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Gender-specific associations between leisure-time physical activity and symptoms of anxiety: the HUNT study

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Abstract

Purpose

The underlying goal of the study was to examine gender-specific effects of leisure-time physical activity on the development of symptoms of anxiety.

Methods

The second wave of a prospective cohort survey (HUNT 2) was conducted during 1995–1997 in the county of Nord-Trøndelag, Norway, with a follow-up in 2006–2008 (HUNT 3). The sample consisted of 12,796 women and 11,195 men with an age range of 19–85 years. A binomial model with a log-link function and generalized linear model analysis with gamma distribution was used to assess the association between physical activity and anxiety symptoms (Hospital Anxiety and Depression Scale anxiety subscale, HADS-A).

Results

A total of 1,211 (9.5 %) women and 650 (5.8 %) men developed HADS-defined anxiety (≥8 on the HADS-A scale). Men who scored in the middle tertile of the calculated physical activity index developed significantly fewer cases of HADS-defined anxiety compared with men in the lowest tertile (p < 0.05). In the gamma regression analysis for women, having higher scores on the moderate-high physical activity was associated with fewer symptoms of anxiety (p < 0.01).

Conclusions

Women developed almost twice as many cases of HADS-defined anxiety compared to men. Significant associations were found between general leisure-time physical activity and anxiety symptoms among women and men, but the true effect is likely to be different from the observed associations due to several threats to the internal validity in the study.

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References

  1. Alonso J, Angermeyer MC, Bernert S et al (2004) Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand 109(240):21–27

    Google Scholar 

  2. Kessler RC, Chiu WT, Demler O, Merkingas KR, Walters EE (2005) Prevalence, severity, and comorbidity of 12-Month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):617–627

    Article  PubMed Central  PubMed  Google Scholar 

  3. The Norwegian Institute of Public Health (2009) Psykiske lidelser i Norge: Et folkehelseperspektiv. [Mental disorders in Norway: a public health perspective]. The Norwegian Institute of Public Health, Oslo. http://www.fhi.no/dokumenter/68675aa178.pdf. Accessed 13 Jan 2012

  4. Biddle SJH, Mutrie N (2008) Psychology of physical activity: determinants, well-being and interventions, 2nd edn. Routledge, New York

    Google Scholar 

  5. Gustavsson A, Svensson M, Jacobi F et al (2011) Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 21(10):718–779

    Article  CAS  PubMed  Google Scholar 

  6. Andlin-Sobocki P, Wittchen HU (2005) Cost of anxiety disorders in Europe. Eur J Neurol 12:39–44

    Article  PubMed  Google Scholar 

  7. Jacobi F, Wittchen HU, Hôllting C (2004) Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med 34(4):597–611

    Article  CAS  PubMed  Google Scholar 

  8. Bienvenu OJ, Gould NF, Mason ST, Fauerbach JA (2009) Anxiety disorders prevention: overview and focus on post-traumatic stress disorder. Minerva Psichiatr 50(3):265–275

    Google Scholar 

  9. McLean CP, Asnaani A, Litz BT, Hofmann SG (2011) Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res 45(8):1027–1035

    Article  PubMed Central  PubMed  Google Scholar 

  10. Bekker MH, van Mens-Verhulst J (2007) Anxiety disorders: sex differences in prevalence, degree, and background, but gender-neutral treatment. Gend Med 4:178–193

    Article  Google Scholar 

  11. Martinsen EW (2008) Physical activity in the prevention and treatment of anxiety and depression. Nord J Psychiatry 62(47):25–29

    Article  PubMed  Google Scholar 

  12. McDonald DG, Hodgdon JA (1991) The psychological effects of aerobic fitness training research and theory. Springer, New York

    Book  Google Scholar 

  13. Petruzzello SJ, Landers DM, Hatfield BD, Kubitz KA, Salazar W (1991) A meta-analysis on the anxiety-reducing effects of acute and chronic exercise: outcomes and mechanisms. J Sports Med 11(3):143–182

    Article  CAS  Google Scholar 

  14. Byrne A, Byrne D (1993) The effect of exercise on depression, anxiety and other mood states: a review. J Psychosom Res 37(6):565–574

    Article  CAS  PubMed  Google Scholar 

  15. Long BC, Vanstavel R (1995) Effects of exercise training on anxiety: a meta-analysis. J Appl Sport Psychol 7(2):167–189

    Article  Google Scholar 

  16. Wipfli BM, Rethorst CD, Landers DM (2008) The anxiolytic effects of exercise: a meta-analysis of randomized trials and dose-response analysis. J Sport Exerc Psychol 30:392–410

    PubMed  Google Scholar 

  17. Asmundson GJG, Fetzner MG, DeBoer LB, Powers MB, Otto MW, Smits JAJ (2013) Let’s get physical: a contemporary review of the anxiolytic effects of exercise for anxiety and its disorders. Depress Anxiety 30(4):362–373

    Article  PubMed  Google Scholar 

  18. Jayakody K, Gunadasa S, Hosker C (2014) Exercise for anxiety disorders: systematic review. Br J Sports Med 48:187–196

    Article  PubMed  Google Scholar 

  19. Stephens T (1988) Physical activity and mental health in the United States and Canada: evidence from four population surveys. J Prev Med 17(1):35–47

    Article  CAS  Google Scholar 

  20. Goodwin RD (2003) Association between physical activity and mental disorders among adults in the United States. Prev Med 36(6):698–703

    Article  PubMed  Google Scholar 

  21. Thorsen L, Nystad W, Stigum H, Dahl O, Klepp O, Bremnes RM, Wist E, Fosså SD (2005) The association between self-reported physical activity and prevalence of depression and anxiety disorder in long-term survivors of testicular cancer and men in a general population sample. Support Care Cancer 13(8):637–646

    Article  PubMed  Google Scholar 

  22. Brunes A, Augestad LB, Gudmundsdottir SL (2013) Personality, physical activity, and symptoms of anxiety and depression: the HUNT study. Soc Psychiatry Psychiatr Epidemiol 48:745–756

    Article  PubMed  Google Scholar 

  23. de Moor MHM, Beem AL, Stubbe JH, Boomsma DI, de Geus EJC (2006) Regular exercise, anxiety, depression and personality: a population-based study. Prev Med 42(4):273–279

    Article  PubMed  Google Scholar 

  24. Mutrie N, Hannah MK (2007) The importance of both setting and intensity of physical activity in relation to non-clinical anxiety and depression. Int J Health Promot Educ 45(1):24–32

    Article  Google Scholar 

  25. Harvey SB, Hotopf M, Overland S, Mykletun A (2010) Physical activity and common mental disorders. Br J Psychiatry 197(5):357–364

    Article  PubMed  Google Scholar 

  26. Jonsdottir IH, Rödjer L, Hadzibajramovic E, Börjesson M, Ahlborg GA Jr (2010) Prospective study of leisure-time physical activity and mental health in Swedish health care workers and social insurance officers. Prev Med 51(5):373–377

    Article  PubMed  Google Scholar 

  27. Azevedo Da Silva M, Singh-Manoux A, Brunner E, Kaffashian S, Shipley M, Kivimäki M, Nabi H (2012) Bidirectional association between physical activity and symptoms of anxiety and depression: the Whitehall II study. Eur J Epidemiol 27(7):537–546

    Article  PubMed Central  PubMed  Google Scholar 

  28. ten Have M, de Graaf R, Monshouwer K (2011) Physical exercise in adults and mental health status: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). J Psychosom Res 71(5):342–348

    Article  PubMed  Google Scholar 

  29. de Moor MHM, Beem AL, Stubbe JH, Boomsma DI, de Geus EJC (2008) Testing causality in the association between regular exercise and symptoms of anxiety and depression. Arch Gen Psychiatry 65(8):897–905

    Article  PubMed  Google Scholar 

  30. Holmen J, Midthjell K, Krüger Ø (2003) The Nord-Trøndelag Health Study 1995-97 (HUNT2): objectives, contents, methods and participation. Norsk Epidemiologi 13:19–32

    Google Scholar 

  31. Kurtze N, Rangul V, Hustvedt B, Flanders DW (2007) Reliability and validity of self-reported physical activity in the Nord-Trøndelag Health Study (HUNT 2). Eur J Epidemiol 22(6):379–387

    Article  PubMed  Google Scholar 

  32. Augestad LB, Schei B, Forsmo S, Langhammer A, Flanders WD (2004) The association between physical activity and forearm bone mineral density in healthy premenopausal women. J Women’s Health 13:301–313

    Article  Google Scholar 

  33. Gudmundsdottir SL, Flanders WD, Augestad LB (2011) Physical activity and age at menopause: the Nord-Trøndelag population-based health study. Climacteric 16(1):78–87

    Article  Google Scholar 

  34. Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  35. Herrmann C (1997) International experiences with the Hospital Anxiety and Depression Scale: a review of validation data and clinical results. J Psychosom Res 42(1):17–41

    Article  CAS  PubMed  Google Scholar 

  36. Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res 52:69–77

    Article  PubMed  Google Scholar 

  37. Whitelaw S, Teuton J, Swift J, Scobie G (2010) The physical activity—mental wellbeing association in young people: a case study in dealing with a complex public health topic using a ‘realistic evaluation’ framework. Mental Health Phys Activity 3(2):61–66

    Article  Google Scholar 

  38. Salmon P (2001) Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psychol Rev 21(1):33–61

    Article  CAS  PubMed  Google Scholar 

  39. Lox CL, Kathleen AM, Petruzzello SJ (2010) The psychology of exercise: integrating theory and practice, 3rd edn. Holcomb Hathaway Publishers, Scottsdale

    Google Scholar 

  40. Petruzzello SJ, Landers DM, Hatfield BD, Kubitz KA, Salazar W (1991) A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Sports Med 11(3):143–182

    Article  CAS  PubMed  Google Scholar 

  41. Martinsen EW, Moser T, Borge L, Moe T, Johannesen B, Kaggestad J (2004) Kropp og sinn: fysisk aktivitet og psykisk helse (Body and mind: physical activity and psychological health). Fagbokforlaget, Bergen

    Google Scholar 

  42. Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191–215

    Article  CAS  PubMed  Google Scholar 

  43. Dishman RK, Renner KJ, Youngstedt SD, Reigle TG, Bunnell BN, Burke KA, Yoo HS, Mougey EH, Meyerhoff JL (1997) Activity wheel running reduces escape latency and alters brain monoamine levels after footshock. Brain Res Bull 42:399–406

    Article  CAS  PubMed  Google Scholar 

  44. Moylan S, Eyre HA, Maes M, Baune BT, Jacka FN, Berk M (2013) Exercising the worry away: how inflammation, oxidative and nitrogen stress mediates the beneficial effect of physical activity on anxiety disorder symptoms and behaviours. Neurosci Biobehav Rev 37(4):573–584

    Article  CAS  PubMed  Google Scholar 

  45. Wittchen HU, Jacobi F (2005) Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 15(4):357–376

    Article  CAS  PubMed  Google Scholar 

  46. McLean CP, Anderson ER (2009) Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev 29(6):496–505

    Article  PubMed  Google Scholar 

  47. Feingold A (1994) Gender differences in personality: a meta-analysis. Psychol Bull 116(3):429–456

    Article  CAS  PubMed  Google Scholar 

  48. Altemus M (2006) Sex differences in depression and anxiety disorders: potential biological determinants. Horm Behav 50(4):534–538

    Article  PubMed  Google Scholar 

  49. Asztalos M, Wijndaele K, De Bourdeaudhuij I, Philippaerts R, Matton L, Duvigneaud N, Thomis M, Lefevre J, Cardon G (2012) Sport participation and stress among women and men. Psychol Sport Exerc 13(4):466–483

    Article  Google Scholar 

  50. Tudor K (2013) Mental health promotion: paradigms and practice. Routledge, New York

    Google Scholar 

  51. Vanhees L, Lefevre J, Philippaerts R (2005) How to assess physical fitness? Eur J Cardiovasc Prev Rehabil 12:102–114

    Article  PubMed  Google Scholar 

  52. Rothman KJ, Greenland S, Lash TL (eds) (2008) Modern epidemiology, 3rd edn. Wolters Kluwer Health, Philadelphia

    Google Scholar 

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Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Neuroscience, The Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Audun Brunes & Liv Berit Augestad

  2. Center for Sport and Health Sciences, University of Iceland, Reykjavik, Iceland

    Sigridur Lara Gudmundsdottir

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  1. Audun Brunes
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  2. Sigridur Lara Gudmundsdottir
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  3. Liv Berit Augestad
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Correspondence to Liv Berit Augestad.

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Brunes, A., Gudmundsdottir, S.L. & Augestad, L.B. Gender-specific associations between leisure-time physical activity and symptoms of anxiety: the HUNT study. Soc Psychiatry Psychiatr Epidemiol 50, 419–427 (2015). https://doi.org/10.1007/s00127-014-0915-z

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  • DOI: https://doi.org/10.1007/s00127-014-0915-z

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