Wang Zhe, Cao Zhi, Min Jiahao, Duan Tingshan, Xu Chenjie
School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China.
School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
BMJ Evid Based Med. 2025 Jan 22;30(1):45-54. doi: 10.1136/bmjebm-2024-112933.
To investigate the associations between device-measured and self-reported physical activity (PA) and incident common mental disorders in the general population.
Large-scale prospective cohort study.
Using the UK Biobank data, a validated PA questionnaire was used to estimate self-reported weekly PA in 365 656 participants between 2006 and 2010 while 91 800 participants wore wrist-worn accelerometers for 7 days in 2013-2015 to derive objectively measured PA. All the participants were followed up until 2021.
Incidences of depression and anxiety were ascertained from hospital inpatient records. Cox proportional hazards models and restricted cubic splines were used to assess the associations between subjectively and objectively measured PA and common mental disorders.
During a median follow-up of 12.6 years, 16 589 cases of depression, 13 905 cases of anxiety and 5408 cases of comorbid depression and anxiety were documented in the questionnaire-based cohort. We found J-shaped associations of self-reported PA with incident risk of depression and anxiety, irrespective of PA intensities. The lowest risk for depression occurred at 550, 390, 180 and 560 min/week of light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA) and moderate-to-vigorous PA (MVPA), respectively. During a median follow-up of 6.9 years, a total of 2258 cases of depression, 2166 cases of anxiety and 729 cases of comorbid depression and anxiety were documented in the accelerometer-based cohort. We found L-shaped associations of device-measured MPA and VPA with incident depression and anxiety. MPA was adversely associated with incident depression and anxiety until 660 min/week, after which the associations plateaued. The point of inflection for VPA occurred at 50 min/week, beyond which there was a diminished but continued reduction in the risks of depression and anxiety.
Different patterns of associations between self-reported and device-measured PA and mental health were observed. Future PA guidelines should fully recognise this inconsistency and increasingly employ objectively measured PA standards.
研究在普通人群中，通过设备测量的身体活动（PA）和自我报告的身体活动与常见精神障碍发病之间的关联。
大规模前瞻性队列研究。
利用英国生物银行的数据，在2006年至2010年间，使用经过验证的PA问卷对365656名参与者自我报告的每周PA进行评估；而在2013年至2015年间，91800名参与者佩戴腕部加速计7天，以得出客观测量的PA。所有参与者随访至2021年。
从医院住院记录中确定抑郁和焦虑的发病率。使用Cox比例风险模型和受限立方样条来评估主观和客观测量的PA与常见精神障碍之间的关联。
在中位随访期12.6年期间，基于问卷的队列中记录了16589例抑郁症、13905例焦虑症以及5408例合并抑郁和焦虑症。我们发现，无论PA强度如何，自我报告PA与抑郁和焦虑发病风险呈J形关联。抑郁症风险最低时，轻度强度PA（LPA）、中度强度PA（MPA）、剧烈强度PA（VPA）和中度至剧烈强度PA（MVPA）的每周时间分别为550、390、180和560分钟。在中位随访期6.9年期间，基于加速计的队列中记录了2258例抑郁症、2166例焦虑症以及729例合并抑郁和焦虑症。我们发现，设备测量的MPA和VPA与抑郁和焦虑发病呈L形关联。MPA与抑郁和焦虑发病呈负相关，直至每周660分钟，此后关联趋于平稳。VPA的拐点出现在每周50分钟，超过该时间后，抑郁和焦虑风险虽有降低但仍持续下降。
观察到自我报告的PA和设备测量的PA与心理健康之间存在不同的关联模式。未来的PA指南应充分认识到这种不一致性，并越来越多地采用客观测量的PA标准。
