Duan Tingshan, Cao Zhi, Wang Xuemei, Min Jiahao, Sun Tao, Luo Hong, Xu Chenjie
School of Public Health, Hangzhou Normal University, China.
School of Public Health, Zhejiang University School of Medicine, China.
Br J Psychiatry. 2024 Dec 4:1-8. doi: 10.1192/bjp.2024.227.
Evidence is largely limited regarding the extent to which abnormal behavioural profiles, including physical inactivity, sedentary behaviour and inadequate sleep duration, impact long-term health conditions in individuals with pre-existing depression.
To investigate the associations between accelerometer-derived daily movement behaviours and mortality in individuals with pre-existing depression.
Between 2013 and 2015, a total of 10 914 individuals with pre-existing depression were identified from the UK Biobank through multiple sources including self-reported symptoms, records of antidepressant usage and diagnostic recording based on the 10th Revision of the International Classification of Diseases (ICD-10) codes F32-F33. These participants were subsequently followed up until 2021. Wrist-worn accelerometers were used for objective measurement of sleep duration, sedentary behaviour, moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) over a span of seven consecutive days.
During a median follow-up of 6.9 years, 434 deaths occurred among individuals with pre-existing depression. We observed a U-shaped association between sleep duration and mortality in individuals with pre-existing depression, with the lowest risk occurring at approximately 9 h/day. Both MVPA and LPA exhibited an L-shaped pattern in relation to mortality, indicating that engaging in higher levels of physical activity was associated with lower risk of mortality in individuals with pre-existing depression, but the beneficial effect reached a plateau after 50 min/day for MVPA and 350 min/day for LPA. We found a positive association between sedentary time and mortality, and the risk apparently increased above 8 h/day. Moreover, substituting 1 hour/day of sedentary time with LPA or MVPA was significantly associated with a 12% (hazard ratio: 0.88, 95% CI: 0.83-0.94) and 24% (hazard ratio: 0.76, 95% CI: 0.61-0.94) lower risk of mortality, respectively.
Our study found the beneficial effect of adequate sleep duration, high levels of physical activity and short sedentary time on risk of mortality among individuals with pre-existing depression.
关于包括身体活动不足、久坐行为和睡眠时间不足在内的异常行为模式对已有抑郁症个体的长期健康状况影响程度的证据在很大程度上有限。
调查通过加速度计得出的日常运动行为与已有抑郁症个体死亡率之间的关联。
在2013年至2015年期间，通过多种来源从英国生物银行中识别出总共10914名已有抑郁症个体，这些来源包括自我报告的症状、抗抑郁药物使用记录以及基于国际疾病分类第十版（ICD - 10）编码F32 - F33的诊断记录。随后对这些参与者进行随访直至2021年。使用腕部佩戴的加速度计对连续七天的睡眠时间、久坐行为、中等到剧烈身体活动（MVPA）和轻度身体活动（LPA）进行客观测量。
在中位随访6.9年期间，已有抑郁症个体中有434人死亡。我们观察到已有抑郁症个体的睡眠时间与死亡率之间呈U形关联，最低风险出现在约9小时/天。MVPA和LPA与死亡率均呈现L形模式，这表明进行更高水平的身体活动与已有抑郁症个体的较低死亡风险相关，但MVPA每天超过50分钟、LPA每天超过350分钟后，有益效果达到平台期。我们发现久坐时间与死亡率呈正相关，且风险在每天超过8小时后明显增加。此外，用LPA或MVPA替代每天1小时的久坐时间分别与降低12%（风险比：0.88，95%置信区间：0.83 - 0.94）和24%（风险比：0.76，95%置信区间：0.61 - 0.94）的死亡风险显著相关。
我们的研究发现了充足的睡眠时间、高水平的身体活动和较短的久坐时间对已有抑郁症个体死亡风险的有益影响。
