Exploring the association between physical activity and depression risk in Xiamen adolescents

Abstract

Depression is a significant mental health issue among adolescents. Physical activity has been identified as an effective intervention to reduce depression risk. This study explores its impact on middle school students. A total of 1,443 middle school students participated. Depression risk was assessed using the CESD-10, and physical activity levels were measured through MET-h, covering vigorous, moderate, walking, and sedentary behaviors. Logistic regression and restricted cubic splines (RCS) were used to examine the relationship between physical activity and depression risk. ROC curves and decision curve analysis (DCA) assessed model performance. Vigorous and moderate activities were negatively associated with depression risk (ORs: 0.96 and 0.86, P < 0.01), while sedentary behavior was positively associated (OR = 1.01, P = 0.06), particularly among females, 7th/8th graders, and underweight students. ROC analysis showed better discrimination for moderate and vigorous activities, with DCA indicating the highest net benefit at lower thresholds. Increased vigorous and moderate physical activity, along with reduced sedentary behavior, can significantly reduce depression risk in middle school students. Schools and families should promote more physical activity to support adolescent mental health.