Author(s):

William Nardi ◽

Alexandra Roy ◽

Shira Dunsiger ◽

Judson Brewer

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Emotional Regulation ◽

Mobile Application ◽

Secondary Analysis ◽

Health Behavior Change ◽

Mental Health Outcomes ◽

Interoceptive Awareness ◽

Point Increase ◽

The Impact

BACKGROUND Mobile health applications provide a promising avenue to help mitigate the burden on mental health services by complimenting therapist-led treatments for anxiety. However, it remains unclear how specific systems' use of application components (i.e., tools) may be associated with changes in clinical symptomatology (i.e., anxiety, worry). OBJECTIVE This study was a secondary analysis of systems usage data from the Stage I randomized controlled trial testing the impact of the Unwinding Anxiety mobile application among adults with GAD. This secondary analysis was conducted to assess how using specific application tools may be associated with improvements in anxiety, worry, emotional regulation, and interoceptive awareness. METHODS We present analyses of the intervention group (i.e., those who received the Unwinding Anxiety program) during the Stage 1 trial. Total use of specific mobile application tools (i.e., ecological tools, meditation practices, educational modules) as well use specific to each tool (e.g., stress meter, lovingkindness meditation practice) were calculated. We utilized multivariate linear models to investigate the effect of total use of these tools on anxiety, worry, interoceptive awareness, emotional regulation at 2-months post-program initiation controlling for baseline scores, age, and education level. In addition, associations between systems usage metrics and baseline participant characteristics were assessed for differences in usage groupings. RESULTS The sample was primarily female (n=25; 92.6%) and the average age was 42.9 years old (SD=15.6) and educational module completion, the central intervention component, averaged 20.2 + 11.4 modules out of XXX for the total sample. Multivariate models revealed that completing >75% of the program was associated with an average 22.6-point increase in interoceptive awareness (SE=8.32, p=0.013) and an 11.6-point decrease in worry (SE=4.12, p=0.009). In addition, a single log unit change in total number of meditations was associated with a 0.95-point reduction in GAD-7 scores (SE=0.27, p=0.005) while a single log unit use of the stress meter was associated with an average of a 0.5-point increase in emotional regulation scores (FFMQ) (SE=0.21, p=0.027). CONCLUSIONS The work presented offers a clearer understanding of the impact of specific mobile app systems use on mental health outcomes. In addition, this research lays the groundwork for future comprehensive investigations of systems usage in dosing studies for health behavior change. CLINICALTRIAL Developing a Novel Digital Therapeutic for the Treatment of Generalized Anxiety Disorder (NCT03683472).

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Longitudinal Effects of Gendered Harassment Perpetration and Victimization on Mental Health Outcomes in Adolescence

Journal of Interpersonal Violence ◽

10.1177/0886260517723746 ◽

2017 ◽

Vol 35 (23-24) ◽

pp. 5997-6016 ◽

Cited By ~ 11

Author(s):

Sarah J. Rinehart ◽

Dorothy L. Espelage ◽

Kristen L. Bub

Keyword(s):

Mental Health ◽

Sexual Harassment ◽

Health Outcomes ◽

Mental Health Outcomes ◽

Depression Symptoms ◽

Negative Outcomes ◽

Cross Sectional ◽

The Impact ◽

Homophobic Name Calling ◽

Gendered Harassment

Gendered harassment, including sexual harassment and homophobic name-calling, is prevalent in adolescents and is linked to negative outcomes including depression, anxiety, suicidality, substance abuse, and personal distress. However, much of the extant literature is cross-sectional and rarely are perpetrators of these behaviors included in studies of outcomes. Therefore, the current study examined the effects of longitudinal changes in gendered harassment perpetration and victimization on changes in mental health outcomes among a large sample of early adolescents. Given that these behaviors commonly occur in the context of a patriarchal society (males hold power), we also investigated the impact of gender on gendered harassment. Participants included 3,549 students from four Midwestern middle schools (50.4% female, 49% African American, 34% White) at two time points (13 and 17 years old). Results indicated that increases from age 13 to 17 years in sexual harassment perpetration and victimization and homophobic name-calling perpetration and victimization predicted increases in depression symptoms and substance use. Gender did not moderate these pathways. These findings highlight that negative outcomes are associated with changes in gendered harassment among adolescents and emphasize the importance of prevention efforts. Implications for school interventions are discussed.

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