Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Acta Psychiatr Scand. 2016 Dec;134(6):546-556. doi: 10.1111/acps.12654. Epub 2016 Oct 5.
Physical activity (PA) is good for health, yet several small-scale studies have suggested that depression is associated with low PA. A paucity of nationally representative studies investigating this relationship exists, particularly in low- and middle-income countries (LMICs). This study explored the global association of PA with depression and its mediating factors.
Participants from 36 LMICs from the World Health Survey were included. Multivariable logistic regression analyses were undertaken exploring the relationship between PA and depression.
Across 178 867 people (mean ± SD age = 36.2 ± 13.5 years; 49.9% male), the prevalence of depression and the prevalence of low PA were 6.6% and 16.8% respectively. The prevalence of low PA was significantly higher among those with depression vs. no depression (26.0% vs. 15.8%, P < 0.0001). In the adjusted model, depression was associated with higher odds for low PA (OR = 1.42; 95% CI = 1.24-1.63). Mediation analyses demonstrated that low PA among people with depression was explained by mobility limitations (40.3%), pain and discomfort (35.8%), disruptions in sleep and energy (25.2%), cognition (19.4%) and vision (10.9%).
Individuals with depression engage in lower levels of PA in LMICs. Future longitudinal research is warranted to better understand the relationships observed.
身体活动（PA）有益健康，但一些小规模研究表明，抑郁与低身体活动量有关。目前，在低中等收入国家（LMICs），缺乏全国代表性的研究来调查这种关系，特别是在低中等收入国家。本研究探讨了 PA 与抑郁及其中介因素的全球关联。
纳入了来自世界卫生调查的 36 个 LMICs 的参与者。进行了多变量逻辑回归分析，以探讨 PA 与抑郁之间的关系。
在 178867 人中（平均±标准差年龄=36.2±13.5 岁；49.9%为男性），抑郁的患病率和低 PA 的患病率分别为 6.6%和 16.8%。与无抑郁者相比，有抑郁者的低 PA 患病率显著更高（26.0%比 15.8%，P<0.0001）。在调整后的模型中，抑郁与低 PA 的发生风险较高相关（OR=1.42；95%CI=1.24-1.63）。中介分析表明，抑郁人群中的低 PA 可由行动受限（40.3%）、疼痛和不适（35.8%）、睡眠和精力紊乱（25.2%）、认知功能障碍（19.4%）和视力问题（10.9%）来解释。
在 LMICs，抑郁患者的身体活动水平较低。需要进行未来的纵向研究，以更好地理解所观察到的关系。
