Zhang Yun, Xu Tong, Cheng Zicheng, Fu Fangwang, Zhan Zhenxiang, Ma Lili, Zhao Meiqi
Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province , 325600, China.
BMC Public Health. 2025 Jul 29;25(1):2573. doi: 10.1186/s12889-025-23815-9.
It remains unclear whether all physical activity (PA) domains (occupational PA [OPA], transportation PA [TPA], and leisure-time PA [LTPA]) have equivalent beneficial effects. We aimed to investigate the associations of OPA, TPA, and LTPA with suicidal ideation in adults.
We included and analyzed 25,497 participants (aged ≥ 18 years) from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. The domain-specific PA was assessed by a self-report questionnaire and categorized based on the PA guidelines. Suicidal ideation was measured by item nine of the nine-item Patient Health Questionnaire.
Participants achieving PA guidelines (≥ 150 min/week) had a 21% (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.63-0.98) and 32% (OR 0.68, 95% CI 0.53-0.89) reduced likelihood of suicidal ideation depending on total PA and LTPA, respectively, while OPA or TPA did not correlated with suicidal ideation. The mediation analysis revealed that 74.1% of this association was mediated by the severity of depressive symptoms. In subgroup analyses, LTPA was associated with suicidal ideation in participants who were aged ≥ 60 years, those with BMI < 30 kg/m, sedentary time < 360 min/day, smoking, hypertension, depression and proportion of vigorous exercise ≥ 0.5. These connections indicate that LTPA could be especially beneficial for older individuals and those with specific lifestyle or health risks. LTPA at levels of 150-299 and ≥ 300 min/week was associated with 31% (OR 0.69, 95% CI 0.49-0.97) and 30% (OR 0.70, 95% CI 0.52-0.94) lower odds of suicidal ideation, respectively. Stratified by exercise intensity, vigorous-intensity LTPA, but not moderate-intensity LTPA, was negatively associated with the risk of suicidal ideation (OR 0.61, 95% CI 0.44-0.86).
When the amount achieving the PA guidelines, LTPA, but not OPA or TPA, was associated with a lower risk of suicidal ideation through the mediation of depressive symptoms. These findings indicate that engaging in LTPA, especially vigorous intensity LTPA, may provide substantial benefits for mental health.
目前尚不清楚所有身体活动（PA）领域（职业性身体活动[OPA]、交通性身体活动[TPA]和休闲时间身体活动[LTPA]）是否具有同等的有益效果。我们旨在研究OPA、TPA和LTPA与成年人自杀意念之间的关联。
我们纳入并分析了来自2007 - 2018年美国国家健康与营养检查调查（NHANES）的25497名参与者（年龄≥18岁）。通过自我报告问卷评估特定领域的身体活动，并根据身体活动指南进行分类。自杀意念通过九项患者健康问卷的第九项进行测量。
达到身体活动指南（≥150分钟/周）的参与者，根据总身体活动和LTPA，分别有21%（优势比[OR]0.79，95%置信区间[CI]0.63 - 0.98）和32%（OR 0.68，95% CI 0.53 - 0.89）的自杀意念可能性降低，而OPA或TPA与自杀意念无相关性。中介分析显示，这种关联的74.1%是由抑郁症状的严重程度介导的。在亚组分析中，LTPA与年龄≥60岁、体重指数（BMI）<30kg/m²、久坐时间<360分钟/天、吸烟、高血压、抑郁以及剧烈运动比例≥0.5的参与者的自杀意念相关。这些关联表明，LTPA可能对老年人以及那些具有特定生活方式或健康风险的人特别有益。每周150 - 299分钟和≥300分钟的LTPA水平分别与自杀意念的优势比降低31%（OR 0.69，95% CI 0.49 - 0.97）和30%（OR 0.70，95% CI 0.52 - 0.94）相关。按运动强度分层，剧烈强度的LTPA而非中等强度的LTPA与自杀意念风险呈负相关（OR 0.61，95% CI 0.44 - 0.86）。
当达到身体活动指南的量时，LTPA而非OPA或TPA通过抑郁症状的中介作用与较低的自杀意念风险相关。这些发现表明，进行LTPA，尤其是剧烈强度的LTPA，可能对心理健康有很大益处。
