Associations between anxiety disorders and depression symptoms are related to 24-hour movement behaviors among Brazilian adolescents

Background: We tested whether 24-hour movement behaviors modified the effect of the association between anxiety and depression symptoms among adolescents.

Methods: This cross-sectional study included 4141 adolescents aged 15 to 19 years (50.0 % females) across all Brazilian geographic regions. Using self-reported data, 4.4 % (n = 180) reported having been diagnosed with anxiety disorders. We used the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Accruing moderate-vigorous physical activity during leisure time, <3 h/day of recreational screen, and good sleep quality were the exposures investigated. We evaluated interactions between anxiety and movement behaviors in the association with depression symptoms adjusted by covariates.

Results: Adolescents diagnosed with anxiety who met two (B: -4.93; 95%CI: -6.43; -3.44) or three (B: -5.71; 95%CI: -7.85; -3.57) movement behavior targets, and adolescents without diagnosis of anxiety who met one (B: -6.97; 95%CI: -8.15; -5.79), two (B: -8.21; 95%CI: -9.38; -7.03), or three (B: -8.46; 95%CI: -9.66; -7.27) of the movement behavior targets had lower PHQ-9 scores for depression symptoms than adolescents with anxiety who did not meet any of the movement behaviors. There was a significant interaction (B: -1.89; 95%CI: -3.24; -0.55) between anxiety disorders status and meeting the movement behavior targets.

Limitations: The cross-sectional design is a limitation.

Conclusions: Variations in meeting movement behaviors modified the effect of the association between anxiety disorders status and depressive symptoms, with favourable modifications seen in adolescents without anxiety who met one, two or three of the movement behavior targets and in adolescents with anxiety who met two or three of the behaviors.