Associations between Physical Activity, Sitting Time, and Time Spent Outdoors with Mental Health during the First COVID-19 Lock Down in Austria

Measures implemented to reduce the spread of SARS-CoV-2 have resulted in a decrease in physical activity (PA) while sedentary behaviour increased. The aim of the present study was to explore associations between PA and mental health in Austria during COVID-19 social restrictions. In this web-based cross-sectional study (April–May 2020) moderate-to-vigorous physical activity (MVPA), sitting time, and time spent outdoors were self-reported before and during self-isolation. Mental well-being was assessed with the Warwick-Edinburgh Mental Well-being Scale, and the Beck depression and anxiety inventories. The majority of the participants (n = 652) were female (72.4%), with a mean age of 36.0 years and a standard deviation (SD) of 14.4. Moreover, 76.5% took part in ≥30 min/day of MVPA, 53.5% sat ≥10 h/day, and 66.1% spent ≥60 min/day outdoors during self-isolation. Thirty-eight point five percent reported high mental well-being, 40.5% reported depressive symptoms, and 33.9% anxiety symptoms. Participating in higher levels of MVPA was associated with higher mental well-being (odds ratio = OR: 3.92; 95% confidence interval = 95%CI: 1.51–10.15), less depressive symptoms (OR: 0.44; 95%CI: 0.29–0.66) and anxiety symptoms (OR = 0.62; 95%CI: 0.41–0.94), and less loneliness (OR: 0.46; 95%CI: 0.31–0.69). Participants sitting <10 h/day had higher odds of mental well-being (OR: 3.58; 95%CI: 1.13–11.35). Comparable results were found for spending ≥60 min/day outdoors. Maintaining one’s MVPA levels was associated with higher mental well-being (OR = 8.61, 95%CI: 2.68–27.62). In conclusion, results show a positive association between PA, time spent outdoors and mental well-being during COVID-19 social restrictions. Interventions aiming to increase PA might mitigate negative effects of such restrictions.

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Strange Days: Adult Physical Activity and Mental Health in the First Two Months of the COVID-19 Pandemic

Frontiers in Public Health ◽

10.3389/fpubh.2021.567552 ◽

2021 ◽

Vol 9 ◽

Author(s):

Madelaine Gierc ◽

Negin A. Riazi ◽

Matthew James Fagan ◽

Katie M. Di Sebastiano ◽

Mahabhir Kandola ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Life Satisfaction ◽

Depressive Symptoms ◽

Satisfaction With Life ◽

Vigorous Physical Activity ◽

Well Being ◽

Anxiety Symptoms ◽

Satisfaction With Life Scale ◽

Mental Health Symptomatology

Background: In addition to its physical health benefits, physical activity is increasingly recognized as a means to support mental health. Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental well-being, reduced likelihood of developing mental illness, and improved symptom management. Despite these benefits, most people fail to achieve minimum recommended levels of MVPA. Population levels of physical activity have further declined since the onset of the COVID-19 pandemic and implementation of public health measures (e.g., shelter-in-place protocols). The potential impact of this decline on mental heath outcomes warrants ongoing investigation.Purpose: To investigate associations between changes in MVPA and mental health (depressive symptoms, anxiety symptoms, and life satisfaction) in adults impacted by the COVID-19 pandemic.Method: Research followed a cross-sectional design. English-speaking adults were invited to complete an online questionnaire. MVPA was assessed retrospectively (before COVID-19) and currently (during COVID-19) with the International Physical Activity Questionnaire. Mental health was assessed with the Patient Health Questionnaire, 9-Item (PHQ-9), the Generalized Anxiety Disorder, 7-Item (GAD-7), and the Satisfaction with Life Scale (SWLS). Regression was used to assess relationships between MVPA and mental health. ANOVA with follow-up tests examined whether participants who differed in mental health status (e.g., no symptoms vs. severe symptoms) differed in their change in MVPA. T-tests were used to examine differences in mental health symptomatology between participants who were sufficiently (i.e., achieving MVPA guidelines of ≥ 150 min/week) vs. insufficiently active.Results: Prior to COVID-19, 68.2% of participants were classified as being sufficiently active, vs. 60.6% during COVID-19. The majority of participants reported experiencing some level of depressive symptoms (62.0%) or anxiety symptoms (53.7%). After controlling for covariates, changes in MVPA accounted for significant variability in the PHQ-9 (7.7%), GAD-7 (2.5%), and SWLS (1.5 %). Participants with clinically significant mental health symptomatology reported greater declines in MVPA than those who reported no symptoms. Conversely, participants who were sufficiently active during COVID-19 reported significantly lower depression and anxiety, and higher life satisfaction.Conclusion: Participants who experienced the greatest declines in MVPA reported relatively greater psychological distress and lower life satisfaction. While preliminary, these findings suggest the importance of maintaining and promoting physical activity during a period of pandemic.

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Perceptions of Study Conditions and Depressive Symptoms During the COVID-19 Pandemic Among University Students in Germany: Results of the International COVID-19 Student Well-Being Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.674665 ◽

2021 ◽

Vol 9 ◽

Author(s):

Paula Mayara Matos Fialho ◽

Franca Spatafora ◽

Lisa Kühne ◽

Heide Busse ◽

Stefanie M. Helmer ◽

...

Keyword(s):

Depressive Symptoms ◽

University Students ◽

Online Survey ◽

Positive Association ◽

Well Being ◽

Cross Sectional ◽

German Student ◽

The University ◽

The Impact ◽

Mental Well Being

Background: Results of previous studies examining the impact of the SARS-CoV-1 epidemic in 2003 on university students' mental well-being indicated severe mental health consequences. It is unclear how the current COVID-19 pandemic and the changes in study conditions due to federal regulations affected mental well-being in the German student population. We examined university students' perceptions of study conditions during the COVID-19 pandemic and investigated associations between study conditions and depressive symptoms.Methods: A cross-sectional online survey was conducted in Germany in May 2020 at four universities (N = 5,021, 69% female, mean age: 24 years, SD: 5.1). Perceived study conditions, as well as sociodemographic information, were assessed with self-generated items and the CES-D 8 scale was used to determine depressive symptoms. Associations between perceived study conditions (academic stress and academic satisfaction), in general, and confidence to complete the semester, in particular, and depressive symptoms were analyzed using generalized linear regressions.Results: Fifty-four percent of survey participants felt that the university workload had significantly increased since the COVID-19 pandemic; 48% were worried that they would not be able to successfully complete the academic year; 47% agreed that the change in teaching methods caused significant stress. Regarding depressive symptoms, the mean score of the CES-D 8 scale was 9.25. Further, a positive association between perceived study conditions and depressive symptoms was found (p < 0.001), indicating that better study conditions were associated with fewer depressive symptoms. Results of the generalized linear regression suggest that better student mental well-being was related to higher confidence in completing the semester.Conclusions: This study provides first insights into perceived study conditions and associations with depressive symptoms among students during the COVID-19 pandemic in Germany. Findings underline the need for universities to provide intervention strategies targeting students' mental well-being during the course of the pandemic.

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Vigorous physical activity, perceived stress, sleep and mental health among university students from 23 low- and middle-income countries

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2017-0116 ◽

2018 ◽

Vol 0 (0) ◽

Cited By ~ 6

Author(s):

Supa Pengpid ◽

Karl Peltzer

Keyword(s):

Mental Health ◽

Physical Activity ◽

University Students ◽

Sleep Quality ◽

Perceived Stress ◽

Vigorous Physical Activity ◽

Well Being ◽

Good Health ◽

Short Version ◽

Cross Sectional

AbstractBackgroundVigorous physical activity (VPA) may be beneficial for mental health. The aim of the study was to investigate cross-sectional associations between VPA, perceived stress, sleep quality and quantity and mental health among university students.MethodsIn a cross-sectional study, using anonymous questionnaires, data was collected from 15122 (42.1% male and 57.9% female) university students [mean age 20.6, standard deviation (SD) = 2.0] from 23 countries in the Americas, Africa and Asia. They were assessed using the International Physical Activity Questionnaire (short version), and measures of sociodemographic, health status, health behaviour and anthropometrics.ResultsStudents who met VPA recommendations were less likely to report perceived stress, more likely to report subjective good health and depression than students without VPA. There was no association between VPA and sleep quality and quantity and PTSD symptoms.ConclusionThis study only found partial benefits of VPA in relation to well-being of university students.

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The mental health and well-being benefits of exercise during the COVID-19 pandemic: a cross-sectional study of medical students and newly qualified doctors in the UK

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-020-02423-z ◽

2020 ◽

Author(s):

Conor Coyle ◽

Hanya Ghazi ◽

Ioannis Georgiou

Keyword(s):

Mental Health ◽

Physical Activity ◽

Medical Students ◽

Well Being ◽

Health Impact ◽

Cross Sectional Study ◽

Cross Sectional ◽

Mood Score ◽

The Uk ◽

Mental Well Being

Abstract Background University students have been uniquely affected by the COVID-19 pandemic. However, there is currently little data upon the measures that medical students and newly qualified doctors have taken to help their mental well-being and mood during the COVID-19 pandemic. Aim We aimed to identify the activities respondents found beneficial for their well-being and mental health and recorded a mood score from survey respondents. Methods A nationwide study was completed to investigate the mental health impact of the COVID-19 pandemic upon medical students and newly qualified doctors (interim foundation year one). We received 2075 respondents from across the UK. Results Physical activity was found to be the most common activity used by the survey respondents to help with their mental well-being (80.1%) (medical students, 83.7%; interim foundation doctors, 72.3%). Participants who stated that exercise helped their well-being had a mean score (SD) of 52.3 (20.7) which was significantly higher (P = 0.048) than those who reported that they did not exercise (49.8 (21.1)). Respondents who stated they had used exercise to help with their mental well-being had (on average) a higher mood score than those who did not. This was seen in both the medical student and interim foundation doctor subgroups. Discussion Exercise can help to benefit the well-being of medical students and interim foundation doctors. It is hoped that higher education providers and employers recognise the importance of promoting physical activity for the well-being of their students and staff, respectively.

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Challenging leisure activities and mental health: are they more beneficial for some people than for others?

Mental Health and Social Inclusion ◽

10.1108/mhsi-06-2021-0033 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Ziggi Ivan Santini ◽

Vibeke Koushede ◽

Carsten Hinrichsen ◽

Malene Kubstrup Nelausen ◽

Katrine Rich Madsen ◽

...

Keyword(s):

Mental Health ◽

Leisure Activities ◽

Leisure Activity ◽

Positive Association ◽

Well Being ◽

Anxiety Symptoms ◽

Depression Symptoms ◽

Work Study ◽

Content Type ◽

Mental Well Being

Purpose Previous studies have shown a positive association between being engaged or challenged through a leisure activity and good mental health; however, this relationship may vary by the extent to which individuals feel challenged at work or school. This study aims to examine whether a challenging work/study (or the lack of it) moderates the relationship between engaging in challenging leisure activity and mental health. Design/methodology/approach Data from 2,406 adults 16–64 years old from The Danish Mental Health and Well-Being Survey 2016 were linked to Danish national register-based data. Mental well-being (outcome) was assessed using the Warwick-Edinburgh Mental Well-being Scale and depression/anxiety symptoms (outcome) were assessed using the Patient Health Questionnaire-4. Multivariable linear regressions were performed to estimate the association between challenging leisure activity (predictor) and challenging work/study (potential moderator). Findings Overall, engaging in a challenging leisure activity was positively associated with mental well-being and negatively associated with anxiety symptoms. For these two, a challenging work/study significantly moderated the relationships. The positive association between a challenging activity and mental well-being was strongest among individuals not employed or studying as well as individuals feeling less challenged at work/school. Similarly, the negative association between a challenging activity and anxiety symptoms was strongest among individuals not employed or studying as well as individuals feeling less challenged at work/school. Among individuals with a very challenging work/study, challenging leisure activity was not associated with anxiety symptoms. Finally, engaging in a challenging leisure activity did not significantly predict depression symptoms. Originality/value Mental health promotion strategies may focus on promoting challenging leisure activities especially among groups not employed or enrolled in education or among individuals that do not feel challenged through their work or studies. The results may further have implications for efforts to address and protect employee/student mental health at workplaces or schools.

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Exploring the Association Between Physical Activity and Risk of Mental Health Disorders in Saudi Arabian Adults: Cross-sectional Study (Preprint)

10.2196/preprints.25438 ◽

2020 ◽

Author(s):

Nora A Althumiri ◽

Mada H Basyouni ◽

Nasser F BinDhim

Keyword(s):

Mental Health ◽

Physical Activity ◽

Depressive Symptoms ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Anxiety Symptoms ◽

World Health ◽

Moderate Intensity ◽

Generalized Anxiety ◽

Cross Sectional

BACKGROUND The relationship between physical activity and mental health, especially the symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD), has received increasing attention in recent years. OBJECTIVE The aim of this study was to explore the association between fulfilling the World Health Organization (WHO) global recommendations on physical activity and the risk and symptoms of MDD and GAD in the Saudi population. METHODS This study was a secondary analysis of data from a large nationwide cross-sectional survey conducted via phone interviews in June and July 2020. In this study, a proportional quota sampling technique was used to obtain an equal distribution of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. The main mental health screening tool used for the risk of MDD was the Patient Health Questionnaire-9 (PHQ-9). Risk of GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Participants self-reported whether they fulfill the WHO global recommendations on (1) moderate-intensity aerobic physical activity (MIPA) and (2) vigorous-intensity aerobic physical activity (VIPA). The results were then analyzed based on the following two categories: fulfilling the WHO global recommendations or not. RESULTS The data analysis included 8333 participants recruited in the main study between June and July 2020. The response rate was 81.45% (8333/10,231). Of them, 50.3% (4192/8333) were female, and the mean age was 36.5 years, with a median age of 36 years and a range from 18 to 90 years. The average total PHQ-9 score was 5.61, and the average total GAD-7 score was 4.18. For men, the average total PHQ-9 and GAD-7 scores were associated with fulfilling recommendations for MIPA; however, there were no associations for VIPA in both sexes. Fulfilling the WHO’s recommendations for MIPA was associated with considerably fewer depressive symptoms in six of the nine items in the PHQ-9. Moreover, fulfilling recommendations for MIPA was associated with considerably fewer anxiety symptoms in six of the seven items in the GAD-7. However, fulfilling recommendations for VIPA was significantly associated with more depressive symptoms in one of the PHQ-9 items (“Thoughts that you would be better off dead or thoughts of hurting yourself in some way;” <i>P</i><.001). CONCLUSIONS This study has shown that fulfilling guidelines on MIPA is associated with less overall risk of MDD and GAD in males and fewer depressive and anxiety symptoms generally in a nonclinical population. In the general population, an increase in MIPA may improve well-being and general mental health.

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The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and Diet

Frontiers in Psychology ◽

10.3389/fpsyg.2020.579205 ◽

2020 ◽

Vol 11 ◽

Author(s):

Shay-Ruby Wickham ◽

Natasha A. Amarasekara ◽

Adam Bartonicek ◽

Tamlin S. Conner

Keyword(s):

Mental Health ◽

Physical Activity ◽

Young Adults ◽

Depressive Symptoms ◽

Sleep Quality ◽

Health Behaviors ◽

Well Being ◽

Higher Order ◽

Cross Sectional ◽

Health And Well Being

BackgroundSleep, physical activity, and diet have been associated with mental health and well-being individually in young adults. However, which of these “big three” health behaviors most strongly predicts mental health and well-being, and their higher-order relationships in predictive models, is less known. This study investigated the differential and higher-order associations between sleep, physical activity, and dietary factors as predictors of mental health and well-being in young adults.MethodIn a cross-sectional survey design, 1,111 young adults (28.4% men) ages 18–25 from New Zealand and the United States answered an online survey measuring typical sleep quantity and quality; physical activity; and consumption of raw and processed fruit and vegetables, fast food, sweets, and soda, along with extensive covariates (including demographics, socioeconomic status, body mass index, alcohol use, smoking, and health conditions) and the outcome measures of depressive symptoms [measured by the Center for Epidemiological Depression Scale (CES-D)] and well-being (measured by the Flourishing Scale).ResultsControlling for covariates, sleep quality was the strongest predictor of depressive symptoms and well-being, followed by sleep quantity and physical activity. Only one dietary factor—raw fruit and vegetable consumption—predicted greater well-being but not depressive symptoms when controlling for covariates. There were some higher-order interactions among health behaviors in predicting the outcomes, but these did not survive cross-validation.ConclusionSleep quality is an important predictor of mental health and well-being in young adults, whereas physical activity and diet are secondary but still significant factors. Although strictly correlational, these patterns suggest that future interventions could prioritize sleep quality to maximize mental health and well-being in young adults.

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Gender Differences in COVID-19 Lockdown Impact on Mental Health of Undergraduate Students

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.813130 ◽

2022 ◽

Vol 12 ◽

Author(s):

Andrea Amerio ◽

Paola Bertuccio ◽

Francesca Santi ◽

Davide Bianchi ◽

Andrea Brambilla ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Undergraduate Students ◽

Positive Association ◽

Well Being ◽

Housing Quality ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Working Performance ◽

At Home

Background: Prolonged university closures and social distancing-imposed measures due to the COVID-19 pandemic obliged students to at-home learning with online lectures and educational programs promoting potential social isolation, loneliness, hopelessness, and episodes of clinical decompensation.Methods: A web-based cross-sectional survey was carried out in a university institute in Milan, Northern Italy, to assess the COVID-19 lockdown impact on the mental health of the undergraduate students. We estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) using adjusted logistic regression models.Results: Of the 8,177 students, 12.8% reported depressive symptoms, 25.6% anxiety, 8.7% insomnia, and 10.6% reported impulsive tracts, with higher proportions among females than males. Mental health symptoms were positively associated with caring for a person at home, a poor housing quality, and a worsening in working performance. Among males compared with females, a poor housing quality showed a stronger positive association with depressive symptoms and impulsivity, and a worsening in the working performance was positively associated with depressive and anxiety symptoms. In addition, the absence of private space was positively associated with depression and anxiety, stronger among males than females.Conclusions: To our knowledge, this is the first multidisciplinary consortium study, involving public mental health, environmental health, and architectural design. Further studies are needed to confirm or refute our findings and consequent recommendations to implement well-being interventions in pandemic conditions.

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High Sitting Time Is a Behavioral Risk Factor for Blunted Improvement in Depression Across 8 Weeks of the COVID-19 Pandemic in April–May 2020

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.741433 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jacob D. Meyer ◽

John O'Connor ◽

Cillian P. McDowell ◽

Jeni E. Lansing ◽

Cassandra S. Brower ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Large Scale ◽

Online Survey ◽

Vigorous Physical Activity ◽

Anxiety Symptoms ◽

Sitting Time ◽

Longitudinal Impact ◽

Negatively Associated ◽

Over Time

The COVID-19 pandemic has elicited increased sedentary behaviors, decreased moderate-to-vigorous physical activity (MVPA), and worsened mental health, yet the longitudinal impact of these changes and their inter-relations remains unknown. Our purpose was to examine associations between changes in self-reported activity behaviors and mental health over an 8-week period following the COVID-19 outbreak. Participants from all 50 states and the District of Colombia were recruited through convenience and snowball sampling at baseline April 3–10, 2020. Prospective data from 2,327 US adults with ≥2 responses (63.8% female; 74.3% response rate) were collected weekly via online survey for eight consecutive weeks (April 3–June 3, 2020). Primary exposures were self-reported time spent sitting, viewing screens and in MVPA, with primary outcomes being depressive symptoms, anxiety symptoms, and positive mental health (PMH). A significant sitting-by-time interaction (p < 0.05) showed slightly higher marginal effects for depressive symptoms for the 90th-percentile of sitting time than the 10th-percentile at baseline (5.8 [95% confidence interval = 5.5–6.2] vs. 5.7 [5.4–6.1]), with the difference magnifying over time (week 8: 3.5 [3.2–3.9] vs. 2.7 [2.4–2.9]). No other interactions over time were significant. Screen time was negatively associated with PMH and positively associated with depressive and anxiety symptoms (p < 0.05). Sitting time was negatively associated with PMH (p < 0.05). Rapid changes in sitting patterns (e.g., due to a pandemic) may have lasting effects on depressive symptoms. Strategies targeting those most affected (i.e., young adults, females) and/or focused on reducing sitting time may be critical for preventing long-term mental health effects resulting from COVID-19 or other large-scale behavior changes in the general population.

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Exploring the Association Between Physical Activity and Risk of Mental Health Disorders in Saudi Arabian Adults: Cross-sectional Study

JMIR Public Health and Surveillance ◽

10.2196/25438 ◽

2021 ◽

Vol 7 (4) ◽

pp. e25438

Author(s):

Nora A Althumiri ◽

Mada H Basyouni ◽

Nasser F BinDhim

Keyword(s):

Mental Health ◽

Physical Activity ◽

Depressive Symptoms ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Anxiety Symptoms ◽

World Health ◽

Moderate Intensity ◽

Generalized Anxiety ◽

Cross Sectional

Background The relationship between physical activity and mental health, especially the symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD), has received increasing attention in recent years. Objective The aim of this study was to explore the association between fulfilling the World Health Organization (WHO) global recommendations on physical activity and the risk and symptoms of MDD and GAD in the Saudi population. Methods This study was a secondary analysis of data from a large nationwide cross-sectional survey conducted via phone interviews in June and July 2020. In this study, a proportional quota sampling technique was used to obtain an equal distribution of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. The main mental health screening tool used for the risk of MDD was the Patient Health Questionnaire-9 (PHQ-9). Risk of GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Participants self-reported whether they fulfill the WHO global recommendations on (1) moderate-intensity aerobic physical activity (MIPA) and (2) vigorous-intensity aerobic physical activity (VIPA). The results were then analyzed based on the following two categories: fulfilling the WHO global recommendations or not. Results The data analysis included 8333 participants recruited in the main study between June and July 2020. The response rate was 81.45% (8333/10,231). Of them, 50.3% (4192/8333) were female, and the mean age was 36.5 years, with a median age of 36 years and a range from 18 to 90 years. The average total PHQ-9 score was 5.61, and the average total GAD-7 score was 4.18. For men, the average total PHQ-9 and GAD-7 scores were associated with fulfilling recommendations for MIPA; however, there were no associations for VIPA in both sexes. Fulfilling the WHO’s recommendations for MIPA was associated with considerably fewer depressive symptoms in six of the nine items in the PHQ-9. Moreover, fulfilling recommendations for MIPA was associated with considerably fewer anxiety symptoms in six of the seven items in the GAD-7. However, fulfilling recommendations for VIPA was significantly associated with more depressive symptoms in one of the PHQ-9 items (“Thoughts that you would be better off dead or thoughts of hurting yourself in some way;” P<.001). Conclusions This study has shown that fulfilling guidelines on MIPA is associated with less overall risk of MDD and GAD in males and fewer depressive and anxiety symptoms generally in a nonclinical population. In the general population, an increase in MIPA may improve well-being and general mental health.

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