Elsevier

Preventive Medicine

Volume 36, Issue 6, June 2003, Pages 698-703
Preventive Medicine

Regular article
Association between physical activity and mental disorders among adults in the United States

https://doi.org/10.1016/S0091-7435(03)00042-2Get rights and content

Abstract

Objective

The objective of this study was to determine the association between regular physical activity and mental disorders among adults in the United States.

Method

Multiple logistic regression analyses were used to compare the prevalence of mental disorders among those who did and did not report regular physical activity using data from the National Comorbidity Survey (n = 8098), a nationally representative sample of adults ages 15–54 in the United States.

Results

Slightly over one-half of adults reported regular physical activity (60.3%). Regular physical activity was associated with a significantly decreased prevalence of current major depression and anxiety disorders, but was not significantly associated with other affective, substance use, or psychotic disorders. The association between regular physical activity and lower prevalence of current major depression (OR = 0.75 (0.6,0.94)), panic attacks (OR = 0.73 (0.56, 0.96)), social phobia (OR = 0.65 (0.53, 0.8)), specific phobia (OR = 0.78 (0.63, 0.97)), and agoraphobia (OR = 0.64 (0.43, 0.94)) persisted after adjusting for differences in sociodemographic characteristics, self-reported physical disorders, and comorbid mental disorders. Self-reported frequency of physical activity also showed a dose–response relation with current mental disorders.

Discussion

These data document a negative association between regular physical activity and depressive and anxiety disorders among adults in the U.S. population. Future research that investigates the mechanism of this association using longitudinal data to examine the link between physical activity and incident and recurrent mental disorders across the lifespan is needed.

Introduction

Previous studies have consistently found that physical activity is associated with improved psychological well-being, physical health, life satisfaction, and cognitive functioning [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]. Clinical and epidemiologic studies have also shown an association between physical activity and decreased symptoms of anxiety and depression [11], [12], [13], [14], [15], [16], [17]. These studies have documented a consistently negative relationship between physical activity and symptoms of depression and anxiety. Evidence of a dose–response relationship between physical activity and protection against symptoms of depression and anxiety has also been documented [17], although these positive effects may be restricted to men [15]. Previous research has also shown that physical inactivity is associated cross-sectionally, and prospectively with increased risk of depressive episodes at 8-year follow-up [8]. Other clinical data suggest that physical activity is related to positive mood and well-being, as well as improved physical health, and, more specifically, shows that aerobic activity, but not anaerobic, is related to reduced depressive symptoms [16]. Further, data from animal models support a neurochemical pathway for the relation between physical activity and depression [10], [11]. As depression can be characterized by low energy, it is possible that depression leads to decreased physical activity [18].

Taken together, previous findings overwhelmingly suggest that physical activity is beneficial for physical and mental health. The identification of prevention and intervention strategies aimed at decreasing depression and anxiety disorders, which can be applied to populations inexpensively and without side effects, is needed, as depression is projected to be the leading burden of disease worldwide by the year 2020 [19]. There are, however, several methodological shortcomings of previous studies that limit conclusions about the relationship between physical activity and mental health in the community, and which therefore hamper their ability to inform the development of community-based intervention approaches. First, the use of symptom subscales in previous studies, rather than diagnostic survey instruments, does not provide information about the relationship between physical activity and mental disorders. As the epidemiology and extent of need for treatment is assessed using DSM-IV [20] criteria for mental disorders, knowledge of the link between physical activity and mental health using consistent definitions is needed to estimate the public health significance of this association. Second, previous studies have limited their investigation to the relation between physical activity and any depressive and anxiety symptoms, grouped. Therefore, it is not clear whether physical activity is associated with any or all symptoms of depression and anxiety, or whether there is specificity to type of depression or anxiety symptoms, which could have implications for etiology and treatment. Third, previous studies have examined the association between physical activity and mental health exclusively in terms of depression and anxiety, but have not looked at whether this association is evident in relation to other mental disorders as well. Fourth, previous studies have not investigated this association in a sample nationally representative of adults in the United States and therefore previous findings may not be generalizable to this population.

The goal of the current study was to determine the association between regular physical activity and mental disorders among adults in the community, overcoming methodological shortcomings of previous studies. First, the study aimed to determine whether regular physical activity was associated with decreased prevalence of mental disorders among adults in the U.S. adult population. Second, the study aimed to determine whether the relation between physical activity and mental disorders was independent of the effects of potential confounders, such as demographic characteristics (e.g., age, income) and physical health problems. Third, the study examined whether there was a dose–response relationship between self-reported frequency of physical activity and the likelihood of each mental disorder. Based on previous findings, we hypothesized that regular physical activity, compared with occasional or seldom, would be associated with a significantly decreased likelihood of current mental disorders.

Section snippets

Sample

The National Comorbidity Survey is based on a national probability sample (n = 5877) of individuals of ages 15 to 54 in the noninstitutionalized population [21]. This was a random sample, and the survey was administered by trained lay interviewers. Fieldwork was carried out between September 1990 and February 1992. There was an 82.4% response rate. The data were weighted for differential probabilities of selection and nonresponse. A weight was also used to adjust the sample to approximate the

Results

Regular physical activity was reported by 60.3% of adults of ages 15–54 in the U.S. adult population. This is consistent with previous estimates in the United States [29]. In this sample, there were no statistically significant differences in gender, race, marital status, age, or income between those who reported regular physical activity and those who did not (see Table 1). Regular physical activity was reported more often by males and by adults less formal education, compared with those who

Discussion

These data provide evidence of a negative association between physical activity and major depression and anxiety disorders, independent of demographic characteristics and physical illness, among adults in the United States [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]. The current study adds to existing knowledge in this area by making several methodological improvements over previous studies. These include the investigation of the relationship

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