Elsevier

Preventive Medicine

Volume 56, Issue 1, January 2013, Pages 59-63
Preventive Medicine

The projected effect of increasing physical activity on reducing the prevalence of common mental disorders among Canadian men and women: A national population-based community study

https://doi.org/10.1016/j.ypmed.2012.11.014Get rights and content

Abstract

Objective

Little quantitative research has been conducted on the effect of physical activity (PA) modification on the prevalence of mental disorders in a nationally representative sample. We aimed to provide quantitative evidence regarding the potential effectiveness of PA in the management of mental disorders.

Methods

We used data from the national Canadian Community Health Survey of Mental Health and Well-being (CCHS 1.2) designed to represent the approximately the 25 million national community population aged 15 years and over in 2002.

Results

Around 1 in 10 Canadians reported a 12-month mental disorder. Women reported more mood and anxiety disorders, men more substance dependence. Almost half of Canadians were physically inactive. After adjusting for covariates, physical inactivity was a significant risk factor for common mental disorders, except manic episode. Approximately 780,000 cases nationally are attributable to physical inactivity. A 10% reduction in the rate of physical inactivity would reduce common mental disorders by 167,000 cases, a 25% reduction would result in 389,000 fewer cases. PA was more beneficial for men.

Conclusions

Clinicians and public health campaigns targeting individual patients and general populations can improve patients' symptoms and prevent a significant proportion of future mental disorders by increasing the amount of PA.

Highlights

► Around 1 in 10 Canadians reported a 12-month mental disorder at 2002. ► Almost half of Canadians were physically inactive. ► Approximately 780,000 cases nationally were attributable to physical inactivity. ► A 25% reduction in physical inactivity would result in 389,000 fewer cases. ► Physical activity was more beneficial for men than for women.

Introduction

Mental disorders are often chronic and recurrent and are associated with a tremendous burden. Although mental disorders have some effective treatments (Butler et al., 2006, Koenig and Thase, 2009, Leucht et al., 2011), the public health impact of these measures is limited (Fournier et al., 2010, Weisberg et al., 2007, Weissman et al., 2006). There is a need for additional cost effective treatment modalities to be identified.

To reduce the burden of mental disorders, greater attention should be given to prevention and promotion strategies which can be used by clinicians targeting individual patients and public health program planners targeting large population groups (WHO, 2002). These public health interventions should be low cost, accessible, and effective.

There has been considerable research interest in the effect of physical activity (PA) upon mental disorders (e.g. depression) (Daley and Jolly, 2012, Daley et al., 2007, Lawlor and Hopker, 2001, Legrand and Heuze, 2007, Trivedi et al., 2011). A recent review of reviews on exercise and depression concludes that exercise as treatment for depression is more effective than no treatment and is as effective as traditional interventions, at least in the short term, although it has minimal side effects, it can be limited by high remission rates, commitment, and motivational commitment from patients (Daley, 2008). Previous literature has qualitatively explored the association between PA and mental disorders, especially for depression (Cairney et al., 2009). Trivedi et al. (2011) quantitatively exploring the effectiveness of PA in a randomized controlled trial, found that exercise was a viable augmentation strategy for depressed patients who were not sensitive to selective serotonin reuptake inhibitors. Rimer et al. (2012) in their systematic review of randomized controlled trials found that: exercise may improve depressive symptoms for those with depression when compared with no treatment or control intervention; the effect of exercise decreased in the more robust trials; caution is needed when interpreting the positive role of exercise in treating depressive symptoms.

There has been a promising trend of using population attributable fractions (PAFs) as effective tools to quantify the potential effects of risk factors on mental disorders at population level (Barnes and Yaffe, 2011, Bolton and Robinson, 2010, Sareen et al., 2008). PAFs are commonly defined as the proportional reduction in average disease risk that would be achieved by elimination of the exposure of interest (Rockhill et al., 1998). Strohle et al. (2007) using a community cohort of adolescents and young adults to explore relationships between PA and mental disorders found that: regular exercise was associated with a substantially reduced risk for some mental disorders and co-morbidity; the potentially preventive effects were greater for males than females. While the research linking PA to the prevention of mental disorders is promising, more research is needed at a national population level to provide quantitative measures of the potential effects of PA modification on the prevalence of mental disorders.

The aim of this study was to provide quantitative evidence regarding the potential effectiveness of PA in the control of mental disorders by calculating PAFs, which takes into account the prevalence of PA as well as the strength of its association with the outcome of interest. Physical inactivity is a largely modifiable risk factor, that can be modified and thus affect health outcomes.

Section snippets

Data source

Data analyzed was from a national mental health survey of the Canadian community population collected between May and December 2002 — Canadian Community Health Survey (CCHS 1.2) (Gravel and Beland, 2005). The survey employed a multistage sampling framework to ensure representation of Canadian community population. Sampling was based on the standard area probability frame employed by Statistics Canada for its Labor Force Survey (Statistics Canada, 2008). The sample consisted of 36,984

Results

The standard reporting format for population-based survey tables presents unweighted numbers (n) based on sample and percentages that are weighted to represent the national community-dwelling population. Table 1 summarizes the socio-demographic characteristics of the sample. The majority of the sample was aged 26 years and more, married, had higher education, were non-immigrants, and urban residents. Table 2 reports on the past three months leisure time PA status. Men, in comparison to women,

Discussion

To the best of our knowledge, this is the first paper to provide quantitative evidence on the projected reduction of mental disorders cases that are potentially attributable to the level of PA in a national community population. Around 1 in 10 Canadians reported past-year mental disorders in 2002. Women were more likely to suffer mood and anxiety disorders and men with substance dependence. Almost half of Canadians reported being physically inactive. Physical inactivity was a major significant

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Acknowledgments

X Meng is funded by the Saskatchewan Health Research Foundation (SHRF), Canada.

The authors have no disclosures. The opinions stated here do not represent the views of Statistics Canada.

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