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The association between physical activity and depression among individuals residing in Brazil

Abstract

Purpose

There is very limited literature investigating the association between physical activity (PA) and depression in South American countries such as Brazil. The purpose of the current study was to evaluate the prevalence of depression and its association with PA in a very large, representative sample of young adults (ages 18–39 years) (YA), middle-aged adults (ages 40–59 years) (MAA) and older adults (ages ≥ 60 years) (OA) residing in Brazil.

Methods

The sample for this cross-sectional study was based on the Brazilian National Health Survey conducted in 2013. The Personal Health Questionnaire depression scale (PHQ-8) was applied to measure current (past 2 weeks) depression as the outcome of interest, and the exposure was self-reported PA for leisure. Multivariable weighted logistic regression models were conducted to investigate the association between PA and depression while adjusting for socio-demographic characteristics and number of health comorbidities among YA, MAA and OA.

Results

The final study sample size was 59,399 (33,480 females; 25,919 males). After adjusting for the covariates of interest, the lack of PA for leisure was associated with a significant increase in depression only among males (YA: OR 1.45, 95% CI 1.02–2.06; MAA: OR 2.38, 95% CI 1.40–4.03; OA: OR 5.35, 95% CI 2.14–13.37). There was no significant association between PA for leisure and depression among females of all age groups.

Conclusions

Although PA for leisure is not associated with depression among Brazilian females, the obtained results suggest that this association is significant among Brazilian males, who may be able to benefit from PA for leisure to reduce their symptoms of depression.

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References

  1. 1.

    Nezu AM (2000) Practitioner’s guide to empirically-based measures of depression. Springer, Berlin

  2. 2.

    Anderson J, Michalak E, Lam R (2002) Depression in primary care: tools for screening, diagnosis, and measuring response to treatment. Br Columbia Med J 44(8):415–419

  3. 3.

    Center for Behavioral Health Statistics and Quality (2015) Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health (HHS Publication no. SMA 15-4927, NSDUH Series H-50). https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf. Accessed 15 Dec 2016

  4. 4.

    Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG et al (1996) Cross-national epidemiology of major depression and bipolar disorder. JAMA 276(4):293–299

  5. 5.

    Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G et al (2011) Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 9:90

  6. 6.

    Reeves WC, Strine TW, Pratt LA, Thompson W, Ahluwalia I, Dhingra SS et al (2011) Mental illness surveillance among adults in the United States. MMWR Suppl 60(3):1–29

  7. 7.

    Lopes CS, Hellwig N, e Silva GA, Menezes PR (2016) Inequities in access to depression treatment: results of the Brazilian National Health Survey—PNS. Int J Equity Health 15(1):154

  8. 8.

    Taylor HL, Jacobs DR, Schucker B, Knudsen J, Leon AS, Debacker G (1978) A questionnaire for the assessment of leisure time physical activities. J Chronic Dis 31(12):741–755

  9. 9.

    Paffenbarger RS Jr, Wing AL, Hyde RT (1978) Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol 108(3):161–175

  10. 10.

    Montoye HJ (1974) Physical activity and health: an epidemiologic study of an entire community. Prentice-Hall, Englewood Cliffs

  11. 11.

    Caspersen CJ, Powell KE, Christenson GM (1985) Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 100(2):126–131

  12. 12.

    CDC (2008) Physical activity guidelines for Americans. Fact sheet for health professionals on physical activity guidelines for adults. http://www.cdc.gov/physicalactivity/downloads/pa_fact_sheet_adults.pdf. Accessed 15 Dec 2016

  13. 13.

    WHO (2010) World Health Organization: global recommendations on physical activity for health. http://www.who.int/dietphysicalactivity/publications/9789241599979/en/. Accessed 01 Dec 2016

  14. 14.

    Ekelund U (2004) Methods to measure physical activity. Medical Research Council. http://clinicalhealthpromotion.dk/Knapper/Exercise/Symposium/Presentations/Ulf%20Ekelund.pdf. Accessed 15 Dec 2016

  15. 15.

    WHO (2016) Global Health Observatory (GHO) data. Prevalence of insufficient physical activity. http://www.who.int/gho/ncd/risk_factors/physical_activity_text/en/. Accessed 15 Dec 2016

  16. 16.

    CDC (2015) Centers for disease control and prevention, National Center for Health Statistics. National Health Interview Survey, leisure-time physical activity for adults. https://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201605_07.pdf. Accessed 17 Nov 2016

  17. 17.

    Szwarcwald CL, Damacena GN, de Souza Junior PR, de Almeida Wda S, de Lima LT, Malta DC et al (2015) Determinants of self-rated health and the influence of healthy behaviors: results from the National Health Survey, 2013. Rev Bras Epidemiol 18(Suppl 2):33–44

  18. 18.

    Morgan WP (1969) A pilot investigation of physical working capacity in depressed and nondepressed psychiatric males. Res Q 40(4):859–861

  19. 19.

    Mammen G, Faulkner G (2013) Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Prev Med 45(5):649–657

  20. 20.

    Stubbs B, Koyanagi A, Schuch FB, Firth J, Rosenbaum S, Veronese N et al (2016) Physical activity and depression: a large cross-sectional, population-based study across 36 low- and middle-income countries. Acta Psychiatr Scand 134(6):546–556

  21. 21.

    Schuch FB, Vancampfort D, Richards J, Rosenbaum S, Ward PB, Stubbs B (2016) Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. J Psychiatr Res 77:42–51

  22. 22.

    Schuch FB, Vancampfort D, Rosenbaum S, Richards J, Ward PB, Veronese N et al (2016) Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias. Rev Bras Psiquiatr 38(3):247–254

  23. 23.

    WHO (2016) Media centre. Depression: fact sheet. http://www.who.int/mediacentre/factsheets/fs369/en/. Accessed 15 Dec 2016

  24. 24.

    Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367(9524):1747–1757

  25. 25.

    Murray CJ, Lopez AD (1997) Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet 349(9063):1436–1442

  26. 26.

    Robertson R, Robertson A, Jepson R, Maxwell M (2012) Walking for depression or depressive symptoms: a systematic review and meta-analysis. Mental Health Phys Act 5(1):66–75

  27. 27.

    Moncrieff J, Kirsch I (2005) Efficacy of antidepressants in adults. BMJ 331(7509):155–157

  28. 28.

    Vancampfort D, Stubbs B, Mitchell AJ, De Hert M, Wampers M, Ward PB et al (2015) Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry 14(3):339–347

  29. 29.

    Vancampfort D, Correll CU, Galling B, Probst M, De Hert M, Ward PB et al (2016) Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta-analysis. World Psychiatry 15(2):166–174

  30. 30.

    Craft LL, Perna FM (2004) The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry 6(3):104–111

  31. 31.

    Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR et al (2013) Exercise for depression. Cochrane Database Syst Rev (9):CD004366

  32. 32.

    Barcelos-Ferreira R, Nakano EY, Steffens DC, Bottino CM (2013) Quality of life and physical activity associated to lower prevalence of depression in community-dwelling elderly subjects from Sao Paulo. J Affect Disord 150(2):616–622

  33. 33.

    Reichert CL, Diogo CL, Vieira JL, Dalacorte RR (2011) Physical activity and depressive symptoms in community-dwelling elders from southern Brazil. Rev Bras Psiquiatr 33(2):165–170

  34. 34.

    De Mello MT, Lemos Vde A, Antunes HK, Bittencourt L, Santos-Silva R, Tufik S (2013) Relationship between physical activity and depression and anxiety symptoms: a population study. J Affect Disord 149(1–3):241–246

  35. 35.

    Kessler RC, Birnbaum HG, Shahly V, Bromet E, Hwang I, McLaughlin KA et al (2010) Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative. Depress Anxiety 27(4):351–364

  36. 36.

    IBGE (2013) Instituto Brasileiro de Geografia e Pesquisa. Pesquisa nacional de saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas—Brazil, grandes regiões e unidades da federação. ftp://ftp.ibge.gov.br/PNS/2013/pns2013.pdf. Accessed 15 May 2016

  37. 37.

    Szwarcwald CL, Malta DC, Pereira CA, Vieira MLFP, Conde WL, Souza Júnior PRBd et al (2014) Pesquisa Nacional de Saúde no Brasil: concepção e metodologia de aplicação. Ciência Saúde Coletiva 19(2):333–342

  38. 38.

    de Jesus Silva MM, Peres Rocha Carvalho Leite E, Alves Nogueira D, Clapis MJ (2016) Depression in pregnancy. Prevalence and associated factors. Invest Educ Enferm 34(2):342–350

  39. 39.

    Silva RA, Jansen K, Souza LD, Moraes IG, Tomasi E, Silva Gdel G et al (2010) Depression during pregnancy in the Brazilian public health care system. Rev Bras Psiquiatr 32(2):139–144

  40. 40.

    Rich-Edwards JW, Mohllajee AP, Kleinman K, Hacker MR, Majzoub J, Wright RJ et al (2008) Elevated midpregnancy corticotropin-releasing hormone is associated with prenatal, but not postpartum, maternal depression. J Clin Endocrinol Metab 93(5):1946–1951

  41. 41.

    Santos IS, Tavares BF, Munhoz TN, Almeida LS, Silva NT, Tams BD et al (2013) Sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) among adults from the general population. Cad Saude Publica 29(8):1533–1543

  42. 42.

    Kroenke K, Strine TW, Spitzer RL, Williams JB, Berry JT, Mokdad AH (2009) The PHQ-8 as a measure of current depression in the general population. J Affect Disord 114(1–3):163–173

  43. 43.

    Moreira AD, Claro RM, Felisbino-Mendes MS, Velasquez-Melendez G (2017) Validity and reliability of a telephone survey of physical activity in Brazil. Rev Bras Epidemiol 20(1):136–146

  44. 44.

    Silva MT, Galvao TF, Martins SS, Pereira MG (2014) Prevalence of depression morbidity among Brazilian adults: a systematic review and meta-analysis. Rev Bras Psiquiatr 36(3):262–270

  45. 45.

    Stopa SR, Malta DC, de Oliveira MM, Lopes Cde S, Menezes PR, Kinoshita RT (2015) Prevalence of self-reported depression in Brazil: 2013 National Health Survey results. Rev Bras Epidemiol 18(Suppl 2):170–180

  46. 46.

    Almeida-Filho N, Lessa I, Magalhaes L, Araujo MJ, Aquino E, James SA et al (2004) Social inequality and depressive disorders in Bahia, Brazil: interactions of gender, ethnicity, and social class. Soc Sci Med 59(7):1339–1353

  47. 47.

    Moreira V (2007) Critical phenomenology of depression in Brazil, Chile and the United States. J Lat Am Fund Psychopathol Online 7(2):193–218

  48. 48.

    Fleck MP, Lima AF, Louzada S, Schestasky G, Henriques A, Borges VR et al (2002) Association of depressive symptoms and social functioning in primary care service, Brazil. Rev Saude Publica 36(4):431–438

  49. 49.

    Azevedo MR, Araujo CL, Reichert FF, Siqueira FV, da Silva MC, Hallal PC (2007) Gender differences in leisure-time physical activity. Int J Public Health 52(1):8–15

  50. 50.

    Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW et al (2012) Correlates of physical activity: why are some people physically active and others not? Lancet 380(9838):258–271

  51. 51.

    Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B (2007) Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 370(9590):851–858

  52. 52.

    Kimbro LB, Mangione CM, Steers WN, Duru OK, McEwen L, Karter A et al (2014) Depression and all-cause mortality in persons with diabetes mellitus: are older adults at higher risk? Results from the translating research into action for diabetes study. J Am Geriatr Soc 62(6):1017–1022

  53. 53.

    Chauvet-Gelinier JC, Trojak B, Verges-Patois B, Cottin Y, Bonin B (2013) Review on depression and coronary heart disease. Arch Cardiovasc Dis 106(2):103–110

  54. 54.

    Boulet LP, Boulay ME (2011) Asthma-related comorbidities. Expert Rev Respir Med 5(3):377–393

  55. 55.

    Murphy LB, Sacks JJ, Brady TJ, Hootman JM, Chapman DP (2012) Anxiety and depression among US adults with arthritis: prevalence and correlates. Arthritis Care Res (Hoboken) 64(7):968–976

  56. 56.

    Zhang MW, Ho RC, Cheung MW, Fu E, Mak A (2011) Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression. Gen Hosp Psychiatry 33(3):217–223

  57. 57.

    ABRAPP (2014) Associação Brasileira das Entidades Fechadas de Previdência Complementar—the Brazilian pension system. http://www.abrapp.org.br/Documentos%20Pblicos/The%20Brazilian%20Pension%20System.pdf. Accessed 15 June 2016

  58. 58.

    NIH (2015) National Institute of Mental Health. Major depression among adults. https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml. Accessed 15 May 2016

  59. 59.

    Coelho CL, Crippa JA, Santos JL, Pinsky I, Zaleski M, Caetano R et al (2013) Higher prevalence of major depressive symptoms in Brazilians aged 14 and older. Rev Bras Psiquiatr 35(2):142–149

  60. 60.

    Munhoz TN, Nunes BP, Wehrmeister FC, Santos IS, Matijasevich A (2016) A nationwide population-based study of depression in Brazil. J Affect Disord 192:226–233

  61. 61.

    Pinheiro RS, Viacava F, Travassos C, Brito AdS (2002) Gênero, morbidade, acesso e utilização de serviços de saúde no Brasil. Ciência Saúde Coletiva 7(4):687–707

  62. 62.

    Wittayanukorn S, Qian J, Hansen RA (2014) Prevalence of depressive symptoms and predictors of treatment among U.S. adults from 2005 to 2010. Gen Hosp Psychiatry 36(3):330–336

  63. 63.

    Zhang J, Yen ST (2015) Physical activity, gender difference, and depressive symptoms. Health Serv Res 50(5):1550–1573

  64. 64.

    The World Bank Group (2013) Women at work. Good for them and the Brazilian economy. http://www.worldbank.org/en/news/feature/2013/02/22/Brazil-why-promoting-equal-pay-is-good-for-economy-job-market. Accessed 15 May 2016

  65. 65.

    Van Klaveren M, Tijdens K, Hughie-Williams M, Martin NR (2009) An overview of women’s work and employment in Brazil. AIAS Working Paper, Amsterdam, 09-83

  66. 66.

    Miquilin Ide O, Marin-Leon L, Monteiro MI, Correa Filho HR (2013) Inequalities in health services access and use among formal, informal, and unemployed workers, based on data from the Brazilian National Household Sample Survey, 2008. Cad Saude Publica 29(7):1392–1406

  67. 67.

    Barrientos A, Møller V, Saboia J, Lloyd-Sherlock P, Mase J (2013) ‘Growing’ social protection in developing countries: lessons from Brazil and South Africa. Dev South Afr 30(1):54–68

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Acknowledgements

Research reported in this publication was supported by an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under Grant no. P20GM103442.

Author information

Correspondence to S. Cristina Oancea.

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The authors declare that they have no conflict of interest.

Ethical standards

All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

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de Oliveira, G.D., Oancea, S.C., Nucci, L.B. et al. The association between physical activity and depression among individuals residing in Brazil. Soc Psychiatry Psychiatr Epidemiol 53, 373–383 (2018). https://doi.org/10.1007/s00127-017-1441-6

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Keywords

  • Brazil
  • Physical activity
  • Depression
  • PNS
  • National Health Survey