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Leisure-time physical activity among adolescents and subsequent use of antidepressant and hypnotic drugs: a prospective register linkage study.
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Department of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway.ORCID iD: 0000-0002-3844-4745
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway & Inland Hospital Trust, Harstad, Norway.
Department of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway.
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Department of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway.ORCID iD: 0000-0002-2986-2128
2018 (English)In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 28, no 2, p. 177-188Article in journal (Refereed) Published
Abstract [en]

In this prospective study, the association between physical activity and subsequent use of antidepressant and hypnotic drug use in adolescents aged 15-16 years was examined. This study is based on information retrieved from the Norwegian Youth Health Surveys (2000-2003) and linked to prescription data from the Norwegian Prescription Database (2004-2013). In total, the study included 10711 participants with a participation rate of 87%. Adolescents were asked how many hours per week they spent on physical activity that made them sweat and/or be out of breath outside of school. Incident psychotropic drug use (outcome measure) was defined as ≥ 1 prescription of one of the following psychotropic drugs: hypnotics and antidepressants registered in the Norwegian Prescription Database. In the crude model for the time period 2004-2007, the odds of incident hypnotic use were lower for those who were physically active 1-2 h per week (OR 0.48-0.64), compared to those who were physically inactive (< 1 h per week). However, the association become non-significant 4-year post-baseline (2008-2010 and 2011-2013). In the crude model for the time periods 2004-2007, 2008-2010 and 2011-2013, the odds of incident antidepressant use were lower for physically active adolescents (2004-2007: OR 0.46-0.71, 2008-2010: OR 0.40-0.67 and 2011-2013: OR 0.37-0.58, compared to those who were physically inactive < 1 h. However, after adjustment for confounders, the association became non-significant in all time periods except in physical activity 5-7 and 8-10 h in the period 2008-2010. Physical activity does not indicate any association with later use of antidepressants, and the significant association with incident hypnotic drug use was for short-term follow-up only and disappeared on longer term follow-up periods. Given the scarcity of longitudinal studies examining the association between physical activity and mental health as well as psychotropic drug use among young people, the current study adds to previous research.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 28, no 2, p. 177-188
Keywords [en]
Adolescents, Leisure time, Longitudinal study, Physical activity, Prescription database, Psychotropic drug use
National Category
Health Sciences
Research subject
Public Health Science
Identifiers
URN: urn:nbn:se:kau:diva-68616DOI: 10.1007/s00787-018-1160-xISI: 000457572400004PubMedID: 29721753OAI: oai:DiVA.org:kau-68616DiVA, id: diva2:1234354
Available from: 2018-07-24 Created: 2018-07-24 Last updated: 2019-02-21Bibliographically approved
In thesis
1. Mental health and physical activity in adolescence
Open this publication in new window or tab >>Mental health and physical activity in adolescence
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis is to examine the association between physical activity and mental health among Norwegian adolescents.

The thesis includes four studies among adolescents in grade 10, aged 15-16 years. Studies I, II and III are based on the Norwegian Youth Health Surveys and study IV is based on data retrieved from Ungdata. In 2000-2003 (Youth Health Survey), the adolescents completed a paper and pencil self-administered questionnaire at school during lesson time. In both 2009 (Youth Health Survey) and 2017 (Ungdata), the adolescents completed an anonymous web-based questionnaire.

The Rasch analysis from study I showed that overall, the HSCL-10 showed good reliability and the items worked well. One item “Sleeping difficulties”, in the HSCL-10 instrument clearly misfit and some items worked differently for boys and girls. Study II showed that the association between physical activity, screen-based sedentary behaviour and psychological distress was weak. In study III, a significant association between physical activity and incident use of hypnotics was shown at short-term follow up. No significant associations were found for later use of antidepressants. Study IV showed that participating in a sports club was significantly associated with lower odds of depressive symptoms.

Mental health and physical activity are both complex phenomena. When investigating the association between adolescent`s physical activity and mental health, it is important to look at physical activities in different contexts, not only volume and frequency.

Abstract [en]

Mental health is considered to be an important public health issue, particularly during adolescence. The World Health Organization has reported that half of all mental health disorders in adults start by age 14, but most of them are undetected and untreated. Furthermore, there are concerns about how to measure mental health, and a need for valid instruments has been identified.

This thesis considers the relationship between physical activity and mental health in Norwegian adolescents. It consists of four studies, all based on data collected from surveys among adolescents aged 15-16 years old. The results indicate a weak association between physical activity and mental health, and that participating in a sports club is associated with fewer symptoms of depression. Furthermore, the psychometric analysis of the Hopkins Symptoms Checklist-10 instrument using Rasch Measurement Theory is a step towards more valid assessment of psychological distress among adolescents.

This thesis contributes to the field of public health sciences by underlining the need for broader approaches in studies of the association between physical activity and mental health using proper measures.

Abstract [sv]

Den här avhandlingen belyser sambandet mellan fysisk aktivitet och psykisk hälsa bland ungdomar. Den läggs fram i en tid med ökande psykisk ohälsa och stigande oro för ökande fysisk inaktivitet och stillasittande. Avhandlingen består av fyra artiklar som baseras på data insamlade bland 15-16-åringar i Norge. Resultaten visar att sambandet är svagt mellan hur ofta ungdomar är fysiskt aktiva och hur väl ungdomar mår psykiskt. När kontexten för den fysiska aktiviteten beaktas framträder ett tydligare mönster: de som är aktiva i en idrottsförening rapporterar signifikant mindre psykiska besvär än de som inte regelbundet är fysiskt aktiva. Detta samband kvarstår även efter kontroll för föräldrarnas socioekonomi och efter kontroll för andra hälsorelaterade vanor. I avhandlingen redovisas också psykometriska analyser baserade på Rasch Measurement Theory av en skala för psykologisk distress och en fördepressiva besvär. Avhandlingen pekar på vikten av bredare analysansatser när fysisk aktivitet och psykisk hälsa studeras och på vikten av reliabla ochvalida mått på psykisk hälsa.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2018. p. 79
Series
Karlstad University Studies, ISSN 1403-8099 ; 2018:32
Keywords
Adolescents, physical activity, sedentary behaviour, psychological distress, depression symptoms, psychotropic drugs, sports club
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-68646 (URN)978-91-7063-865-7 (ISBN)978-91-7063-960-9 (ISBN)
Public defence
2018-09-14, Nyquistsalen, 9C 203, lstad, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2018-08-28 Created: 2018-08-01 Last updated: 2018-09-05Bibliographically approved

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